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D&D Unit 4 > Flu, RSV, Ebola (complete) > Flashcards

Flu, RSV, Ebola (complete) Flashcards

1
Q

What is the basic structure of influenza?

A
  • RNA virus w/ a segmented genome
  • Genome: 8 pieces of ssRNA
  • Lipid envelope

Have A and B types

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2
Q

What are important proteins in influenza?

A
  • Hemagglutinin (surface)
  • Neuraminidase (surface)

Matrix protein lines inner lipid envelope

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3
Q

Describe the role influenza plays in pathogenesis

A

Causes problems in:

  • upper/lower respiratory tract
  • nasopharynx
  • trachea
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4
Q

What is the basic structure of RSV?

A
  • Paramyxoviridae family
  • ss, nonsegmented RNA virus

Have A and B types — A causes worse disease

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5
Q

What are important proteins in RSV?

A
  • F protein: fusion of viral envelope w/ host cell

- G protein: initial binding of virus to host cell

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6
Q

Describe the role RSV plays in pathogenesis

A
  • Causes severe damage to epithelium and brochiolar ciliary apparatus
  • Causes collection of fluid in bronchioles => obstruction of brochioles and alveoli — maybe collapse of emphysema of airway
  • Can constrict smooth muscle of bronchioles
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7
Q

What is the basic structure of ebola?

A
  • Enveloped, negative sense RNA
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8
Q

What are important proteins in ebola?

A
  • Glycoprotein (important for attachment/entry)

- Matrix proteins VP40 (structure, stability) and VP24 (assembly, budding)

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9
Q

Describe the role ebola plays in pathogenesis

A
  • Enters body through mucosal surfaces or cuts in skin
  • Only need a few virions for infection
  • Travels in immune cells to regional lymph nodes where it replicates and spreads throughout the body
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10
Q

Outline routes of viral entry of influenza virus

A
  • Binds to sialic acid

- Endocytosed

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11
Q

Which cells/organs are infected with influenza infection?

A
  • Upper/lower respiratory tract
  • Nasopharynx
  • Trachea
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12
Q

Describe the mechanism of infection of influenza

A
  • Binds to sialic acid
  • enters cell
  • replicates
  • releases from cell
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13
Q

Describe the clinical presentation of influenza infection

A
  • Adolescents&adults: fever, chills, myalgias, HA, cough
  • Infants/toddlers: GI probs, fever >103, anorexia, resp probs
  • Neonates: high fever, lethargy, decreased eating, mottling, apnea
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14
Q

Which cells/organs are infected with RSV infection?

A
  • Nasopharynx

- Lower respiratory tract

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15
Q

Describe the mechanism of infection of RSV

A
  • Invades conjunctiva/nasopharynx
  • Replicates in nasopharynx => then in respiratory epithelium
  • Spreads to lower resp tract by inhalation or spread
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16
Q

Describe the clinical presentation of RSV infection

A
  • Respiratory distress
  • Wheeze/rhonchi
  • Hypoxia
  • Copious secretions
  • Brochiolitis
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17
Q

Which cells/organs are infected with ebola infection?

A

Infection of vessel wall cells => severe fluid/blood loss

18
Q

Describe the mechanism of infection of ebola

A
  • Replicates in lymph nodes => very efficiently
  • Induces massive cytokine storm => destroy vessel walls and induce DIC, shock
  • Causes dysregulated immune response and extensive tissue death
19
Q

Describe the clinical presentation of ebola infection

A
  • IP: 2-21 days, usually 6-10 — not contagious until symptomatic
  • Febrile (fatigue, malaise, body aches)
  • GI probs (n/v/d, epigastric pain)
  • Shock
  • Gastro hemorrhage, secondary infections, meningoencephalitis
20
Q

Describe the transmission of influenza virus

A
  • Respiratory route (coughing/sneezing)

- Also contact w/ infectious particles on hands or inanimate objects

21
Q

Describe the effective prevention strategies for influenza

A
  • Vaccination!!!
  • Also washing hands
  • Sneeze into arm

Just wash your fucking hands!!!

