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29 Cards in this Set

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Arboviral Hemorrhagic Fever Review

- Lethal Dz?
- clinical characters of syndrome? x8
- Begins with what symptoms x3
- Progresses to what symptoms? x4
- Leads to what? x2

Fever, Malaise
Vomiting, Myalgia
Mucosal & GI bleed*
Hypotension, Edema

Conjunctival Injection
Petechial hemorhage

Frank mucosal hemorrhage
Circulatory Collapse

Multisystem Organ Failure
Yellow Fever Virus:

- Family
- Genus
- First reported case in New World & Europe
Family Flaviviridae

Genus Flavivirus

Yellow Fever Virus:

Outbreaks in port cities until when?

Last US epidemic was where and when?

1905, New Orleans
(>3000 cases & 452 deaths)
Yellow Fever Virus:

- What happened in 1901
- When was the causative agent isolated?
First filterable human pathogen by Walter Reed

Yellow fever Virus - First Vaccine

- Components
- Name
- Discovered when?
- By whom?
Live attenuated

17D vaccine


Max Theiler (Nobel Prize - 1952)
Yellow Fever Virus:

- reservoir host
- vectors
- most transmissions occur where? x2


Sub-Sahara Africa
South America
T/F - Yellow fever has been reportedly transmitted in Asia.

Just b/c it says yellow fever, don't mean that asians want it.
Yellow Fever Virus:

- S. America cases/year
- what population group?
100 cases/year

Young males
(agricultural/forestry workers)
Yellow Fever Virus:

- African cases/year x2
30 - 1000 epidemic cases/year

~200,000 endemic cases/year
Discuss the expanding nature of Yellow Fever virus currently. x2
Re-emergence in part of Africa

Re-establishment of urban YFV mosquito vector in SE US.
Yellow Fever Virus Clinicals:

- List the two TYPES of manifestations.
- List symptoms under each x7 and x2
1. Hepatic induced coagulopathy & hemorrhage manifestations

- "black vomit" & bloody diarrhea
- Epistaxis & Gum bleeding
- Petechial, ecchymotic, or pupuric hemorrhage.

2. Systemic manisfestions

- deeping jaundice
- albuminuria
What is a poor indicator of prognosis in early Yellow Fever virus?
Early Jaundice (day 3)
What lab test will reflect the degree of hepatic injury?
Transaminase elevations.
What late stage symptoms arise in Yellow Fever? x6

What about late CNS manifestations?
Metabolic Acidosis
Acute Tubular Necrosis

Myocardial Dysfunction


What is the prognosis of Yellow fever from onset of symptoms?
Death usually follows in 7-10 days.
Rift Valley Fever Virus:

- Family
- Genus
- Outbreaks found where? x2
- Has it spread? x2
- Is it a threat? x2


Sub-Sahara & North Africa

In 2000, Saudi Arabia and Yemen were first cases outside of Africa.

Threatens Asia and Europe
Rift Valley Fever Virus:

- Primarily affects what?

sheep, cattle, camels, goats...
Discuss the epizootic outbreaks associated with Rift Valley Fever Virus.

- when?
- signaled by?
Epizootic outbreaks in years of heavy rainfall and flooding.

Signaled "Abortion storm" amongst livestock.
Humans are infected by Rift Valley Fever virus in what three ways?
1. Mosquito vector

2. Contact with blood, or other bodily fluids/infected organs.

3. Inhalation of aerosolized virus
Crimean-Congo Hemorrhagic Fever

- Family
- Genus
- Reservoir Host
- Vector
- Endemic where? x3
- Recent outbreaks where? x5




Africa, Asia, Eastern Europe

South Africa
Crimean-Congo Hemorrhagic Fever:

- severity
- fatality
SEVERE in humans

HIGH mortality rate
During Crimean-Congo Hemorrhagic Fever epizootic, humans get infected in what two ways?

What groups are at risk?
Tick vector bite

Contact with blood, bodily fluids, or infected organs

Majority of agricultural & slaughterhouse workers, vets....
For arboviral hemorrhagic fevers, of paramount importance to differential diagnosis are: x4
1. Place of residence and/or exposure

2. Occurence/serodiagnosis of similar cases in community

3. Prior exposure/infection

4. Specific symptoms are typically NOT diagnostic
T/F - In arboviral Hemorrhagic Fevers, the specific symptoms prove to be a diagnostic.
The Yellow Fever Virus 17D Vaccine:

- name of the YSF strain isolated in 1928.
- what is down to the viral isolate?

Passaged through mouse brain and chick embryo tissue ~ 200x's to attenuate virus
The YFV 17D Vaccine:

- how safe?
- how efficacious
- last how long?
Among safest

Most efficacious viral vaccine available

Long-lasting immunity
THE YFV 17D Vaccine:

- Grown in what?
- Safety tested?
Embryonated eggs

In monkeys
The YFV 17D Vaccine:

- annual production?
- what country uses it the most?
- recommended for whom
- contraindicated for whom? x3
13 million

Brazil 11 million

People traveling to endemic areas

Pregnant women
Infants under 6 months old
Immunocompromised people
If Yellow Fever Virus re-emerged in urban areas, would we have enough of the stock-piled vaccine?

Not enough.