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I & I Part II > MMR and Other Childhood Exanthems > Flashcards

MMR and Other Childhood Exanthems Flashcards

1
Q

Mumps

A
  • Paramyxovirus genus of the Paramixoviridae family
  • ( - ) ss RNA virus
  • pleomorphic
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2
Q

Mumps Structure

A
  • (–) Single stranded RNA virus | Nucleoprotein complex
  • Matrix protein surrounds nucleocapsid complex
  • Envelope contains 2 spikes. One has both H and N activity. The other is called F (fusion) protein.
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3
Q

Mumps Replication

A
  • Replicates in the cytoplasm like (-) RNA viruses by using virion associated RNA dependent RNA polymerase
  • Assembles in the cytoplasm
  • Buds through cytoplasmic membranes
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4
Q

Mumps Clinical Disease

A
  • Enters respiratory tract
  • Replicates in respiratory tract epithelium and local lymph nodes
  • Viremia: spreads virus throughout body
  • Fever followed by painful swelling of one or both parotid glands (parotitis) usually 12 to 29 days (16–18 days average) after exposure
  • Symptoms last 7–10 days
  • Immunity is life long
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5
Q

Mumps Incubation Period

A
  • usually 12 to 29 days (16–18 days average) after exposure
  • symptoms last 7–10 days
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6
Q

Mumps Common Complications

A
  • Meningitis |Encephalitis (hearing loss)
  • Pancreatitis
  • Orchitis (10–20% of infected men)
  • Oophoritis (inflammation of ovaries)
  • Myocarditis (less common)
  • 500 cases every year
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7
Q

Mumps Diagnosis

A
  • Clinical picture (most common)
  • Isolate virus (saliva, urine)
  • Serology
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8
Q

Mumps Treatment

A

•supportive

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9
Q

Mumps Prevention

A

•Live attenuated vaccine after 1st year of life or adults (particularly men)

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10
Q

Measles

A
  • Morbillivirus genus of the Paramyxoviridae family
  • ( - ) ss RNA
  • one antigenic strain
  • causes rubeola (5 day measles) and hard measles
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11
Q

Measles Structure

A

•same as mumps virus but the envelope protein of the measles virus lacks neuraminidase (N) activity

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12
Q

Measles Replication

A
  • same as mumps virus but the envelope protein of the measles virus lacks neuraminidase (N) activity
  • Replicates like (-) RNA virus
  • Assembles in the cytoplasm
  • Buds out from the plasma membrane
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13
Q

Measles Pathogenesis

A
  • Enters respiratory tract and replicates in and destroys mucosal epithelium, necrosis and inflammation
  • Spreads to local lymph nodes followed by viremia
  • Virus transported to all body organs, conjunctiva, urinary tract, small blood vessels, CNS
  • T and B lymphocytes, monocytes, polymorphonuclear leukocytes are infected
  • Cell-mediated immunity is depressed by IL-12 downregulation, Natural killer cells impaired
  • Enhanced susceptibility to bacterial superinfection
  • Skin lesions show vasculitis; vascular dilation, edema and perivascular mononuclear cell infiltrates
  • Viral components can be seen in the rash
  • In some patients, an immune mediated post infectious encephalitis through CD8 T-cells infiltration in the CNS
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14
Q

Measles Clinical Disease

A
  • Spreads to local lymph nodes
  • Viremia: transported to all body organs, symptoms occur 7-18 days (9–11 days average) post exposure
  • Koplik spots first appear in mouth (buccal mucosa) as small bluish– yellow spots 1–2 days before rash.
  • Rash first appears on head, then trunk and extremities.
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15
Q

Measles Incubation

A

•symptoms occur 7-18 days (9–11 days average) post exposure

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16
Q

Measles Koplik Spots

A

•Koplik spots first appear in mouth (buccal mucosa) as small bluish– yellow spots 1–2 days before rash.

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17
Q

Measles Severity

A

•High fever, delirium, cough, photophobia (light–induced eye pain), conjunctivitis.

