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Viruses Flashcards

1
Q

What are the common portals of entry for viruses

A
  • respiratory tract
  • GI tract
  • GU tract
  • placental
  • eye
  • skin
  • transplanted organs/blood
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2
Q

What are the periods of infection from a virus

A
  • incubation period (communicable toward the end)
  • prodromal period (communicable)
  • illness period (communicable)
  • convalescent period (communicable at the beginning)
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3
Q

Describe zoonosis

A
  • when an infectious disease jumps from a vertebrate animal to a human
  • can spread through direct contact or through indirect contact
  • covid, avian flu, ebola, etc
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4
Q

What are the types of viral hosts

A
  • maintenance host: symbiosis (mosquito vector)
  • link host
  • amplifier host: high replication, ideally asymptomatic
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5
Q

What is responsible for the variability in symptoms between different people to the same virus

A
  • different biomedical profile/immunity
  • genetics & prior exposures
  • difference in severity of current exposure
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6
Q

Describe how to diagnose a viral infection

A
  • viral culture gold standard
  • direct detection (cytopathology, electron microscopy, PCR, immunoassay)
  • serology (IgG & IgM levels to check Abs)
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7
Q

What is the primary treatment for viral infection

A
  • prevention (vaccines, hygiene, isolation)
  • supportive care (treat sxs)
  • antivirals (inhibit replication)
  • immunomodulators (boost immune system)
  • interferons (cytokines inhibit replication)
  • virucidal agents (kill inactive virus)
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8
Q

Why is it hard to treat viruses (RNA viruses specifically)

A
  • RNA viruses have high mutation rates with replication compared to DNA viruses
  • Recombination: viruses can swap genetic material
  • much more diverse than bacteria
  • use the hosts building blocks (also hiding inside host cells)
  • robust capsid
  • ability to become resistant to meds that previously worked d/t mutations & recombinations
  • antivirals are expensive $$$
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9
Q

List some viruses in the Herpesviridae family

A
  • HSV 1 & 2
  • varicella zoster
  • EBV
  • cytomegalovirus
  • Human herpesvirus 6 & 7
  • Kaposi’s sarcoma associated herpesvirus
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10
Q

What is the etiology of cytomegalovirus

A

DNA Virus

CMV: seroprevalence 40-100% of adults worldwide
- diverse spectrum of illness depending on immune status
- produces acute primary infection & latent infection (reactivation can occur any time)

Transmission through close contact, sexual, blood exposure

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11
Q

Describe the clinical presentation of CMV

A

Primary: resembles mononucleosis, significant protracted fever, fatigue

Colitis, hepatitis, encephalitis, GBS, retinitis

CMV Mono: fever predominates, less so of the LAD & tonsillitis, exudates, splenomegaly

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12
Q

Describe the diagnostic testing for CMV

A

Lymphocytosis, atypical lymphocytes

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13
Q

Describe the etiology of influenza

A

RNA virus

Seasonal epidemics

A & B cause global pandemics

Primary transition thru resp droplets, close contact, contact with contaminated surfaces

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14
Q

Describe the clinical presentation of influenza

A

Incubation 1-4 days

Sxs vary with each strain: abrupt onset fever, nonproductive cough, myalgia, sore throat, nausea, congestion, HA

Vomiting & diarrhea not common in adults

Complications: pneumonia, MI, carditis, encephalitis, GBS, myositis

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15
Q

Describe the diagnostic testing for influenza

A

Labs normal on uncomplicated flu

Confirmatory testing (rule out covid) - PCR

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16
Q

Describe the treatment for influenza

A

Oseltamivir (Tamiflu) bid x5 days shortens duration of symptoms by 1 day, reduces viral shedding, reduces severity of sxs

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17
Q

Describe the viral shedding of influenza

A

viral shedding starts in first 24hrs, peaks at day 2, rapidly declines and undetectable by day 5-10

18
Q

Describe the etiology of Covid-19

A

RNA virus - SARS-CoV-2

Highly infectious, all ages at risk but varying risk of severity

Transmitted thru respiratory droplets, airborne, fomite, fecal-oral, vertical transmission rare

19
Q

Describe the clinical presentation of covid-19

A

Acute respiratory syndrome

Incubation 3-14 days following exposure

If symptomatic: cough, fever, myalgia, HA, sore throat, diarrhea, loss of taste/smell, congestion

