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10 Cards in this Set

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Blood and Lymph- Viral Hemorrhagic Fevers by Blue
Blood and Lymph- Viral Hemorrhagic Fevers by Blue
What is the biggest factor in the spread of dengue fever?
limited mosquito control in most dengue-endemic countries.

vector control is the best way to control these diseases
Where is yellow fever? what is the host/vector? how about dengue hf?
yellow fever- africa/south america; monkeys/mosquitos

dengue hf- global/tropical; monkeys mosquitos


*both are flavivirus
Pathogenesis, clinical overall summary
Virus-specific; May involve endothelial cell infection of blood vessels during initial viremia. Mesothelial, reticuloendothelial. Increased vascular permeability (cytokine-induced; e.g., Dengue...macrophage, t cell and b cell... huge cytokine response).

Fever, rash, malaise, myalgia, hemorrhage (petechial, most organs; GI, hepatic most prominent), edema; jaundice. History of recent travel to endemic area.
Treatment, prevention overall summary
Treatment: Fluid and electrolyte balance, transfusion (or plasma,platelets, clotting factor). Isolation, infection control precautions (all body fluids). Ribavirin (Arenavirus and Bunyavirus). *anything to prevent more fluid loss.

Prevention: Vaccine for yellow fever. Under development for dengue, Ebola, Argentinian, Rift Valley. Vector control/eradication, insect repellents; rodent control.

*category A biological warfare agents
Arbovirus (which includes flavivirus) has something unique and not seen anywhere else in nature. what is that?
Unique ambisense [mixed (+) and (–) sense] single-stranded RNA genomes.
clinical presentations of Yellow Fever
YF mild fever/headache to liver infection (hepatitis & jaundice), nephritis, encephalitis.

Hemorrhage in YF a direct action of the virus (gastric mucosa, *“black vomit”).

Liver damage may also induce coagulation defects.

*Councilman bodies – intracellular inclusions of viral antigens in hepatocytes.
What are the characteristics of the intial infection of Dengue fever (3)?
fever,
rash
muscle and joint pain
What is the principle site of replication?

where is the characteristic pain located?
Entry via mosquito bite.

Dendritic cell is principle site of replication, then through-out reticulo-endothelial system. Mild hepatitis (compared to YF)

Fever, headache, anorexia, nausea/vomiting, retro-orbital pain, back pain, skin rash. Deep “bone” pain = “breakbone fever”.

Immune complex deposition.

Incubation period 3-7 days, disease course 3-9 days. Uncomplicated recovery.Severity directly related to blood virus titer.

4 strains of DF, and protection against one is not protection against other 3.
ok, so that was the first exposure to dengue. what happens during second exposure (from a different strain)?
first exposure: breakbone fever.
second exposure: Dengue Hemorrhagic Fever
Antibody-dependent enhancement (ADE)

enhanced virus growth

cytokine storm, increased vascular permeability (plasma loss)

spontaneous hemorrhage, dengue shock syndrome (DSS).