Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
141 Cards in this Set
- Front
- Back
What are the three diseases dealing with vesicular or pustular rashes? |
1. chickenpox 2. herpes zoster 3. smallpox |
|
What is chicken pox? |
1. signs and symptoms: skin lesions, merciless and papule to itchy fluid-filled vesicles 2. Shingles-herpes zoster (reactivation of virus in ganglia) 3. causative agent: HHV , VZV, enveloped DNA virus |
|
What is the pathogenesis and treatment of chickenpox? |
HHV3 remains latent in ganglia and protects virus from attack by the immune system
**prevent by attenuated vaccine, Oka strain, Zaostavax prevents shingles in people 60 years or older |
|
What is the taxonomy of VZV? |
1. family: herpesviridae 2. species: HHV3 (VZV)
|
|
What is the structure of VZV? |
1. genome: dsDNA 2. enveloped 3. no fomite transmission
**VZV smallest genome of herpes virus |
|
What does VZV cause/ |
chicken pox primary infection and shingles (herpes zoster) second/latent infection |
|
How do i know i have VZV? |
maculopapular rash appears 14 days post infection and starts on trunk!...1st lesion is 204 mm red papule with irregular outline (rose petal)...thin walled clear vesicle (dew drop) develops on top of red area....."dew drops on a rose petal
**within 12 hours, vesicle becomes postural and crusts and then scapped. All three can be present and this is the hallmark. |
|
What is the transition of VZV in clinical manifestation? |
macules....papules...vesicles....pustules...dried crust (not infectious) 7-10 days later |
|
What is the 3 hallmark signs of VZV? |
1. rash more severe on trunk than extremities 2.lesions itch 3. primary infection more severe in adults than kids |
|
What is the pathogenesis for VZV? |
acquired through inhalation of infectious droplets....make their way to regional LN and spreads to T cells and carry it to skin.....
primary viremia occurs 5 days post infection and secondary viremia 11 days
*must engage in syncytial formation |
|
What is syncytial formation and what does it help VZV? |
fusion of virus infected host cell with neighbors regardless of being infection helps evade neutralizing antibodies.......this is its cytopathic effect |
|
Can VZV be dangerous? |
Yes...in adults much more severe....some get interstitial pneumonia, encephalitis, difficulty walking and seizures.
**infants, adolescents, adults, pregnant, immunocompromised |
|
What are the serious complications of chickenpox? |
dehydration, pneumonia, bleeding probles, infection/inflammation of brain, andbactertial infections of skin (GAS, blood stream infection, TSS< bone infections) |
|
How do i know if i have Herpes zoster? |
rash will appear only in single dermatomes (travel down nerve and reactivating in dermatome supplies by that nerve)
**lot of neuronal pain....should resolve in 7-10 days but completely in 4 weeks. |
|
What is the most common complication for hepres zoster? |
PHN (postherpectic neuralgia): chronic syndrome >90 days of pain lasting for years. |
|
What is zoster without rash called? |
zoster sine herpete |
|
How do diagnose herpes zoster? |
1. observe symptoms and look for "dewdrops on a rose petal" and examine the development 2. see GIANT CELLS when doing vesicle scrapings 3. CPE: intranuclear inclusions and syncytial formation
**lab confirmation of varicella is very important to confirm cause of outbreaks |
|
What is the most sensitive method for confirming varicella diagnosis? |
PCR ! |
|
How can you infect other people if you have VZV? |
Both chicken pox and zoster are contagious illnesses...VZV highly communicable and people in same household can contract infection
|
|
Patients are contagious from how many days before or after the rash appears until all lesions have dried? |
contagious from 1-2 days before rash appears until scab |
|
How can I transmit VZV? |
resp droplets and direct contact with lesions....zoster rash also contagious
**humans are only reservoir |
|
T or F: is VZV seasonal? |
false....worldwide all the time |
|
How can I protect my family if I have VZV? |
1. antiviral drugs + VZV immunoglobulin for immunocompromisd people and newborns 2. live vaccine for prevention of both |
|
What are FDA approved dugs for tx of adults with shingles and varicella? |
1. acyclovir 2. famciclovir 3. valcyclovir
**analgesics and topical anesthetics can provide releif ***VZig for immunocompromised people within 4 days after exposure |
|
What is the window for Varicella vaccine to be effective? |