22
Q

Describe the transmission of RSV

A
  • Large, droplet spread — respiratory spread
23
Q

Describe the effective prevention strategies for RSV

A

wash yo handzz

24
Q

Describe the transmission of ebola

A

Enters through mucosal surfaces or cuts in skin

25
Q

Describe the effective prevention strategies for ebola

A

Avoid body fluids of someone with ebola

26
Q

What are the different stages of vaccine development for influenza?

A

Phase 4! Got em out and using em!

27
Q

What are the different stages of vaccine development for RSV?

A
  • No vxs
  • Used to be one in the 60s but causes crazy horribleness (kids who got the vx were more likely to be hospitalized when they got the disease)
28
Q

What are the different stages of vaccine development for ebola?

A
  • 2 vaccines in phase 2/3 trials

- another vx in phase 1

29
Q

What are the differences between the types of influenza vaccines?

A

IIV:

  • 3 or 4 strains
  • Killed virus
  • IM

LAIV:

  • 4 strains
  • Live
  • Intranasal
30
Q

What are the differences in populations in terms of who can and cannot receive certain types of vaccines?

A

IIV:

  • > /=6 months
  • Yes for preggers
  • Yes for immunocompromised

LAIV:

  • 2-49 years
  • No preggers or immunocompromised
  • Slightly higher cost
31
Q

Describe antigenic drift

A
  • Point mutation in neuraminidase
  • Does NOT change subtype of the virus — just a minor change

Can result in epidemic b/c Abs that were resistant to previous flu type are now unable to prevent binding of flu to sialic acid

32
Q

Describe antigenic shift

A
  • reassortment of genome segments
  • A major change => new subtype
  • Caused by exchange in gene segments
  • May result in pandemic

Think Contagion: bat and pig genes combined => pandemic craziness

33
Q

Describe the origin of pandemic H1N1

A
  • Mexico

- Has gene segments similar to viruses found in pigs

34
Q

Describe the basic epidemiology and morbidity/mortality of H1N1

A
  • Affected primarily those under 24yo
  • Hospitalizing primarily those between 18 and 64
  • Pregnant women at crazy high risk
35
Q

Discuss the newly-emerging influenza viruses including H5N1. What is an outline of its geographic occurrence and its importance to public health?

A
  • Started in China => spread to most of Asia, and parts of ME and Africa
  • Infects whole flocks of birds (e.g. wild and domestic, chickens, geese)
  • Have to wipe out whole flocks to prevent spread — otherwise horrible public health problems

Also just imagine your whole livelihood, income, family, everything relies on a flock of chickens and then they get this flu… they have to be killed otherwise it will affect other families in the same boat. Plus it might get you sick too!

36
Q

Describe the necessary qualities in an influenza virus strain to potential cause a pandemic

A

1) Emergence of new flu virus subtype
2) Virus must infect humans => cause serious illness
3) Sustained transmission and spread (continue w/o interruption) easily among humans

37
Q

Describe the stages of a pandemic

A

Efficient and sustained human-to-human transmission

38
Q

Describe the stages leading up to a pandemic

A

1) Low risk of human cases
2) Higher risk
3) No or very limited human-to-human transmission
4) Evidence of increased transmission
5) Evidence of significant transmission
6) Efficient and sustained transmission (PANDEMIC)

39
Q

Describe the naming system of influenza A viruses

A

Virus type / geographic origin / Strain # / Year of isolation (Virus subtype)

Eg for H1N1:
A/California/7/2009(H1N1)

40
Q

Describe clinical management of ebola

A
  • No approved therapies
  • Supportive: fluid repletion (b/c of leaky vessels)
  • Dialysis, ventilation
  • Pt isolation
41
Q

Describe the treatment of ebola

A

Abs from survivors (convalescent serum) — trial stage

Drugs:

  • favipiravir => under development, trial in Guinea
  • Brincidovovir => targets DNA viruses (used in tx of US ppl)

D&D Unit 4 (18 decks)

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