Viral Disease Of Resp Tract - Microbiology

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Rhinovirus is a _________ disease of the __________

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viral disease of the resp tract

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Characteristics of Rhinovirus includes

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naked, icosahedral virion; RNA

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Rhino means

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nose

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There are ____ serotypes of rhinoviruses that cause ________ of the common cold

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113 serotypes; cause 50% of the common cold

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Rhinovirus infections average

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3-5/y

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Rhinovirus immunity

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is type specific but only last about 1y

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S/S rhinovirus:

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mild, no fever. runny nose, H/A, sorethroat without fever, causes many lost days from work

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Rhinovirus is spread by:

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resp aerosols produced by coughing and sneezing

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Rhinoviruses grow

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at relatively cool temps of the nose and do not invade the bloodstream (perhaps breathing fumes of hot chicken soup or steaming aromatics helps)

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Characteristics of Adenoviruses

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naked, icosahedral virion
DNA

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describe adenovirus

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naked, dsDNA-containing viruses for which there are at least 50 serotypes

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adenovirus immunity is

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lifelong and type specific

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adenovirus is isolated from the

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adenoids, remain latent in the tissues for life

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adenovirus causes _____10-15% of ________, including the ______

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10-15% of URIs, including common cold

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Adenoviral colds tend to be

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relatively severe colds with a fever

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Most adenoviral serovars cause

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mild disease, several cause a more severe infxn seen in military camps ( the militaray has produced a vaccine against the relevant types)

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Pharyngo-conjuctivitis aka: d/t

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swimming pool conjunctivitis is d/t insufficient chloorine and ooutbreaks are common

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at least one strain of adenovirus causes

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keratoconjunctivitis, inflammation of the conjunctiva and the cornea of the eye.

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Measles is a ________ disease of the __________

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viral disease of the resp tract

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Characteristics of the measles virus include:

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enveloped virion; RNA

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The measles virus cause

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rubeola or 7d measles (7day rash, starts as red spots on head/trunk and spreads to extremities)

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The most distinctive dx sign of measles is:

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reddish patches with white, salt crystal like centers called Koplik's spots

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measles is ________ in most cases; but is_________

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mild in most cases but is highly contageous

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measles causes:

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pneumonia in 5% and encephalitis in 0.1% which can result in permanent mental retardation, epilepsy, deafness, and death.

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in 1990 measles epidemic peaked at

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27,000 cases d/t lax vaccination

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Now measles vaccine is

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more potent and vaccinate susceptible people

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a rare, but uniformly fatal complication of measles is:

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a rare neurological disease called SSPE (subacute sclerosing panencephalitis) that may occur years after having measles.

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mumps is a ______disease of _________

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viral disease of the resp tract

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characteristics of the mumps virus include:

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enveloped virion; RNA

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Mumps virus causes:

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inflammatio of the parotid gland (parotitis), so the glandular orifice swells shut; the gland fills with saliva and becomes tight and tender, chewing is painful

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mumps in children is

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mild but not in an adult

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mumps in adults

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testes can become infected (orchitis) and sterility can result. 25% of post adolescent males contracting mumps develop orchitis

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mumps vaccine

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live attenuated vaccine developed in 1967. In 200 only 315 cases.

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Rubella is a _______disease of the _____

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viral disease of the resp tract

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characteristics of rubella:

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enveloped virion; RNA

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Rubella virus cause

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the 3 day measles or german measles and aren't considered a problem to the pt

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s/s rubella

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slightly red rash tends to last about 3d and is less pronounced than the measles rash

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rubella and pregnant women

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pregnant women pass it to her fetus transplacentallly during 1st trimester = congenital rubella syndrome (devastating) any organ can be affected: eyes, brain ABD, thoracic organs, bone etc

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we vaccinate the general public for rubella to

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protect others esp the unborn

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The rubella vaccine is

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an excellent live attenuated vaccine and the three are give together MMR (measles, mumps, rubella)

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RSV is

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respiratory synctial virus

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RSV is a _____disease of the _____

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viral disease of the resp tract

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Characteristics of RSV:

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Enveloped virion; RNA

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RSV causes

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serious infxn of the lower resp tract in young children

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spread of RSV

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viruses easily spread in an infant ward

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RSV tx:

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ribavirin via respirator to prevent or reduce epidemics

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Infants infected with RSV

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need to be separated from uninfected

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health care workers and RSV

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workers can easily become sensitized to the drug, so protective equip[ment to prevent air exposure is indicated

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RSV induces

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the formation of synctia by causing infected cells to fuse togher; hence, the name

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RSV death rate

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>4,000 children in US die / y

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Poliovirus is a ______disease of _____

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viral disease of resp tract

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Characteristics of poliovirus:

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naked, icosahedral virion; RNA

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poliovirus is a

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tiny RNA virus that infects the alimentary canal and invades neurons in spinal column where it causes poliomyelitis

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polio---
myelon--

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polios-gray; myelon refers to the brain and spinal column

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poliovirus is transmitted

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in food/water, est. initial infxn in adenoids and lymphatic tissue in the intestinal tract

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in poliovirus sometimes virions are spread via

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bloodstream to the meninges, which may lead to paralysis of legs, arms, body, depending on how high up the spinal column cells are destroyed.