must be used within 72 hours (3 days) and possibly u to 5 days after exposure
1.Varivax can prevent chicken pox in 70-90% of people 2, Zostavax is given to people above 60 to precent shingles (even if they've had it)...some 50 or above |
|
What is breakthrough varicella? |
MVLS "mild varicella like syndrome" is infection of those who have been vaccinated....use PCR to diagnose this!!! |
|
How is breakthrough varicella different from varicella infection in people who weren't vaccinated? |
mild in those who were vaccinated....breakthrough people have: 1. maculopapular rash instead of vesicular. 2. show less than 50 lesions and no fever
**breakthru can transmit varicella to others |
|
How can I test my immune status against virus? |
Whole infected cell ELISA to see if you have antibodies from previous infection |
|
What is general info about smallpox? |
1. signs and symptoms: fever, rash in mouth, mc pap vest and pus 2. causative agent: variola virus is an orthopoxvirus....enveloped brickshaped DNA virus
|
|
What is the taxonomy of pox viruses (smallpox virus)? |
1. family: Poxviridae 2. species: Variola virus |
|
What is the structure of pox viruses (smallpox virus)? |
1. genome: dsDNA 2. enveloped 3. largest human viruses that code for their own polymerases in the cytoplasm (DNA dep. RNA polymerase) 4. most enveloped viruses don't give off fomites...but this one DOEs |
|
History of smallpox: |
jenner made the vaccinia virus (cowpox) to prevent it....ovoid to brick shaped viruses and sDNA with fused ends....replication happens in the cytoplasmic inclusion bodies (Guarnieri)....virus core assumes dumbbell shape (2 large lateral bodies) |
|
Why is smallpox still considered a threat? |
In the US and russia bc of bioterrorism.....smallpox is the first dz to be controlled by immunization and the first to be eradicated! |
|
How do I know if I have pox viruses (smallpox virus)? |
1. typical presentation: fever, malaise, myalgia, FOLLOWED by pus filled/vesicular rash which leaves disfiguring scars....usually after 3-17 day incubation period 2. rash emerges 1st. small red spots on tongue and mouth and develop into sores that break open in the mouth and throat (MOST CONTAGIOUS here) 3. rash appears on skin, start on face, work through the arms and legs, hands and feet...spreads everywhere in 24 hours. When rash appears, fever falls and feel better.....by the 3rd day of rash, it becomes raised bumps....by 4th day it fills with thick opaque fluid and often have a depression in center that looks like bellybutton - the most distinguishing characteristic ...fever will rise again and stay until scabs form. they will fall off after 3 weeks leaving pitted scars |
|
What are two clinical forms of smallpox? |
1. viral major (severe and most common form with more rash and higher fever) 2. variola minor |
|
What are the 4 types of viral major? |
1. ordinary (most common, 90%) 2. modified (mild and occur in people who were vaccinated) 3. flat (rare and severe) 4. hemorrhagic (rare and very severe) |
|
Can pox viruses (smallpox virus) be dangerous |
es...even with vaccination can cause serious effects in ppl w skin conditions, eczema, atopic dermatitis or weakened immune systems |
|
How can i transmit pox viruses (smallpox virus)? |
1. respiratory route requiring close contact (transmission doesn't occur before rash) 2. fomites (bedding, clothing) 3. virus has immune escape mechanisms (cell mediated and humoral are needed to resolve)
**very young and very old can die |
|
How can I protect my family from pox viruses (smallpox virus)? |
1. Vaccinia virus vaccine provides complete protection for 5 years, waning for 10 2. can prevent/decrease severity when administered 3-6 days following exposure 3. put patients in negative pressure rooms with HEPA air filtration |
|
What are the two live vaccinia virus preps available? |
1. dryvax (made in calf lymph) 2. ACAM 2000 (african green monkey kidney cells (Vero cells))
**US has enough smallpox vaccine to vaccinate everyone in case of outbreak |
|
Is there a treatment? |
no. 1st disease to be eradicated by immunization |
|
What are the properties of smallpox that led to its eradication? |
1. exclusive human host range (no animal reservoirs) 2. single serotype 3. safe, live vaccines prepared from animal poxviruses 4. consistent dz presentation with visible pustules easy ID and quarantine 5. stable, inexpensive, easy vaccine....scar at injection site = success!
