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97 Cards in this Set
- Front
- Back
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what are the important differences between rhinoviruses and enteroviruses, both members of picornavirus family?
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rhinovirus has optimal replication at 33 C instead of 37 C and is inactivated at pH 3 whereas enteroviruses are stable and can pass through stomach to replicate in intestines
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what are the general features of the common cold syndrome?
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acquisition by direct aerosol spread or hand contact/self-inoculation; incubation period of approx. 2-3 days, 6-10 day duration; coryza (nasal inflammation, runny nose), headhache, cough, sore throat
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what is the major cause of common cold in humans and when is its peak incidence?
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rhinoviruses; spring and fall
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what is an important cause of the common cold in the winter?
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coronaviruses
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what is the newly discovered virus from exotic animals in asia, transmitted from human to human in asian epidemics and outbreaks elsewhere in the world from late 2002 through mid 2003?
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SARS (severe acute respiratory syndrome)
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what are the major classes of localized but highly contagious and sometimes serious adenovirus infections?
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respiratory tract, eye, genitourinary tract, gastrointestinal tract
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what specific clinical syndromes are associated with adenoviral infection?
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pharyngoconjunctival fever in children, acute respiratory disease in young adults, epidemic keratoconjunctivitis, acute hemorrhagic cystitis
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describe the adenovirus types 4 and 7 vaccine used by military to prevent ARD in military recruits
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live virus with enteric coating to prevent clinical infection of respiratory tract but allow subclinical infection in GI tract
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what are the important members of the paramyxovirus family?
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measles, mumps, parainfluenza types 1-3, RSV, human mteapneumo
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what viral infection is associated with syncytia and why is this an important mechanism?
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paramyxovirus; cell-to-cell transfer of infection in vivo
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what are the important clinical features of generalized infections with measles and mumps virus?
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koplik's spots (buccal mucosa)and distinctive maculopapular rash of measles; parotitis and orchitis or oophoritis with mumps; long term protection from active immunization with live attenuated vaccines; pneumonia, postinfectious encephalomyelitis or subacute sclerosing panencephalitis as complication of measles and aseptic meningitis as a complication of mumps
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what is the most important cause of serious lower respiratory tract infections in infants and young children and what is recommended prevention?
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RSV; prophylactic passive immunization with a humanized monoclonal antibody recommended for high risk infants monthly during annual winter epidemics
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what is the major cause of croup (laryngotracheobronchitis) during fall epidemics in young children, as well as occasionally causing bronchiolitis or pneumonia in infants and milder URTI in older children and adults?
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parainfluenza virus
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what are the major symptoms of congenital rubella syndrome
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CRS; blindness, brain defects, deafness, hepatosplenomegaly
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what are the assyas for specific diagnosis of in utero rubella virus infection in the newborn?
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detection of serum antiviral IgM with ELISA or hemagglutination inhibition assay
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what zoonotic members of paramyxovirus family can cause potentially fatal encephalitis and/or pneumonia in humans, what is their natural reservoir, and how are they transmitted?
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Hendra and Nipah; fruit-eating bats are natural reservoir; transmitted from infected animals
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what are the important clinical features of influenza cause by type A and B?
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rapid onset of symptoms following an incubation period of ~2 days; headache, fever, chills and generalized aches; sore throat with dry, non-productive cough
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what is antigenic shift and which type of influenza does it occur in?
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major antigenic change in HA or NA observed in type A
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what is antigenic drift and which type of influenza does it occur in?
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gradual change in antigenicity of either HA or NA in type A and B
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which should receive the influenza vaccine?
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increased risk for complications, children 6 mo -18 yrs, those that can transmit to those at high risk
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what are the important characteristics of trivalent influenza vaccine?
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whole inactivated vaccine for >12 yrs or purified subunit vaccine for >6 mos; A(H3N2), A(H1N1), B components; newer cold-adapted intranasal vaccine currently licensed for healty persons aged 2-49 yrs
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what are the inhibitors of influenza virion uncoating for therapy/phrophylaxis against type A viruses?
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amantadine and rimantidine; although most current is resistant
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what is the drug for prophylaxis/therapy against both type A and B viruses?
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zanamivir and oseltamivir
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when did influenza pnademics occur and what was the subtype that occured with reassortment between avian and human viruses?
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1918 (H1N1)
1957 (H2N2) 1968 (H3N2) |
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why have there been sporadic zoonotic cases of human A(H5N1) but no efficient human-to-human spread?
