Childhood Viral Infections

Question 1

Name 6 notifiable diseases

Answer 1

Acute meningitis
Acute poliomyelitis
Measles
Mumps
Rubella
Smallpox

Question 2

What antibodies are in breast milk?

Answer 2

IgG

IgA

Question 3

Virus that causes measules

Answer 3

Paramyxovirus- enveloped single stranded RNA virus

Question 4

Describe the transmission for measles

Answer 4

Person-person. Droplet spread

Question 5

Infectivity of measles and incubation period

Answer 5

4 days before rash to 4 days after disappearance (10-12 days incubation)

Question 6

Natural hosts for measles

Answer 6

Only humans

Question 7

Clinical features of measles

Answer 7

Rash, fever, conjunctivitis, coryza and cough

Koplick spots 1-2 days before rash.

Question 8

Complications of measles

Answer 8

Otitis media
Pneumonia
Diarrhoea
Acute encephalitis
Subacute sclerosing panencephalitis (SSPE)

Question 9

Describe the features of subacute sclerosing panencephalitis (SSPE)

Answer 9

Rare, fatal, late (7-30 yrs after measles) infection in pregnancy- 20% foetal loss

Question 10

Treatment for measles

Answer 10

Supportive

Antibiotics for superinfection

Question 11

Prevention of measles

Answer 11

MMR-1yr

Question 12

Describe the causative organism for chicken pox

Answer 12

Varicella Zoster Virus-herpes virus- DNA virus

Question 13

How is VZV transmitted?

Answer 13

Respiratory spread/personal contact

Question 14

Incubation period for VZV

Answer 14

14-15 days

Question 15

Infectivity of VZV

Answer 15

2 days before onset of rash until vesicles dry up.

Question 16

Describe the rash in VZV

Answer 16

Centripetal (starts on trunk and diffuses peripherally)

Macular?papular>vesicuar>papular

Question 17

Complications of VZV

Answer 17

Pneumonitis (increased risk for smokers)
CNS involvement
Thrombocytopenic purpura
Shingle (zoster)

Question 18

Treatment for VZV

Answer 18

Aciclovir

Chlorpheniramine can relieve itch (>1yr)

Question 19

Prevention for VZV

Answer 19

Live vaccine- 2 doses (not routine)

VZ immunoglobulins given in high risk cases

Question 20

Where is Rubella a problem?

Answer 20

Poland

Question 21

Causative organism for rubella

Answer 21

Togavirus, RNA virus

Question 22

Transmission for rubella

Answer 22

Droplet spread

Question 23

Incubation period for rubella

Answer 23

14-21 days

Question 24

Infectivity of rubella

Answer 24

1 wk before rash to 4 days after

Question 25

Clinical features of rubella

Answer 25

50% infectious children are asymptomatic. Non specific prodrome. Lymphadenopathy. V. non specific rash-behind ears, face and neck

Question 26

Complications of rubella

Answer 26

Thrombocytopenia. Post infectious encephalitis, arthritis

Question 27

Complications of rubella in pregnancy

Answer 27

'congenital rubella syndrome'- more severe when contracted early in pregnancy. Cateracts and other eye defects Deafness Cardiac abnormalities Microcephaly Retardation of intra-uterine growth Inflammatory lesions of brain, liver, lungs and bone marrow

Question 28

When in pregnancy is there a high risk of transmission of rubell?