Complications; pneumonia, resp failure, cardio complications, clotting, stroke, multisystem inflammatory syndrome in children, long covid (4-9 mos)

20
Q

Describe the diagnostic testing for covid-19

A

COVID NAAT PCR from NP or oral swab, antigen nasal swab to detect viral protein

CXR may show ground glass opacities bilaterally

Lymphopenia, elevated ALT AST, elevated LDH, elevated inflammatory markers (ESR, CRP, ferritin), abnormal coag tests (d-dimer)

21
Q

Describe the etiology of monkeypox

A

DNA virus

Orthopoxvirus (same as smallpox)

22
Q

Describe the clinical presentation of monkeypox

A

Rash similar to smallpox - vesicular lesions

Fever, chills, myalgias, rash at site of inoculation

Incubation 7-10 days

23
Q

Describe the diagnostic testing for monkeypox

A

PCR swab of lesion

24
Q

Describe the etiology of HIV

A

RNA virus

Started with “pneumocystis carinii pneumonia” in 5 men in the 80s

Transmitted through sexual intercourse, blood, vertical transmission

RF: high viremia, sexual exposure with mucosal disruption/bleeding, uncircumcised

25
Q

Describe the clinical presentation of HIV

A
  1. Acute: flu like sxs in first 2-4 weeks, fever, LAD, sore throat, rash, myalgias
  2. Latency: chronic infection that can last for decades, relative stability with progressive CD4 cell count decline, no sxs or nonspecific fatigue, weight loss, sweats
  3. AIDS: CD4 count falls below 200 c/mm3, vulnerable to opportunistic infection, AIDS defining conditions present
26
Q

Describe the treatment for HIV

A

Start ART asap (Biktarvy)

27
Q

Describe the etiology of Rabies

A

RNA virus

Highest case fatality of any infectious dz (rare)

Canines & bats are common reservoirs, caused by lyssavirus that spreads to peripheral nerves

28
Q

Describe the clinical presentation of Rabies

A

Incubation 1-3 mos (sometimes years)
Prodromal: mild, paresthesias around bite

Progressive encephalopathy, death

Classic encephalopathy: fever, hydrophobia, pharyngeal spasm, hyperactivity subsiding to paralysis, coma

29
Q

What is the diagnostic test for rabies

A

PCR

30
Q

Describe the treatment for rabies

A

Pre- exposure: High risk groups should get vaccine on days 0 and 7(rabies lab workers, bat autopsiers, spelunkers)

Post-exposure: wash wound well, rabies immunoglobulin on day 0, rabies vaccine on days 0, 3, 7, 14

31
Q

Describe the etiology of Measles/Rubeola

A

RNA virus

Highly contagious, humans only reservoir, leading cause of mortality under 5 worldwide

Transmission: contact, airborne up to 2 hrs

32
Q

Describe the clinical presentation of Measles

A

Incubation: 6-21 days, contagion begins day 5

Prodrome days 2-4: fever, malaise, cough, coryza, conjunctivitis, koplik spots for 12-72hrs

Exanthem: starts days 2-4 post-fever beginning on face & spreading down, LAD and high fever

Recovery: lifelong immunity

33
Q

Describe the diagnostic testing for measles

A

IgM Ab, PCR, viral culture

34
Q

Describe the treatment for measles

A

supportive, vitamin A

35
Q

Describe the etiology of mumps

A

RNA virus

Transmitted by resp droplets, direct contact, fomites

36
Q

Describe the clinical presentation of mumps

A

Incubation 16-18 days

Fever, HA, myalgia, fatigue, then 2 days later parotitis (unilateral or bilateral) for 10 days

37
Q

Describe the diagnostic testing for mumps

A

PCR, IgM Ab

38
Q

Describe the etiology of rubella

A

RNA virus -German Measles

Transmission through inhaled aerosolized particles

Eradicated in the US in 2004, Americas in 2015

39
Q

Describe the clinical presentation of rubella

A

Incubation 14-18 days (contagious 1-2 weeks prior to symptoms)

Kids likely to have less sxs than adults, maculopapular rash, low grade fever, LAD

Rash starts on face, spreads to trunk & extremities, Forchheimer spots on palate, arthralgias common in adults

40
Q

Describe the diagnostic testing for rubella

A

IgM Ab, PCR

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