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need genetic modification of receptor-binding domain of H5 to efficiently bind human cells
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what are the important characteristics of the novel influenza A virus?
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swine origin H1N1 subtype and original outbreaks in North America in spring 2009
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why do influenza viruses need to be updated?
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antigenic drift
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why is it difficult to make a vaccine for avian origin influenza?
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too toxic for chick embryos
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what class of antiviral drugs would be used as prophylaxis of health care workers and therapy of patients in event of an A(H5N1) or novel swing A(H1N1) pandemic?
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neuramindase inhibitors
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what are common epidemiology and pathogenesis of enteroviruses?
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contagious, fecal oral transmission, peak incidence in late summer and early fall, subclinical or mild infections in majority of cases, long term acquired immunity
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what virus causes herpangina and hand food mouth disease/
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coxsackie A or entero71
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what virus causes acutee hemorrhagic conjuctivitis?
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coxsacki A or entero70
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what virus causes non-vesicular exanthems?
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echo
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what virus causes pleurodynia?
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coxsackie B
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what enterovirus causes aseptic meningitis?
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echo and coxsackie A and B
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what enterovirus causes encephalitis?
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entero71
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what enterovirus causes myocarditis and pericarditis?
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coxsackie B
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what enterovirus causes acut-flaccid paralysis?
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polio, entero71
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what is used to diagnosis serious humanl enteroviral infections?
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cell culture, RT-PCR of CSF
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what is the current recommended vaccine for polio in US?
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salk inactivated polio vaccine, trivalent, formalin inactivated
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what are the risk of OPV vaccine for polio?
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vaccine-associated paralytic poliomyelitis
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what causes acute viral encephalitis?
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encephalitic arboviruses and others
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what causes sporadic necrotizing viral encephalitis?
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herpes simplex
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what causes subacute viral encephalitis?
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measles and SSPE (subacute sclerosing panencephalitis)
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what causes post-infectious viral encephalitis?
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measles
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what is the major cause of viral meningitis in late summer and fall and what was major cause in 'pre-vaccine' era in winter and spring?
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non-polio enteroviruses; mumps
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what is major cause of meningo-encephalitis in summer and fall in the US?
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arboviruses
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what is the major non-arboviral zoonotic agent of encephalitis globally?
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rabies virus
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what is the only serious viral CNS syndrome which has specific effective antiviral therapy?
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herpesvirus
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which animal has the highest reported incidence of rabies?
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raccoons
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what animal is associated with the vast majority of rare human cases in the US?
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bats
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pathogenesis of rabies?
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initial replication near bite in striated muscle --> infection of nerve endings and centripetal spread via axons to spinal cord and brain --> infection of brain and spread to salivary gland --> overwhelming encephalitis resulting in coma and death
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what is the current recommended post-exposure prophylaxis for humasn potentially exposed to rabies?
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active immunization with inactivated virus vaccine (4 dose) and passive immunization with high-titer human IgG
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what is recommended for 'at risk individuals' for rabies?
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active immunization, 3 dose primary and boosters every 1-2 years
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what are public health programs for prevention of animal rabies?
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annual rabies vaccination of dogs and cats in all states, vaccination of wildlife on a more limited scale with live-recombinant vaccinia virus vaccine
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where does kuru occur?
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new guinea
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what are the receptors for gp120 envelope glycoprotein subunit of most clinical strains of HIV1?
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CD4 and CCR5 coreceptor
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what is the significance of homozygous for defective CCR5 gene?
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resistance to infection by most clinical strains of HIV1
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what are the important nonstructural proteins involved in upregulation HIV viral gene expression?
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tat and rev proteins
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what is the major factor for HIV in vivo pathogenesis?
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nef protein
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what are the commonly used lab assays for diagnosis/monitoring of HIV?
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antibody capture ELISA (initial screening test) and western immunoblot (confirmatory test) to detect antiviral IgG in serum/plasma; RT-PCR or bDNA to detect and quanitfy viral load
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why is antibody capture ELISA and western immunoblot not appropriate for diagnosing HIV infection in newborns and infants <12 mos?
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antiviral IgG is maternal in origin and is only indicative of maternal infection
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what are important body fluids in transmission of HIV and what are they rich in?
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blood, semen, vaginal fluid, colostrums/breast milk; rich in lymphocytes and monocytes/macrophages
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what region has highest incidence of HIV?