Answer 28

less than 11 wks- 90% rish of transmission | Over 20 wks, no increased risk

Question 29

Diagnosis of rubella

Answer 29

Serology IgG +ve for 3 months

Question 30

Treatment for rubella

Answer 30

No treatment. Ig given to exposed pregnant women. Vaccine= MMR

Question 31

Slapped cheek

Answer 31

Parovirus B19

Question 32

Virus for parovirus B19

Answer 32

B19-DNA virus

Question 33

Transmission of parovirus B19

Answer 33

Respiatory secretions or from mother to child

Question 34

Incubation/infectivity for parovirus

Answer 34

Incubation- 4-14 dyas | Not infecctious once rash has developed

Question 35

Foetal disease-parovirus B19

Answer 35

Anaemia, hydrops- foetal transfusion

Question 36

Clinical features of parovirus B19

Answer 36

``` Minor respiratory illness Rash illness 'slapped cheek' Arthralgia Aplastic anaemia Anaemia in immunosuppressed ```

Question 37

Treatment for parovirus B19

Answer 37

None if self-limiting illness. Blood transfusion. No vaccine available. Infectious prior to rash so infection control difficult

Question 38

Causative organsisms for enteroviral infection

Answer 38

Cocksackie, entero, echoviral infections

Question 39

Transmission of enteroviral infection

Answer 39

Faecal-oral and by skin contact. Hand, foot and mouth disease.

Question 40

Clinical presentation of enteroviral infection

Answer 40

Fever-rash symptoms, can develop into meningitis

Question 41

Treatment/prevention for enteriviral infections

Answer 41

Supportive management and good hygeine to prevent transmission

Question 42

Causative organisms of respiratory synctial virus

Answer 42

Pneumovirus

Question 43

Clinical manifestation of RSV

Answer 43

Bronchiolitis in under 1yrs.

Question 44

Incubation period for RSV

Answer 44

4-6 days

Question 45

Complications of RSV

Answer 45

Can be life threatening. Reinfections common

Question 46

Causative organism of metapneumovirus

Answer 46

Paramyxovirus

Question 47

Clinical manifestation of metapneumovirus

Answer 47

similar to RSV- from mild URTI to pneumonia. Nearly universal by 5yrs.

Question 48

Adenovirus accounts for what proportion of childhood respiratory infections?

Answer 48

10%

Question 49

Clinical manifestation of adenovirus

Answer 49

Mild uRTI Conjunctivitis Diarrhoea

Question 50

Treatment for adenovirus in immunocompromised

Answer 50

Cidofovir

Question 51

Causative organisms for parainfluenza

Answer 51

Paramyxovirus

Question 52

How many types of parainfluenza are there?

Answer 52

4- 1 in winter, 3 in summer

Question 53

Transmission of parainfluenza

Answer 53

Person-person, inhalation

Question 54

Clinical manifestation of parainfluenza

Answer 54

Croup/bronchiolitis/URTI

Question 55

The common cold- 70% children with mild URTI

Answer 55

Rhinovirus

Question 56

3 infectious childhood diseases that result in diarrhoea

Answer 56

Rotavirus | Noravirus

Question 57

Causative organism for rotavirus

Answer 57

Reovirus (RNA virus)

Question 58

Transmission for rotavirus

Answer 58

Faecal-oral, occasionally respiratory

Question 59

Incubation period for rotavirus

Answer 59

1-2 days

Question 60

Prevention for rotavirus

Answer 60

Oral live vaccine

Question 61

Causative organism for mumps

Answer 61

Paramyxoviridae family

Question 62

Transmission of mumps

Answer 62

Direct contact, droplet spread

Question 63

Infectivity of mumps

Answer 63

Several days before parotid swelling to several days after

Question 64

Incubation period for mumps

Answer 64

2-4 weeks

Question 65

CLinical manifestation of mumps

Answer 65

Non specific prodrome-fever, malaise, anorexia, headache. Next 24 hours-earache, tenderness over ipsilateral partid. Next 2-3 days, enlarging parotid, severe pain. Normally bilateral. Pyrexia

Question 66

Complications of mumps

Answer 66

Meningitis, encephalitis, renal function abnormalities, pancreatitis, apididymo-orchitis-inflammation of epididymis. Infection in 1st trimester increases the risk of foetal death.

Question 67

Diagnsosis of mums

Answer 67

Normal WCC. Raised serum amylase. Serology (IgM)

Question 68

Treatment for MMR

Answer 68

MMR vaccine