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21 Cards in this Set

  • Front
  • Back
natural hosts of arenavirus?
rodents - note they cause persistent and acute infections in them
describe junin virus.
arena, argentine hemorrhagic fever, ag workers exposed to dust and grain with rodent excrement and aerosols from rodents being chopped up in the machines, no human to human spread, flu sxs +/- photophobia and vomiting, no respiratory sxs, second stage is epistaxis, hematemesis, or acute neuro disease. hypotension and shock is the killer (30% mortality if untreated)
describe the machupo virus
arenavirus causing bolivian hemorrhagic fever, 30% fatal, rodent control has decreassed disease, sxs very similar to argentine hemorrhagic fever
describe whitewater arroyo virus.
arenavirus in southwest US to texas and OK. sxs are fever, headache, myalgia, lymphopenia, thrombocytopenia, acute respiratory distress, liver failure and hemorrhaging.
describe lymphocytic choriomeningitis virus (LCMV)
arenavirus, old world, no person to person, can be asympto but typical is fever, nausea, myalgia, severe headaches, photophobia, 1/2 pts get sore throat, vomiting, or arthralgia and aseptic meningitis or encephalitis occasionally. rarely fatal. birth defects if fetus is infected - usually neuro or visual or death. immunocompromised maybe fatal - 3 organ transplant patients died in 2005. rough idea of frequency in US is 0.1 to 5%...
describe lassa virus.
arenavirus in west africa. from rat saliva or urine. SPREADS PERSON TO PERSON. 40% mortality. begins with flu like sxs, goes to joint and lumbar pain, headache, sore throat, cough, low BP, chest and ab pain, GI issues... pharyngeal exudate, possible pleural effusions. signs of poor prognosis are edema of face and neck, mucosal bleeding, or neuro signs. high viremia. death from hypovolemic shock
describe diagnosis of arena hemorrhagic fever.
early sx are milder than flu and later stages are like hemorrhagic fever of other viruses. diagnosis by titers or isolation of virus. travel to endemic region is crucial info,
treatment for arenavirus infection?
correct fluid and electrolyte imbalances to prevent shock. give human convalescent immune plasma in argentine hemorrhagic fever wi 8 days... ribavirn for lassa fever wi 6 days, it is also recommended as a prophylactic in contacts.
vaccines for arenaviruses?
argentine hemorrhagic fever
describe mortality associated with rabies.
if caught early 100% survival, if too late 100% mortality
genera of rhabdoviruses that contain human pathogens and describe them.
lyssavirus includes rabies. vesiculovirus includes vesicular stomatitis virus - can cause flu like stuff in lab workers.
describe history of vaccine.
pasteur figured out he could attenuate/"fix" virus before it was even known what viruses were.
how many die from rabies each year? in US?
25K mainly from infected dogs. used to be 10K in the US until vaccination and control lowered it to 10
describe rabies in our region.
mainly in skunks in LA. In TX it is found in skunks, coyotes, and foxes; it was a state health emergency in TX in '94.
describe the pathogenesis and sxs of rabies in ppl.
incubation of 14 to 90 days depending on innoculum size and distance from brain. first replicates in muscles then NMJs. it is neurotropic and goes up the neurons from the NMJs to get to the CNS, hits neurons first then goes to salivary glands, adrenal, kidney, heart. some enceph, but disease mainly due to neuronal dysfunction not death. the prodromal phase is flu like sxs and emotional lability (from replication in limbic system). next is one of two forms. Fulminant or furious form is classic rabies, hydrophobia, seizures, hallucinations, and alternating aggressive behavior periods with periods of lucidity. eventual paralysis, then cardiac or resp arrest, possibly preceded by coma. note pts do not bite. Paralytic or dumb form is less common, get parasthesias and ascending flaccid paralysis to fatal paralysis of diaphragm. note you want to prophylax during prodromal period
diagnosis of rabies?
post mortem - negri bodies (cytoplasmic inclusions). do epi and clinical info. sometimes confirmation via immunofluorescence or RT PCR. lotsa ppl esp in US do not get diagnosed until post mortem, scores of medical personnel may be treated for possuble exposure.
prevention and prophylaxis of rabies?
vaccination of domestic cats and dogs. prompt postexposure prophylaxis and wound treatment. prophylaxis consists of both passive and active immunization. killed virus vaccines. note vets and ppl going to areas where it is a problem get pre exposure prophylaxis
describe rabbies vaccines for wild animals.
has a bait that they eat and is a recombinant vaccinia virus containing the gene for rabies G protein
what animal strain of rabies is responsible for most human fatalities?
random fact: four ppl from TX and AR died of rabies in June 2004 after receiveing transplants from an organ donor who had died of rabies acquired from a bat.
describe the one case of treatment of rabies wo postexposure prophylaxis that was succesful.
pt was put into a coma with GABA agonists and NMDA antagonists ketamine and amantadine (both have been shown to have anti rabies activity in animals) and then treated with ribavirin. she survived with minor neuro impairment