|
|
How do you distinguish smallpox and chickenpox? |
1. all smallpox have same stage of development everywhere and develop slowly (chickenpox...rapid and different stages at same time) 2. smallpox lesions are big (5-10mm) and chicken pox 1-5 mm 3. BY DAY 7: smallpox scabs haven't formed yet (chicken pox most have scabs) 4. smallpox= arms and legs >trunk (opposite for chicken pox) 5. smallpox commonly on palms, soles |
|
Why can't we vaccinate pregnant woman against smallpox? |
danger to fetus |
|
What are the three reportable cases to US? |
1. smallpox 2. varicella 3. MMR |
|
What is general information about maculopapular rash diseases? |
(Measles-Rubeola) 1. signs/sx: Koplik's spots, maculopapular exanthemum, SSPE (subacute sclerosing panencepthalitis) 2. causitive agent: MORBILLIVIRUS (single stranded RNA enveloped virus) 3. pathogenesis/virulence factors: cause viremia, induce syncytia, disable human immune response 4. transmission: respiratory droplets 5. culture/diagnosis: clinical presentation, ELISA 6. prevention: MMR vaccine
|
|
What is the taxonomy of Morbillivirus (measles)? |
1. family: paramyxoviridae 2. species: Measlesvirus |
|
What is the strucutre of Morbillivirus (measles)? |
1. genome: ssRNA, enveloped
|
|
What does Morbillivirus (measles) cause? |
measles (rubeola) which is 1 of 5 classic childhood exanthema (rubella, roseola, fifth disease and chicken pox)...before 1960 most kids were affected by it..
confused with roseola and rubella |
|
How do I know if I have Morbillivirus (measles)? |
1. fever and three C's + P: cough, coryza (acute rhinitis), conjunctivitis and photophobia 2. after 2 days, Koplik's spots appear on mucous membrane on inside of cheek across from molars..."grains of salt surrounded by red halo."....Koplik spots precede measles rash and seen for 1st 2 days after rash 3. rash starts on head and takes 1-2 days to cover body....gradually coalesces into red patches which fade to brown. |
|
What happens with atypical measles? |
receive killed vaccine or unsuccessful immunication) spread from extremities inward and petechiae, vesicles, papules show up |
|
How do we diagnose Morbillivirus (measles) in the laboratory? |
1. clinical manifestations (Koplik's spots) 2. RT-PCR of throat/nasopharyngeal swabs/blood/urine 3. staining of respiratory cells from urine reveal syncytia 4. Ig detection when rash is present (IgM in serum within first few days) ....rapid, presumptive dx for recent infection |
|
Can Morbillivirus (measles) be dangerous? |
YES....30% cause: pneumonia, bacterial secondary infections(ear), diarrhea
1. 1/1000 children develop encephalitis causing deafness or retardation. 2. developing countries: malnutrition and vitamin A defiiciency can kill.....leading cause of blindness among African children 3. Worldwide, Measles used to kill 1 million children every year. |
|
What is the most serious complication for Morbillivirus (measles) |
subacute sclerosing panencephalitis (SSPE) |
|
Can I infect others if I have morbillivirus (measles) |
1. highly contagious, spread via respiratory droplets. 2. rash caused by immune T cells attacking infected endothelial cells 4. decrease in eosinophils/lymphocytes....host cell mediated immunity and hypersensitivity responses are DISABLED.....reason why predisposed to secondary bac. infections |
|
Whos is at feat of contracting this illness? |
all newborns, immunocompromised and non vaccinated people |
|
How can I protect my family? |
1. vaccinated with MMR vaccine...live attenuated virus given to kids 12-15 months with booster at 4-6 years old (mandated by state school entry requirements) 2. two ways to prevent infection when exposed: give a shot of measles vaccine within 72 hours of exposure and a shot of sIgs within 6 days of exposure
**you need MMR vaccine if u are going to college, work at health care facility, child baring age, or about to travel international
- no complications to vaccine...vaccine is grown in chick embryo tissue culture and given to people to egg allergies |
|
Why is MMR vaccine so successful in preventing measles? |
measles limited to humans and immunity is lifelong. only 1 type of serotype! |
|
How can measles (rubeola) be treated? |
no specific antiviral...supportive care with bed rest, fluids, control fever |
|
What is research on measles? |
inhalable form of dry powder vaccine triggered no adverse effect....why do we have to know this..? |
|
