Enteroviruses

Question 1

Viral meningitis is most common in

Answer 1

Summer

Question 2

What is the most common viral syndrome

Answer 2

Aseptic Meningitis

Question 3

What are the symptoms of aseptic meningitis

Answer 3

Headache
Neck stiffness
Photophobia
Vomiting

Question 4

Encephalitis is a disease of the grey or white matter?

Answer 4

Grey matter

Question 5

What are symptoms of encephalitis ( different to aseptic meningitis) ?

Answer 5

Focal neurological signs
fever

drowsiness
confusion
convulsions

Question 6

Causes of encephalitis

Answer 6

HSV1
Enteroviruses
Rabies
Arboviruses

Question 7

Polioviruses target x and cause Y

Answer 7

Directly infect motor neurone in the spinal cord (anterior horn -> LMN weakness) and cause -> Acute flaccid paralysis

Question 8

CSF results in Viral meningitis

Answer 8

• normal glucose
• normal protein levels
• elevated WCC milder than bacterial

Question 9

List the 4 groups of Enteroviruses

Answer 9

puppies can excite nerves

1. Polioviruses
2. Coxsackie Viruses
3. Echovirus
4. Numbered enteroviruses

Question 10

Polio and echoviruses are both
…..
family …
description

Answer 10

Enteroviruses
Family picornaviridae
Small, enveloped, ssRNA viruses
- spherical, symmetrical with external capsized composed of 4 viral proteins

Question 11

What environment are enteroviruses suited to and why?

Answer 11

GIT - they are adapted to replicate in an acidic environment

Question 12

When do enteroviruses peak?

Answer 12

Summer/ Autumn

Question 13

When does coxsackie peak?

Answer 13

Summer/ Autumn

Question 14

When does echovirus peak?

Answer 14

Summer/ Autumn

Question 15

How are enteroviruses transmitted?

Answer 15

Faecal oral route

Question 16

Who is most commonly effected by enteroviruses?

Answer 16

Children

Question 17

What lab tests should be done for diagnosing an enterovirus?

Answer 17

Blood sample - if negative, does not rule out infection
Check stool
Check CSF if meningitis suspected

Question 18

Which polio vaccine is now used and why?

Answer 18

IPV instead of Oral polio vaccine aka Sabin vaccine
because the Sabin vaccine was a live attenuated vaccine that caused an immune reaction.
Sabin vaccine produces IgA in the gut

Question 19

When is a blood sample useful for diagnosis?

Answer 19

In neonates

90days

Question 20

Where does replication of rhinovirus occur?

Answer 20

Epithelial cells in the resp tract at pH of 7

Question 21

Bacteria, viruses, fungi or parasites are most common cause of meningitis

Answer 21

Viruses

Question 22

Viral causes of acute flaccid paralysis

Answer 22

Polio 1,2,3

Enteroviruses

Question 23

How do most enteroviruses manifest in the host

Answer 23

Asymptomatic

Question 24

Difference between Enteroviruses and rhinoviruses?

Answer 24

EV are acid stable pH2

Question 25

How long are enteroviruses shed for in the host?

Answer 25

1-3 weeks in URT | up to 8 weeks in faeces

Question 26

What proportion of enteroviruses reach the RES and then cause major viraemia?

Answer 26

4-8% get to RES | 1-2% cause major viraemia

Question 27

Where do polioviruses replicate?

Answer 27

In gut associated lymphoid tissues

Question 28

Polio targets the anterior horn of grey matter in spinal cord, T or F?

Answer 28

True

Question 29

What proportion of polio infection results in paralysis?

Answer 29

Less than 1%

Question 30

Which polio vaccine is associated with causing polio?

Answer 30

Oral polio virus ( live attenuated )

Question 31

What is the immune response to the inactivated polio vaccine?

Answer 31

IgG in blood

Question 32

What vaccine is available for enteroviruses?

Answer 32

No vaccine

Question 33

Use of Pleconaril?

Answer 33

Used against rhinoviruses and enteroviruses in vitro

Question 34

What type of antivirals are tried for enteroviruses?

Answer 34

Capsid inhibitors - pocapavir - pleconaril

Question 35

Which usually has a better outcome, viral or bacterial meningitis?

Answer 35

Viral -