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Flashcards in Arboviruses Deck (22):
1

Arboviruses are

a group of viruses that are transmitted by ARTHROPOD VECTORS, and are RNA VIRUSES

2

All of the VHF virsues are

RNA viruses

3

Arbovirsues can produce what four syndromes? HEFS

1. Systemic febrile illness (Chikungunya, O'nyong-nyong, Ross River, dengue)
2. Fever with arthritis (chikungunya, Ross River, O'nyong-nyong)
3. Encephalitis (Jap, West Nile virus, Murray Valley, Eastern Equine, Western equine)
4. Hemorrhagic Fever (Yellow, Dengue, Rift Valley Fever, chikungunya)

4

The mosquito uses its ______ for feeding, and much of the virus would be concentrated in the _______

proboscis; salivary gland

5

64 year old white guy presents in August with fever, headache, mental status changes and neck stiffness. Patient didn't travel outside of NY state, and lives near Cicero swamp. CBC done shows leukopenia. Lumbar puncture shows WBC is high with lymphophilila, high protein, and low glucose. What are you considering?

Eastern equine encephalitis (would have inflammation and edema in the thalamus)

6

For EEE, list the family, the genus, and the four types of viruses in this genus.

Family: togaviridae;
Genus: alphavirus
Type: positive ssRNA
alphavirus contains: EEE, WEE, VEE, Everglades

7

Where are the four alpha virus types endemic? Clinical manifestations? List prob of developing encephalitis and mortality for three of them

EEE: Eastern USA;
WEE: Western USA;
VEE: South and North America;
can vary from inapparent to influenza-like illness to syndrome of encephalitis; highest for EEE and lowest for VEE;
5% WEE, 35% VEE, 50% EEE

8

64 year old white guy presents in March with fever, headache, mental status changes, and neck stiffness. He had gone to Thailand 2 weeks before illness and also lives near Cicero swamp. Lab values were like the same in that other 64 year old dude. What does this guy have and what other lab test would be of interest?

Japanese encephalitis; look at the MRI for zat inflammation and edema

9

For JE, list family, virus type, and where you could find the virus

Family: flaviviridiae
Type: positive ssRNA
Location: think Asia!!!

10

For JEV, list the vector, timing of infection, and hosts, both natural and accidental

Vector: culex tritaeniohynchus (culex mosquitos);
Timing: feeds at night and seen during rainy season;
Natural host: pig (can amplify the titer) and migrating birds/domestic fowl;
accidental: humans and horses

11

Where is JEV increasing?

Nepal and India

12

List the spectrum of the disease for JE and what's the prognosis?

Spectrum: febrile headache can progress to aseptic meningitis and lastly ENCEPHALITIS; POOR!!!

13

Is there a vaccine for JE?

YES!! can give two doses 28 days apart (IXIARO)

14

For yellow fever, what are three ways you can react to the vaccine?

1. Immediate hypersens or anaphylactic reactions
2. YF vaccine-associated neurologic disease
3. YF vaccine-associated viscerotropic disease (begins 3-5 days after vaccination)

15

For yellow fever, list the family and genus, and how did it even get into the US?

Family: flaviviridiae;
genus: flavivirus;
West African lineage that came to Caribbean via slave trade and later to US!!!

16

Host for yellow fever? What is the vector?? Big clinical features for yellow fever?

Non-human primate host (e.g. Africa and South America);
Aedes!!
Hemorrhagic phase (coffee-ground hematemesis, melena, metorrhagia, petechiae, ecchymoses) as well as volume depletion, renal failure!! Preceded by mild nonspecific febrile illness

17

56 year old woman comes to hospital with a week of fever, headache, myalgia , and maculopapular rash. Travel history includes Key West, and she has petechiae on her chest wall, arms, and soles of feet. Labs show hemoconcentration, leukopenia, and low platelets. What diagnosis do you suspect and what can make the diagnosis definitive?

Dengue fever, with IV fluids

18

For dengue, list genus, family, vector, and the serotypes. What is significant about there being these serotypes?

Genus: flavivirus
family: flaviviridae;
vector: aedes!!
DEN-1, -2, -3, -4 (infection with one serotype protects you against one, but still vulnerable to the other three; upon SECOND INFECTION, more likely to get hemorrhagic disease)

19

For dengue, what does the vector prefer to feed on?

Aedes prefers to feed on humans

20

Dengue is going ______, and what country is having more of these cases?

global; THAILAND!!!

21

Clinical manifestations of dengue? What is the hallmark for the extreme case?

Can go from febrile illness to severe hemorrhagic fever; you can see petechiae (like a kid with a blood pressure cuff, gastric bleeding, melana);
PLASMA LEAKAGE!!

22

What is the most common arbovirus?

Dengue!!!