What is general information for Rubella? |
1. "3 day measles"..."little red" = rubella.."german measles"....one of the 5 classics 2. signs and sx: postnatal or congenital infection of the fetus. 3. causative agent: Rubivirus found in the family Togavirus: sRNA with loose lipid envelope |
|
What is the taxonomy for Rubivirus (rubella)? |
1. family: togaviridae 2. species: Rubella virus |
|
What is the structure of Rubivirus (rubella)?? |
1. genome: +ssRNA, enveloped |
|
How do I know if I have Rubivirus (rubella)? |
1. normally benin in children.....multiplies in the respiratory epithelium, goes to LN and reaches blood....early sx: fever, malaise, lymphadenopathy
2. maculopapular rash 14-17 days AFTER exposure.....lasts 3 days and pruritic. initially on face and then goes to feet. more faint than measles
3. rash is more prominent when taking a hot shower/bath
4. older kids, young adults: can have arthralgia, arthritis, thrombocytopenic purport instead of rash...+ encephalitis |
|
How do we diagnose in the laboratory for Rubivirus (rubella)? |
1. RT-PCR of viral DNA (specimens: nasal, blood, throat, CSF) 2. detection of anti-rubella IgM (ELISA or latex agglutination) 3. clinical symptoms not specific bc easy to confuse with others
|
|
What is the most commonly used method to isolate rubella virus? |
interference technique using African green monkey kidney (AGMK) cells and an enterovirus....inoculate cell onto primary AGMK monolayers....incubate for 9-12 days and then challenge with enterovirus.
**presence of Rubivirus (rubella) will interfere with enterovirus and prevent enterovirus CPE on the cells |
|
How can I diagnose congenital rubella? |
VIRAL ISOLATION is preferred bc rubella serology is difficult to interpret....since IgG can cross the placenta it can confuse and also IgM may not be detectable.
**also can do a placental biopsy, rubella antigen detection via monoclonal antibody and PCR
**specimens for viral isolation: nasopharyngeal swab, urine, CSF, buffy coat of blood |
|
Can I infect others with Rubivirus (rubella)? |
Yes. via: 1. respiratory droplets 2. urine |
|
Who is at risk for Rubivirus (rubella)? |
newborns, immunocompromised peeps, non-vaccinated susceptible individuals
|
|
What is the most serious outcome due to rubella? |
Congenital Rubella Syndrome
**fetus is at risk until 20th week of pregnancy....most common defect is deafness + abortion/stillbirth |
|
How can I protect my family from Rubivirus (rubella)? |
1. MMR vaccination (promotes humoral and cell mediated immunity) bc of increase in seropositve moms......dont get pregnant until after 3 months of getting the vaccine and don't get it at all during pregnancy. |
|
How can I be treated for Rubivirus (rubella)? |
no specific antiviral drug. Supportiv care only |
|
What is interesting about the potential for research in Rubivirus (rubella)? |
rubella viral capsid is an anti-apoptotic protein |
|
What is general information about fifth disease? |
1. erythema infectiosum 2. "slapped cheek" appearance 3. causative agent = parvovirus B19 4. bery contagious and can cause still birth |
|
What is the taxonomy for Parvovirus B19? |
1. family: Parvoviridae 2. species: Human B19 virus |
|
What is the structure for Parvovirus B19? |
1. genome = +ssDNA 2. no envelope 3. smallest human DNA virus |
|
What does Parvovirus B19 cause? |
fifth disease (erythema infectiosum) |
|
How do I know I have Parvovirus B19? |
1. low grade fever, malaise, "cold" for a few days before rash 2. bright redness of cheeks (slapped cheek), most intense under eyes and initial sign of sparing of eyelids, chin, premolar area 3. 2nd rash can go around later... 4. itchy on soles of feet 5. rash goes away in 7-10 days but can last many weeks 6. as it goes away, can look "lacy" 7. viremia occurs during initial phase of "cold symptoms" and is infectious then....rash with lacy pattern and pruritic in 50%
* adults= flulike symptoms +polyarthralgia and joint swelling |
|
How do I diagnose in the laboratory for Parvovirus B19? |
1. appearance of slapped cheek 2. ELISA of serum, test for IgM and IgG to B19 antigens 3. detection of vial DNA by PCR of blood specimen |
|
What causes the rash in Parvovirus B19? |
immune system recognizes as foreign...spits out antibodies...antibody-virus complex causes rash and can be exacerbated by warmth/sunlight |
|
Can fifth disease be dangerous? |
Yes....ppl with chronic anemia can fall into aplastic crisis and potentially die.
