6 - Childhood Viral Infections Flashcards Preview

Clinical Pathology > 6 - Childhood Viral Infections > Flashcards

Flashcards in 6 - Childhood Viral Infections Deck (53):
1

What diseases would you report for to PHE?

Acute meningitis
Acute poliomyelitis
MMR
Smallpox

2

IgM is made when

Acute infection

3

IgG is made when

long term immunity

4

Which Ig from breast milk

IgA

5

Measles - virus

Paramyxovirus - enveloped single stranded RNA virus

6

Measles - transmission

Person to person
Droplet spread

7

Measles - infectivity

From start of first symptoms to after rash

8

Measles - incubation

7-18 days average = 10-12

9

Measles - clinical features

Prodrome: Fever, malaise, conjunctivits, coryza and cough (3 c's)
Rash: erythematous, maculopapular, head-trunk
Koplik's spots 1-2 days before rash

10

Measles - diagnosis

Clinical
Leukopenia
Oral fluid sample
Serology

11

Varicella noster virus: virus type

Herpes virus - DNA virus

12

Varicella noster virus: transmission

Respiratory spread / personal contact (face to face/ 15mins)

13

Varicella noster virus: incubation period

14-15 days

14

Varicella noster virus: infectivity

2 days before onset of rash until after vesicles dry up

15

Varicella noster virus: clinical features

Fever, malaise, anorexia
Rash - centripetal - macular > papular > vesicular > pustular

Complications: pneumonia, CNS involvement, thrombocytopenic purpura, foetal varicella syndrome, congenital varicella, zoster

16

Varicella noster virus: diagnosis

Clinical via PCR of vesicle fluid/CSF

17

Varicella noster virus: serology

Immunity
IgG in pregnant women in contact with ZVZ and no history of chickenpox

18

Varicella noster virus: treatment

Symptomatic adults and immunocompromised children
Aciclover oral, IV in severe disease or neonates
Chlorpheniramine can relieve itch (>1yo)

19

Varicella noster virus: prevention

Vaccine - live
For healthcare workers + immunocompromised

20

Varicella noster virus: when would you give VZ Ig?

Significant exposure
Clinical condition that increases risk of severe varicella e.g. pregnant, neonates
No Ab to VZ virus
Ig does not prevent infection, reduces severity

21

Rubella: virus

Togavirus
RNA virus

22

Rubella: transmission

Droplet spread - air-bourne, less contagious

23

Rubella: incubation period

14-21 days

24

Rubella: infectivity

One week before rash to 4 days after

25

Rubella: clinical features

Prodrome - non-specific
Lymphadenopathy
Rash - non-specific

Complications: thrombocytopenia, post-infectious encephalitis, arthritis

50% of infectious children are asymptomatic

26

Rubella: in pregnancy

Congenital rubella syndrome (CRS)

27

What is CRS?

Congenital rubella syndrome?

Cataracts + eye defects, deafness, cardiac abnormalities, microcephaly, retardation of intra-uterine growth, inflammatory lesions of brain, liver, lungs and bone marrow

Severity based on weeks into pregnancy

28

Rubella: diagnosis

Oral fluid testing - IgM/G (PCR if within 7 days of rash)

29

Rubella: serology

IgM and IgG. Antibodies detectable from time of rash

30

Rubella: treatment

No treatment available
Ig given to exposed pregnant women

31

Rubella: prevention

Initially 11-14 yo.
Now part of MMR

32

Erythema infectiosum: virus

Parvovirus B19 - slapped cheek virus
DNA virus

33

Erythema infectiosum: transmission

Respiratory secretions from mother to child

34

Erythema infectiosum: incubation

4 to 14 days

35

Erythema infectiosum: symptoms

Risk of miscarriage in early pregnancy - but low
Asymptomatic in 20%
Foetal disease: anaemia;
Hydrops (foetal transfusion)

36

Erythema infectiosum: clinical features

Minor resp illness
Rash (slapped cheek)
Arthralgia
Aplastic anaemia
Anaemia in the immunosuppressed

37

Erythema infectiosum: diagnosis

Serology IgM/IgG
Amniotic fluid sampling
PCR is immunocompromised

38

Erythema infectiosum: treatment

None if self-limiting illness
Blood transfusion
No vaccine

Prevention: relies on infection control

39

Enteroviral infection e.g.

Coxsackie
Entero
Echoviral infections

40

Enteroviral prevalence

Worldwide, prevalent in under 5 yo

41

Enteroviral symptoms and transmission

90% asymptomatic
Transmission is faecal-oral and skin contact

42

Enteroviral diseases

Hand, foot and mouth
Fever, rash syndrome
Meningitis - PCR of CSF

43

Viruses associated with respiratory symptoms

Respiratory syncytial virus
Parainfluenza
Influenza
Adenovirus
Metapneumovirus
Rhinovirus

44

What is respiratory syncytial virus?

Aka RSV
Pneumovirus, bronchiolitis (

45

What is metapneumovirus?

Paramyxovirus
Nearly universal by aged 5
Respiratory illness similar to RSV
Dx - PCR
Rx - supportive only

46

What is adenovirus?

10% of childhood resp infection
Clinical disease: mild URTI, conjunctivitis, diarrhoea

Dx: resp panel PCR, eye swab PCR, serology possible

Rx: None/cidofovir if immunocompromised

47

Parainfluenza

Paramyxovirus
Transmission: person-to-person, inhalation

Clinical: croup, bronchioltis, URTI

Dx: multiplexed PCR
Rx: None

48

Rhinovirus

Member of picornaviridae
Found in 70% with mild URTI
Similar clinical features

49

Rotavirus features

RNA virus
Transmission: faecal-oral + occasionally resp
Low infective dose
Incubation: 1-2days
Epidemiology: seasonal in UK

50

Rotavirus clinical features

Diarhoea and vomiting
6/12 - 2 yrs
Severe disease
Increased mortality in poorer countries

Dx: PCR
Rx: Rehydration
Prevention: oral live vaccine

51

Norovirus

Winter vomiting bug
Outbreaks
Foodbourne
Person-to-person
High incidence of vomiting (>50%)
Short course - 12-60 hrs
Dx: PCR
Rx: Rehydration

52

Mumps features

Paramyxoviridae virus
Transmission - direct contact, droplet, fomites
Infectivity - several days before parotid swelling to several days after
Incubation - 2-4 weeks

53

Mumps clinical features

Prodrome e.g. low-grade fever, anorexia, malaise and headache
24 hrs - earache, ipsilateral parotid
2-3 days - gradually enlarging parotid with severe pain
Pyrexia up to 40 degrees

Decks in Clinical Pathology Class (65):