Infectious disease Flashcards
(125 cards)
suspected case
- epidemiological exposure
- 2+ sx
probable case
- relevant epidemiological exposure
- no disease sx
- positive IgM
confirmed case
- viral RNA or antigen detected
- IgM antibody
- “tested positive for virus”
what causes zika
- flavivirus
- single strand RNA virus
how is zika transmitted
- mosquitoes
- aedes aegypti and aedes albopictus strands
- day and twilight feeders
- breed in standing water
- can be transmitted sexually, maternal-fetal
- less frequently transmitted through blood transfusions, organ transplant, lab exposure
where did zika originate
uganda in rheusus monkeys
where are the more recent zika outbreaks
- yap island- 2007
- french polyesia- 2013-14
- chile easter island - 2014
- brazil- 2015
- current- americas, caribbean, pacific islands, sub-saharan africa, asia
- pregnant women/ attempting avoid travel below 6500 feet
- cases in US related to travel
what fluids is zika detected in
- blood
- semen
- saliva
- female GU secretions
- amniotic fluid
- breast milk
clinical manifestations of zika
- only in 20% of pts
- mild in those with sx
- low grade fever
- pruritic rash
- arthralgia - small joints
- conjunctivitis
- microcephaly in pregnant females
- dx if 2+ sx
- immunity after infection
what is the incubation period for zika
- 2-14 days
- resolves in 2-7 days
less common sx of zika
- HA
- retro-orbital pain
- myalgia
- n/d
- abd pain
- mucus membrane ulceration
complications of zika
- fetal loss
- microcephaly
- guillian barre syndrome
- brain ischemia
- myelitis
- meningoencephalitis
diagnosis of zika
- serum virus if sx onset < 14 days
- serum IgM if sx onset > 14 days
management of zika
- supportive- rest, hydrate, APAP
- NAIDS avoided until r/o dengue
- ASA avoided in kids- Reye
prevention of zika
- no vaccine
- limit travel to certain areas
- remove standing water
- mosquito repellent
- long sleeves/pants
- environmental control
- protected intercourse
- must report zika cases to CDC
what causes chikungunya
- alphavirus
- single strand RNA
where is chikungunya found
- endemic to west africa
- asia
- europe
- islands in indian and pacific oceans
- americas
- during rainy seasons
- outbreaks have high attack rates
- all US cases d/t travel
how is chikungunya spread
- mosquitos
- aedes aegypti and aedes albopictus
- day feeder mosquitos
- vertical transmission, blood donation, and organ transplant rare causes of transmission
clinical manifestations of chikungunya
- abrupt fever (high grade) and malaise
- polyarthralgia 2-5 days after fever in smaller joints bilaterally
- pain is intense and disabling
- maculopapular rash +/- pruritis
- nonspecific lab changes
what is the incubation period of chikungunya
- 3-7 days
- acute phase lasts 7-10 days
- majority of pts show sx
complications of chikungunya
- death in pts >65 with comorbidities
- persistent debilitating and immobilizing arthritis
- resp, renal, and CV failure
- can be persistent and relapsing up to 3 years
diagnosis of chikungunya
- virus detected 1-7 days
- antibodies detected > 8 days
- IgM present after 5 days onset, persists for 3 mo
- IgG present after 2 weeks, persists for years
management of chikungunya
- supportive
- NSAIDS
- steroids, methotrexate, immune modulating agents for severe arthritis
- no vaccine
prevention of chikungunya
- minimize mosquito exposure
- repellants
- bed nets