18
Q

Measles Complications

A
  • Encephalitis: death or permanent impairments.
  • Bacterial superinfection: otitis media, mastoiditis, pneumonia, sinusitis.
  • Death: extensive progressive viral infection.
19
Q

Measles Epidemiology

A
  • childhood disease; 6 mo. and older. Currently many infections found in teenagers, winter and spring.
  • Measles cases have been on rise in US reaching 1250 in 2019
20
Q

Measles Diagnosis

A
  • Clinical picture (most common)
  • Virus isolation (throat, urine), Serology
21
Q

Measles Prevention

A

•live, attenuated vaccine after 1st year of life

22
Q

Measles Treatment

A

•supportive

23
Q

Measles - Subacute Sclerosing Pancencephalitis (SSPE)

A
  • Rare, progressive neurologic disease of children, 2 to 10 years after a measles infection
  • Insidious onset of personality change, poor school performance, progressive intellectual deterioration, development of myoclonic jerks (periodic muscle spasms), and motor dysfunctions (spasticity, tremors, loss of coordination, ocular abnormalities, blindness)
  • Most of the pathologic features of the disease are localized to the CNS and retina
24
Q

Rubella

A
  • Rubivirus genus of the Togaviridae family
  • German or 3 day measles
  • ( + ) ss RNA
  • one antigenic strain
25
Q

Rubella Structure

A
  • Simple, icosahedral, enveloped virus
  • The genome is (+) single stranded RNA
  • Single species of capsid protein
26
Q

Rubella Replication

A
  • Entry by receptor mediated endocytosis
  • (+) RNA is translated to produce viral proteins including RNA dependent RNA polymerase
  • These proteins are required for the synthesis of replicative intermediates, the genomic RNA, and the subgenomic RNA
  • The subgenomic RNA is the mRNA for viral structural proteins
  • Virus assembly may take place at Golgi complex or plasma membranes
27
Q

Rubella Clinical Disease

A
  • Virus enters through inhalation
  • Multiplies in upper respiratory tract
  • Spreads, regional lymph nodes
  • Viremia develops
  • Symptoms appear 14–21 (average 16 days) days post infection
28
Q

Rubella Incubation

A

•Symptoms appear 14–21 (average 16 days) days post infection

29
Q

Rubella Rash

A
  • Mild fever with rash
  • Rash first appears on head, neck and trunk
  • Rash may be mild or even inapparent
  • Symptoms persist 1– 3 days
  • Contagious from 7 days before to 7 days after the onset of rash
30
Q

Rubella Clinical Disease

A
  • Immunity (generally) life–long
  • Mainly seen in the winter-spring season
  • Maternal infection
  • Placental infection
  • Invasion of fetus
  • Chronic fetal infection
  • All organs are (may be) infected
31
Q

Clinical Manifestations of Congenital Rubella

A
  • Cardiac defects
  • Ocular defects (cataracts)
  • Hearing loss
  • Liver and/or spleen enlargement
  • Thrombocytopenia
  • Failure to thrive (after birth)
  • Low birth weight
  • Mental retardation
  • Mortality during first year of life
  • Defects vary from very subtle to very severe
32
Q

Rubella Diagnosis

A

•isolate virus, hemagglutination inhibition (most common)

33
Q

Rubella Prevention

A

•live attenuated vaccine after 1st year of life, vaccine not given to pregnant females or immuno-compromised patients

34
Q

Rubella Treatment

A

•supportive

35
Q

Erythema infectiosum

A
  • B19 of the Parvovirus genus of the Parvoviridae family
  • A moderately benign contagious epidemic disease in children
  • icosohedral ss DNA
36
Q

Erythema infectiosum Structure and Replication

A
  • Small (18–26 nm), icosahedral single– stranded DNA virus
  • Replicates in the nucleus of dividing cells
  • Virus assembly takes place in the nucleus
  • Virus released by cell disruption
37
Q

Erythema infectiosum Clinical Diseases

A
  • Fifth disease
  • Mild fever, headache, rash
  • Rash first appears on face (slapped face) (lace–like) rash may persist 1– 2 weeks, may recur, children and young adults
38
Q

Erythema infectiosum Diagnosis

A

•Clinical picture

39
Q

Erythema infectiosum Treatment

A

•supportive

40
Q

Roseola Infantum

A
  • Rose colored rash
  • Agent (?) human herpes virus type 6, adenovirus, coxsackieviruses, echoviruses
  • Common disease in infants and children ages 6 months to 4 years
  • Clinical diseases
  • Abrupt onset of fever
  • Brief convulsions
  • After 3–5 days fever goes down followed in few hours by faint, transient rash
  • Roset on face and body (Echo 19), Finger (Hand and Mouth-Coxsackie virus A)
41
Q

Other Causes of Rubella like Rash

A
  • Disease caused by numerous other agents can mimic rubella clinically.
  • These agents are:
  • 17 Echoviruses
  • 9 Coxsackieviruses
  • Several adenoviral serotypes
  • Arboviruses
  • Epstein-Barr virus (EBV)

I & I Part II (25 decks)

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