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sub-saharan africa
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antiretroviral therapy to reduce perinatal/neonatal transmission of HIV from mother to newborn or for post-exposure prophylaxis?
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AZT [NRTI] or nevirapine [NNRTI]
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what is definition of AIDS?
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one or more of: encephalopathy, wasting syndrome, OI, AIDS-assoc malignancy, CD4 <200 for adults and adolescents >13
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characteristics of acute retroviral syndrome?
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infectious mono-like or flu-like several weeks after exposure/infection, followed by seroconversion
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long-term non-progressor?
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elite controllers who remain healthy and asymptomatic with undetectable viremia even in absence of antiretroviral therapy
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idiopathic CD4 T-lymphocytopenia?
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no evidence for infectious agent nor good reason to believe a new virus is responsible
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GART (genotype antiretroviral resistance testing)?
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drug sensitivity/resistance profile of predominant viral strains --> intelligent decisions about new drug regimen
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important OIs with AIDS?
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herpesviruses (CMV, HHV8, EBV, VZV, HSV1, HSV2); HPV, JC polyomavirus [progressive multifocal leukoencephalopathy], molluscus contagiosum poxvirus
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what is peak for VZV?
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winter-spring
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what is PHN (post herpetic neuralgia)?
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extremely painful complication of zoster which can persist for many months
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which is only licensed vaccines for a herpesvirus and describe?
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VZV: live attenuated virus as childhood or as larger dose for adults
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what is therapy/prophylaxis for nonimmune persons at special risk of serious primary infection with VZV?
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VZIG/acyclovir
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therapy for persons with zoster)
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oral valacyclovir or famciclovir
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what is single most common congenital infection and significant cause of microbial birth handicap, even though immunocompetent usually has benign infection?
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CMV
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complications of primary or reactivated CMV infection in immunocompromised individuals?
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pneumonia or retinitis in AIDS; hepatits, GI infections
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appropriate prophylaxis or therapy for individuals at risk of serious CMV infection?
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gangciclovir or vanganciclovir; foscarnet or cidofovir; passive immunization with CMVIG
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cause of infectious mono and lab diagnostics?
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EBV: anti-EBV IgM or IgG, assays for heterophile agglutinins/antibody [polyclonal activation], atypical large lymphocytes in peripheral blood
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complications of EBV in immunodeficient?
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oral hairy leukoplakia, b cell lymphoma, fatal infection in rare x-linked lymphoproliferative syndrome, burkitt's lymphoma, nasopharyngeal carcnoma
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common clinical syndromes associated with primary infection with HHV-6 and HHV-7?
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exanthema subitum (roseola, sixth disease): febrile illness with maculopapular rash, year round
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recently discovered herpesvirus with association with kaposi's sarcoma?
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HHV8
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what characterized zoonotic outbreak of monkeypox in midwest 2003?
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wild animals [rodents] imported infected prairie dogs, humans
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occupational parapoxvirus diseases?
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orf: contagious pustular dermatitis from infected sheep or goats; milder's nodes from cows
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characteristics of molluscum contagiosum infection?
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sexual transmission; mulluscipoxvirus; central umbilication
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what made eradication of smallpox possible?
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cross-reactivity or surface antigens among orthopoxviruses, lack of animal reservoir, lack of antigenic variation, no respiratory transmission prior to lesions, no subclinical cases, life long immunity, no recurrence, immunization effective up to 3-4 days post exposrue
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complications of smallpox vaccination?
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autoinoculation of eyes and eyelids, generalized vaccinia, eczema vaccinatum [those with eczema receiving or in contact with those receiving], postvaccinial encephalitis, carditis, vaccinia necrosum
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unique genome of human papilloma and polyoma viruses?
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dsDNA circular which is supercoiled like bacterial plasmids
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virus responsible for fatal neurological syndrome 'progressive multifocal leukoencephalopathy' (PML) in immunocompromised?
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JC polyoma virus
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common warts caused by?
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HPV 2,4,7
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plantar warts caused by?
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HPV1
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flat warts caused by?
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HPV3,10
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anogenital warts caused by?
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HPV6,11
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quadrivalent vaccine against HPV?
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recombinant virus-like particlees
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clinical syndromes with primary infection with erythrovirus?
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erythema infectiosum (5th disease); arthritis and arthralgia with or without rash; erythrocyte aplasia or aplastic crisis of those with hemolytic anemias; fetal death/hydrops fetalis
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cellular pathogenesis of erythrovirus B19?
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cytocidal replication in rbc precursors
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