1. if seronegative for B19 pregnant woman infected: virus will affect fetus and cause anemia, CHF (hydrops fetalis)....infected fetuses have in utero transfusions and can live |
|
How can I give Parvovirus B19 to others? |
1. inhalation of respiratory droplets....found in saliva, sputum, nasal mucus before onset of rash 2. direct contact with secretions by sharing of cups, utensils |
|
Who is at risk for infection of Parvovirus B19? |
children (elementary schools), parents of kids with B19, pregnant women, chronic anemic patients, immunosuppresed
**animal parvovirus doesn't affect humans and human doesn't affect pet |
|
How can I be treated for Parvovirus B19? |
no treatment but Ig can be given to treat percents infections in immunocompromised......n active caccine .
**ppl with aplastic crisis need transfusion |
|
What are the biggest complication caused by Parvovirus B19? |
B19 targets erythroid precursor cells and lyses them in the bone marrow
|
|
What is general information about Roseola? |
1. maculopapular rash 2. HHV-6 and HHV-7 3. 1st isolated from blood of AIDS patients.....virus is lymphotropic and ubiquitous....kids are 45% seropositive for 6 and adults are 90% seropositive for both
|
|
What is the taxonomy for Human Herpesvirus 6 and Human Herpesvirus 7? |
1. family: Herpesviridae 2. species: Human Herpesvirus 6/7 |
|
What is the structure for Human Herpesvirus 6 and Human Herpesvirus 7? |
1. genome: dsDNA 2. enveloped 3. no fomite transmission |
|
Primary infection for HHV-6 happens in: |
first year of life |
|
Primary infection for HHV-7 happens: |
first 2-3 years of life |
|
Two forms of HHV 6 have been identified....what are they? |
Variant A and B.....B is major cause of roseola, while A is unknown
|
|
What is Roseola? |
1.aka exanthema subitum....rapid onset of high fever for up to 3 days 2. possible seizures 3. on the 4th day, fever gone but faint maculopapular rosh over neck, trunk, butt and lasts 24-48 hrs |
|
How can I give Human Herpesvirus 6 and Human Herpesvirus 7 to others? |
1. transmission of 6B primarily via saliva and vertical transmission 2. sexual transmission 3. 6A detected more on skin....direct contact 4. HHV7 shed throughout life in saliva |
|
How can I be treated for Human Herpesvirus 6 and Human Herpesvirus 7? |
1. self-limited dz and requires supportive care 2. no formal treatment 3, acyclovir, foscarnet, cidofovir, ganciclovir IN VITRO helps. not in vivo |
|
What are the wart like eruption diseases? |
1. viruses cause all warts 2. warts (papillomas) are benign, squamous epithelial growth.
**HPV
can become malignant when caused by a particular HPV |
|
What is the taxonomy for HPV? |
1. family: papovaviridae 2.species: Human papilloma virus |
|
What is the structure for HPV? |
1. genome: dsDNA 2. no envelope 3. fomite transmission |
|
HPV is the most prevalent viral cause of: |
STD s in the US (over 100 types and 40 can infect the genital area) |
|
What does HPV cause? |
1. warts (papillomas)....can be painless like on finer (HPV 2,4,27,29) or painful warts can be on sole of feet (plantar warts) and caused by HPV 1
**flat warts: smooth, skin colored on face, trunk, elbows, knees (HPV 3,10,28,49) |
|
What is genital warts? |
found in genital/anal of both men and women....17-33 y/o commonly.
