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47 Cards in this Set

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Japanese Encephalitis
Flavavirus
Culex mosquitoes, flight range 20km
Japanese Encephalitis
Most infections are subclinical, otherse get encephalitis, "sleeping sickness", neck pain, drowsiness
Japanese encephalitis
Antibodies to this virus can actually enhance an infection via Fc receptors on macrophages
Flavivirus
This virus, found in asia, involves birds and pigs, a long distance mosquito, and has an effective vaccine available
Japanese Encephalitis
Yellow Fever
Flavavirus
2 Flavors of Yellow Fever
Jungle - cycle between primates and forest mosquitoes

Urban - transmitted between humans by Aedes mosquito
What happens in yellow fever?
Flulike syndrome, hepatitis, hemorrhage, shock. NO encephalitis. Can also get bradycardia (Fayet's Sign).

50% get fatal form with hemorrhagia, oliguria, hypotension
What is a strange symptom of yellow fever?
Decreased pulse with high fever
What is there to treat yellow fever?
Nothing. There is a vaccine, live attenuated, 17D for people traveling to endemic areas.
Dengue
Flavavirus
What are the 3 forms of Dengue?
Dengue Fever
Dengue Hemorrhagic Fever
Shock Syndrome - occurs when you are exposed to both type I and type II dengue.
Aedes Mosquito, 4 serotypes, 3 forms
Dengue, a flavivirus
What is there for a vaccine for dengue?
No current vaccine, one is being tested in thailand. Must be careful with added problem of Shock Syndrome
What are the symptoms of dengue?
High fever, lymphadenopathy, myalgia, bone and joint pain, headache, maculopapular rash. Also known as Breakbone fever.
West Nile Virus
Flavavirus
Fever, headache, fatigue, body ache, skin rash on trunk, lymphadenopathy, 1% get encephalitis
West Nile Virus
Spread by birds thru a mosquito vector
West Nile Virus
This flavavirus is diagnosed by serology and IgM for recent infection. Man and horse are accidental hosts.
West Nile virus
Colorado Tick Fever
Orbovirus, DS RNA segmented, a reovirus
Found in the western united states, this arbovirus normally has a tick-rodent cycle and can pass the virus to its offspring transovarianly
Colorado tick fever, orbovirus, DS RNA segmented
Lassa Fever
Arenavirus, ssRNA, negative, enveloped.
This disease has 2 pieces of antisense ss RNA, an envelope with protruding spikes
Lassa Fever, Arenavirus
What is the pathology of Lassa Fever?
fever, malaise, myalgia, sore throat, PATCHY ULCERATIVE PHARYNGEAL LESIONS

Can develop myocarditis, pneumonia, encephalitis, hemorrhagic manifestations, shock
Where do you find lassa fever?
West Africa like liberia, sierra leone, nigeria.
Mastomys Rat is where the infection comes from
Lassa Fever, an arenavirus
This Arenavirus is a type IV pathogen that has a 25% Mortality rate, more if you're pregnant.
Lassa Fever.
How do you treat Lassa Fever?
Ribavirin

Sometimes hyperimmune serum has a dramatic effect.

Can do post exposure prophylaxis

No vaccine
How do you diagnose Lassa Fever?
Don't CULTURE! Detect viral antigen by EIA, which can happen even before you can detect IgM.
Junin Virus and Macupo virus come from these two areas, respectively
Junin = Argentina
Macupo = Bolivia
Junin and Macupo Hemorrhagic Fever
Arenavirus with similar presentation to Lassa Fever
This disease is an arenavirus with calomys musculinis and calomys callosus vectors. There is no record of human to human spread.
Junin and Macupo Hemorrhagic Fever
How do you treat Junin and Macupo hemorrhagic fever?
Hyperimmune serum and ribavarin
This virus is enveloped, ssRNA negative, and consists of 3 RNA segments, L, M, and S
Hantavirus, part of Bunyaviridae
Name the five subtypes of hantavirus
1. Porogian, Hantaan - China, Russia, Europe. Classic, severe.
2. Seoul - moderate, worldwide
3. Puumala - Scandinavia, UK, France, Russia, mild - nephropathic
4. Sin Nombe - US, Canada, Mexico - carried by deer mice, causes pulmonary syndrome
What does hantavirus cause?
Hemorrhagic fever with renal syndrome (HFRS)

Pulmonary syndrome - damage to capillaries, vasodilation, congestion, hemorrhage
What are the five distinct phases of Hantvirus?
1. Febrile
2. Hypotensive
3. Oliguric
4. Diuretic
5. Convalescent
Sin Nombre causes this type of disease
Hantavirus Pulmonary Syndrome - damage to lung capillaries and not kidney, get some cardiac complications
Unlike all the other viruses in Bunyaviridae, this one has no arthropod vector
Hantavirus
How is hantavirus transmitted?
Between mice by agressive behavior

To humans thru inhalation of secondary aerosols, particularly urine, mucous membrane contanct, skin breeches. This is uncommon in US because it's not shed in urine, more feces.

It is spread easily person -> person
How do you diagnose hantavirus?
Chest X-ray for pulmonary edema

Direct antigen detection (better than serology, 4x increase in IgM)

RT-PCR for HPS

Viral isolation from urine if early in disease.

Sin Nombre has never been isolated in patients
How do you treat Hantavirus?
Supportive care

Ribavarin if early

No vaccine

Rodent control
This member of filoviridae causes severe hemorrhagic fever, internal and external bleeding, and extremely high mortality
Ebola and Marburg
How is ebola transmitted?
Thru blood, often due to burial rituals. It is not airborne.

Marburg may be transmitted by African Green Monkeys, must kill infected animals.
This disease requires level 4 isolation, can sometimes only be diagnosed by animal inoculation, and requires quarantine.
Ebola, a filoviridae. Can also diagnose due to large eosinophilic cytoplasmic inclusion bodies, ELISA, PCR.
In dengue, if you're infected with more than one strain you get this unpleasant side effect
Enhanced infection, because antibodies to flavavirus can enhance infection via Fc receptors on macrophages
What is St. Louis encephalitis?
Caused by flavavirus, it is similar to WEE and has a mosquito vector and a bird host. Seen throughout the US.