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in poliovirus if nerves that innervate the diaphragm muscles are destroyed

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the pt can't breathe and dies

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iron lungs

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kids lived in them with only head sticking out - provided pressure change on the chest to force breathing. few recovered

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salk vaccine

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salk (killed) vaccine (taken via injection, prevents sprade of virus thru bloodstream but not intestinal growth and fecal shedding.

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Sabin vaccine

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live vaccine- orally induces a secretory IgA response in intestinal tract so future infxns intercepted enterically/not spread to the feces. developed in 50s/virtually eliminated endogenous polio for the US.

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WHO and poliovirus

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WHO is trying to eradicate this virus from the world as the smallpox has been

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cases in 2000

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99.5% of worldwide cases in war torn countries of Africa, SE Asia, Middle East, Only 2,850 cases in 2000 and the effort continues.

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Chicken pox is a ______disease of ____

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viral disease of resp tract

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Characteristics of chicken pox

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enveloped virion; DNA;

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____________causes chicken pox

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varicella virus causes chicken pox, most highly contagious disease known

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___________causes shingles

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zoster virus

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_________&________virus are actually the same virus

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varicella virus (chicken pox) and zoster

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_________ is the primary disease;
________is the recurrent disease, hence the compound name,________

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chicken pox is primary disease; zoster or shingles is the recurrent disease, hence the compound name, varicella-zoster virus

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chicken pox rash lasts

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2-3wks with intense itching

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Why is it imp to prevent secondary, bacterial infxn of pox lesions that become broken?

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so that scarring doesn't happen

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Chx pox is mild in kids but not adults so

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it became a practice to see that kids were infected before school started was common

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Chx pox pt under 17yo given ASA =

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Reyes syndrome associated with vomiting and may lead to coma and death

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health care workers must educated parents to

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avoid ASA containing products for kids with chx pox

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chx pox virus can resurface in

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adults >40yo causing a rash called shingles, painful neuralgia lasting 3-5wks

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Shingles comes from

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one of the cranial neurons and the rash appears only where that neuron enervates the skin on one side of the body or face. facial paralysis may result.

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chx pox vaccine

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1995, live attenuated vaccine introduced in US for kids >1yo. it has been used in Japan for about 20y, and preliminary results suggest that vaccinated individuals have less shingles

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Tx of shingles inlcudes

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pain meds

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to reduce itching in kids with chx pox

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frequent baths

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influenze is a _____disease of the _____

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viral disease of the resp tract

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Characteristics of influenza

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enveloped virion; RNA

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Influenza virus was named because

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some believed it was d/t astrological influences when a conjunction of stars occurred

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influenza can result in

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millions of deaths in any year

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the influenza virus kills

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very few, but secondary pneumonia infections, such as s.pneumonia, kill people because this virus predisposes victims to bacterial infections

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the influenza virus contains

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two viral proteins: neuraminidose and hemagglutinin

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neuraminidase

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breaks down the protective mucous layer that lines the throat

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hemagglutinin

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attaches the virus to the ciliated epithelial cells in the throat so the virus can enter and kill the cells

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influenza virus inhibits

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phagocytic activity in the lung tissue

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the 2 surface proteins and inhibition of phagocytic activity in the lung in influenza together

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severely predispose an individual for bacteria to est infections that result in pneumonia

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influenza spreads

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from person to person in only 2-3d and has a sudden onset of fever, chills, H/A, muscle pains, and a cough develops that transmits the virions. s/s last 7-10d, relapse w/o rest

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There are _____ serotypes of the influenza virus

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There are 0 serotypes of the influenza virus - but it does change year to year

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sometimes the influenza virus

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acquires a new hemagglutinin gene for which the population has no immunity = pandemic (worldwide epidemic).

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in the influenza virus both the

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hemagglutinin and the neuraminidase can change in small steps by mutation = local epidemics Qy

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antigenic shift

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the complete hemagglutinin gene change in influenza virus

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antigenic drift

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the mutational change in influenza virus

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swine flu

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1970s occured when the virus traded the normal human hemagglutinin gene for one from a pig influenza virus

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Hong kong flu

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may 1997, boy died rapidly of influenza - virus traced to chickens that also died suddenly with hemorrhages from bodily orifices. as more cases mounted govt killed all 1.5million chickens in hong kong and burried the carcases. the potential epidemic/pandemic averted

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effective influenza tx

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can be achieved with amantadine, ribavarin, sanamivir if started early

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amantadine

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is unusual in that it inhibits uncoating

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ribavirin

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an RNA polymerase inhibitor

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zanamivir

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relenza, an inhibitor of neuroaminidase

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flu vaccine

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a killed vaccine is produced Qy for the expected antigenic types. protection rate 70-80%. saves many lives. elderly, impaired pulmonary function need vaccination Qy

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influenza is one illness for which ASA should

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never be given <17yo = Reyes syndrome which is probably d/t hypersensitivity rxn

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Guillain-Barre syndrome

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a risk that occurs rarely (1 in million doses) from the flu vaccine

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s/s of guillain-barre syndrome

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neural damage, parlysis, and coma probably d/t hypersensitivity rxn