**HPV 6 and 11 (sexual contact) |
|
How do I know I have HPV? |
1. external warts 2. immunohistochemical detection of HPV structural proteins 3.Southern blot (more sensitive/specific technique and can tell u what HPV type) 4. PCR |
|
Can HPV be dangerous? |
almost all nongenital warts are harmless |
|
Can I infect others with HPV? |
YES. via direct contact....auto inoculation.
**viruses are stable and transmit via fomites (counters, showers, medical equipment) and inadequately chlorinated swimming pools |
|
How can I be treated for HPV? |
1. remove with salicylate acid preps, cryotherapy, electrocautery, laser, surgical excision, chemical 2. inject IFN and stimulate immune response 3. imiquimod applied topically to activate immune response 4. podophilox causes tissue necrosis and destroys warts via antimitotic activity 5. topical cidofovir inhibits viral DNA synthesis (immunodeficient people) |
|
How do I prevent HPV? |
avoid contact with infected people and wear slippers in communal showers |
|
What is the taxonomy for Molluscum contagiosum? |
1. family: Poxviridae 2. species: Molluscuscum contagiosum virus
|
|
What is the structure of Molluscum contagiosum? |
1. capsid: brick shaped 2. genome dsDNA 3. enveloped |
|
How do I know I have Molluscum contagiosum? |
1. papules to pearly unbilicated nodules in different size 2. central caseous plug 3. common on trunk, genitalia, proximal extremities 4. clusters of 5-20 and painless 5. children: face, neck, armpits, hands and arms (ABOVE WAIST) and adults: can come from STD so genitals, lower abdomen, inner upper thigh and buttox (BELOW WAIST) 6. lesions disappear within 6-18 months without treatment and without scar |
|
How do I diagnose in the laboratory for Molluscum contagiosum? |
1. case study and confirm histologically by large eosinophilic cytoplasmic inclusions 2. PCR |
|
When can I get Molluscum contagiosum? |
worldwide and genital is a marker for sexual activity |
|
How can I give Molluscum contagiosum to others? |
1. poor hygiene 2. climatic factors 3. direct contact (including sexual) 4. fomite transmission via towels or clothing....also swimming pools and sharing baths.
*if infected with molluscum bumps: 1. cover lesion w bandaid 2. dispose of used bandage at home 3. don't share anything!
****sexual transmission most common in adults |
|
How can I be treated for Molluscum contagiosum? |
1. IV cidofovir (antiviral) which blocks DNA replication 2. crettage: most efficacious tx with low rate of side effects 3. cantharidin topically 4. imiquimod (induce IFNs)...more effective than #3 but more expensive
+ salicylic acid and laser therapy......lesions should disappear in 6-18 most without tx or scars |
|
What are the viral infections of the eye? |
1. viral conjunctivitis by adenovirus 2. viral keratitis by HSV |
|
What is the taxonomy for adenovirus? |
1. family: adenoviridae 2. species: human adenovirus |
|
What is the structure for adenovirus? |
1. genome: dsDNA 2. no envelope 3. can spread by fomite |
|
What is general information about adenovirus? |
1. about 100 serotype an 51 infect humans.....unlikely for universal vaccine
2. most important defense against is CELL MEDIATED IMMUNITY....
