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32 Cards in this Set
- Front
- Back
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important paramyxoviruses?
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respirovirus (parainfluenza), rubulavirus (mumps and parainfluenza), avulavirus (newcastle), morbillivirus (measles, canine distemper, rinderpest), henipavirus (hendra, nipah), pneumovirus (respiratory syncytial virus)
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important structural aspects of paramyxoviruses?
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enveloped, neg strand RNA, 6 to 10 proteins, replicate in cytoplasm, F glycoprotein, trimer, mediates fusion, HN glycoprotein, tetramer, that binds and cleaves sialic acid via neuramidase to prevent sticking together of particles, cell membrane gives the envelope, matrix, viral RNA pol is made up of N (capsid), P (phosphate), and L (large pol proteins) proteins
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what gene creates different proteins via RNA editing and alternative start sites?
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P protein
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describe the transmission and immunity of measles.
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respiratory spread, most in US vaccinated, those susceptable are unvaccinated and unexposed, usually underdeveloped countries, but some ppl who have been vaccinated in the US have gotten it in recent years, endemic, usually a childhood infection that confers immunity after primary infection,
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describe the spread of measles in the body.
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infects the resp tract, trach and bronch epi cells as well as pulm macs, go to regional lymph nodes, makes giant cells (synctia made from F peplomer), viremia, to multiple organs including thymus, spleen, lymph nodes, skin, eye, kidney, lung, GI, liver
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describe the symptomatic time course of measles.
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latent pd of 10 to 14 days, 2 to 3 day prodrome of flu like sxs, pink eye, possible koplik's spots on tongue or inner cheek (blue center); then generalized maculopapular rash with immune response and initiation of viral clearance - high fever, cough, runny nose, watery eyes, lasts for 1 to 2 wks, recovery lasts in life long immunity
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describe the measles maculopapular rash.
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lasts 5 to 6 days, starts at the head and goes down, highest fever day rash appears, fades in same order it appears, macules (flat discolored skin) and papules (small raised bump)
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when is a measles pt contagious?
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4 days before to 4 days after the rash
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complications in measles?
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ear infections > pneumonia > encephalitis. 1 to 2 per 1000 die, usually from pneumonia. Can make pregnant women miscarry or premature birth
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describe a serious disease that can arise after a measles infection
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subacute sclerosing pan encephalitis. Probly persistant measles infection of the brain (do not know how it gets into the CNS), usually 7 yrs after measles, progressive deterioration - ataxia, seizures, death. Rare, like 1 - 5 per 500K measles cases
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describe atypical measles
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seen in ppl who gota an inactivated measles vaccine in the 60's, worse sxs, higher fever, pneumonitis, hemorrhage
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diagnosis of measles?
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RASH, can do IgM for acute, as well as IgG in acute and then see 4X that amount in convalescent
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describe the measles vaccines.
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live attenuated and killed viruses (taken off market), live further attenuated vaccine called Edmonston Enders strain is what is used in MMR
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course of infection and virus spread in mumps?
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droplet spread, 18 day incubation, replicates in URT, to the local lymph nodes, viramia, then to the organs that it makes swell (can go almost anywhere)
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describe sx of mumps
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1/3 are asympto, and 40 to 50% are nonspecefic or primary respiratory sx. Prodrome is flu like with low fever, parotits is most frequent presentation, orchitis can occur in 1/4 of men which can cause sterility, sx decrease after 1 wk and usually gone by 10 days
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complications of mumps?
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asympto aseptic meningits in 50 to 60%, sympto in 15%, normal resolution, adults > kids, boys > girls, RARE encephalitis; pancreatitis; deafness in 1/20K, usually unilateral and permanent.
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diagnosis of mumps?
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usually clinical (parotitis) but serology can confirm. IgM for acute, or IgG rise in convalescent stage
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vaaccines for mumps?
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jeryl lynn strain of live attenuated mumps virus is used in MMR
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MMR indications?
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get between 12 and 15 mos and second dose bw 4 and 6 yrs. Give to susceptible adolescents and adults w/o documented evidence of immunity - can give 2nd dose 28 days later too, very very few complications
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contraindications for MMR?
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previous life threatening allergy to gelatin, neomycin or MMR. If mod to severely ill wait til your better, avoid getting pregnant for 4 wks after MMR; immunocompromised should check with their physicians first (AIDS, steroids, cancer, cancer treatment, low platelets, recent transfusion, recently given blood products)
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MMR risks?
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mild: fever, rash, swelling of glands. Moderate: seizure, pain and stiff joints (women), loe platelets, all are temporary. Severe problems are serious allergy (1/mil) unexplainable problems, deafness, long term seizures, coma, permanent brain damage, all of these are very, very rare
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what is the link bw MMR and autism?
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NONE, no scientific evidence
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quick facts on parainfluenza.
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large droplet spread, small infectious dose bc not stable in the environment, major cause of croup, pneumonia, and bronchiolotis, 4 serological types, 1-3 can cause LRT infections, in infants and young adults, 4 is a mild URT
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describe pathogenesis and disease of parainfluenza.
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infects URT epi cells, giant cell formation, rare viremia, cold like sx, typically over in 48 hrs, ab 1/4 cases go to LRT and only 2 - 3% of these get severe croup (most common cause of all croup though), pneumonia in elderly, re infection common bc no long term immunity but 2ndary infections are milder, no vaccines
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what paramyxovirus has potential anti tumor therapies? Details?
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new castle disease virus, usually hits birds, relatively asympto in ppl. Likes human tumor cells, but Ab response gets the virus.
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quick facts about respiratory syncitial virus?
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most common cause of bronchiolitis and pneumonia in < 1 yos. As well as most common fatal acut resp tract infection in same population. Most are infected within year 1, all of us by 5 yo, highly infectious, most are minor URT infections, can hit elderly and immunocompromised too, spreads through large droplets or fomite contamination
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describe the pathogenesis of RSV (resp syncitial)
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incubates for up to a wk, usually enters body through eye or nose, spreads through resp epi, as it hits the LRT bronchioloitis and pneumonia may occur, viremia does not occur
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complications in RSV.
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apnea in 20%, can lead to chronic lung disease in later life (this is rare however)
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vaccine and treatment for RSV?
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currently no vaccine, supportive treatment like O2, iv fluids, nebulized cold steam. Ribavirin in premies and immunocompromised, anti RSV Ig in premies and kids with bronchopulmonary dysplasia (will protect from long term consequences)
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what virus has been involved in horses and associated with deaths in humans from resp illness and CNS illness?
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hendravirus
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what virus has been involved in pigs and fruit bats and caused epidemics in humans leading to many deaths via resp and CNS illnesses?
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nipah virus, note it has been in the US.
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what are the viruses of the henipa genus?
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nipah and hendrah
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