3. shows latent infection of lymphoid tissues |
|
What does adenovirus cause? |
1. URT infections 2. conjnctivits 3. hemorrhagic cystitis 4. gastrotenteriris. 5. EKC (conjunctivitis and epidemic keratoconjunctivitis): causes mucosa of palpebral conjunctiva to be nodular and both palpebral and bulbar to be inflamed...blame the swim,ming pools and 8,19,37 serotypes |
|
What is the most common cause of viral conjunctivitis in people of all ages? |
adenovirus |
|
What is the most problematic cause of conjunctivitis? |
herpes simplex conjunctivitis |
|
How do I know if I have adenovirus? Lab diagnosis? |
1. clinical presentation and history 2. epidemiologic studies use lab dx 3. immuno assays, PCS, DNA probe to detect
|
|
Can adenovirus be dangerous? |
lytic DNA viruses that can disseminate in immunocompromised or neonates.....significant morbidity and mortality |
|
How can I transmit adenovirus? |
1. spread by fomites 2. resistant to drying, detergent, GI tract secretion and mild chlorine 3. spread to eye by fingers or contaminated water 4. direct contact with ocular secretion, fomites contact, food borne route, inhalation of infectious aerosols |
|
How do adenovirus evade immune system? |
1. able to interfere with operation of CTLs by blocking function of MHC I 2. virus producs protein that provides resistant to tumor necrosis factor (TNF)...TNF released by monocytes that are exposed to viruses and lyses the virally infected cells 3. interfere with the supervise action of interferon by making 2 small RNA molecules (VC RNAs) that mimic darns and bind to proteins that shut down protein synthesis
|
|
How can I protect my family from adenovirus? |
1. strict hand washing 2. isolation apparel in hospital
|
|
How can I be treated? |
1. no known treatment ....run its course 2. live oral vaccine for type 4 and 7 is for MILITARY ONLY ages 17-50 (1st 4 then 7) 3. eyedrops for comfort. 4. steroids for swelling |
|
What is the taxonomy for HSV I and II? |
1. Family: Herpesviridae 2. species: HSVI, HSVII |
|
What is the structure for HSV I and II? |
1. genome: dsDNA 2. enveloped |
|
What is general information about HSV I and II? |
1. don't survive well on environmental surfeit and requires direct inoculation in mucus membranes, genitals, anus
2. can be lyric or latent (latent advantage that it can avoid immune system)
3. after primary infection virus establishes latency in neurons...reactivation results in lesions of lips, eyes, fingers, genitals...most are asymptomatic.
**50-80% seropositvie for HSVI....20-40% seropositive for HSV2 |
|
What does HSV I and II cause? |
1. herpes keratitis: usually caused by reactivation by HSV1....travels down ophthalmic branch instead of mandibular of trigeminal nerve. 2. herpetic whitlow: inflammed nlister (HSVI or II) enters a cut in skin of finger 3. Herpes gladiatorum and eczema herpeticum |
|
How do I know if I have herpes keratitis? |
gritty feeling in eye, conjunctivitis, sharp pain, photophobia....recurrent and interfere with vision
|
|
How do I know if I have herpes gladiatorum? |
skin infection with wrestlers/athletes engaged in contact sports. (treat with aciclovir) |
|
How do I know if I have eczema herpeticum/ Kaposi's varicellum eruption? |
preexisting skin disorder or immunocompromised....abrupt clusters of dimpled blisters emerge 7-10 days and spread widely...untreated and fatal. can heal in 2-6 wks |
|
How can I diagnose HSV I and II? |
1. case study 2. viral culture/isolation (grab from the vesicles) 3. PCR for HSV DNA 4. Tzanck smear: look for multinucleate and eosinophilic intranuclear leasions |
|
Can HSV I and II be dangerous? |
Yes, neonates and immunocompromised
|
|
What is the leading infectious cause of blindness in the US |
herpes |
|
How can I transmit HSV I and II to others? |
usually via asymptomatic source of infection...HSV1 usually orally and HSV2 sexually or placement of hands into eyes/breaks of skin....asymptomatic shedding helps with its transmission. LIFELONG infection |
|
Latent HSV infections |
1. advantage : virus can avoid immune system and activate later... 2. reactivation causes virus to replicate on lips, eyes, fingers, genitals. 3. limted # of viral genes are transcribed (LATS) |
|
Lytic HSV infection |
DNA replication starts as soon as cell allows synthesis of viral DNA polymerase....show local spreadd and progression of lesions. rarely systemic except in the immunocompromised and neonates |
|
How can I protect my family from HSVI and II? |
wear gloves, wash hands, keep away from risky people. |
|
How can I develop protective immunity from HSV 1 and 2? |
1. humoral and cell mediated immunity can help 2. during primary infection, interferon production and NK cells limit the disease....HSV rarely causes viremia 3. production of ABs help limit virus |
|
How can I be treated for HSV 1 and 2? |
1. Trifluridine: herpes keratitis treatment; use of artificial tears for conceal healing (Virdarabine if allergic) 2. cidofovir (CMV retinitis and HSV infections) 3. acyclovir/valacyclovir for herpes gladiator and eczema herpeticum) |