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Respi tract viruses Flashcards

(43 cards)

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1
Q

Structure of influenza virus

A

Envelope
- lipoprotein
- covered w/ radially-projecting glycoprotein surface projections

Neuraminidase -> cleaves neuraminic acid receptors to allow virus release

Nucleocapsid
- type specific antigenicity -> influenza A,B,C
- RNA

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2
Q

Features of the radially-projecting glycoprotein surface projections

A

Haemagglutinin

Spikes for virus attachment to host cells -> specific for respi tract receptors

Antigenic variation

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3
Q

Clinical features of influenza

A

Incubation period -> 1-4 days

Abrupt onset of fever, myalgia, malaise, headache

Rhinorrhoea, sneezing

Sore throat, dry cough

Viral multiplication in respi epithelium w/ desquamation and ciliary damage

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4
Q

Complications of influenza virus infection

A

Pneumonia
- pri viral -> respi failure
- sec bacterial after damage of bronchial mucosa -> a lot of inflammation and excessive mucus production -> affect gaseous exchange

Myocarditis

Myositis

Reye’s syndrome

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5
Q

Common cause of sec bacterial pneumonia

A

S. pneumoniae

H. influenzae

S. aureus

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6
Q

Features of Reye’s syndrome

A

Usually associated w/ influenza B and aspirin intake in children

Cerebral oedema

Fatty degeneration -> liver

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7
Q

Lab diagnosis for influenza

A

Virus isolation

IF of antigen in respi epithelial cells

RT-PCR

Point-of-care (POC) test

Serology -> not commonly done

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8
Q

What are the various antigen structures of influenza?

A

Souluble/’s’ antigen
- same antigen shared by all influenza A viruses

Haemagglutinin
- varies from 1 strain to another
- main neutralising antigen responsible for host immunity

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9
Q

Why are there epidemics of influenza?

A

Due to antigenic variation

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10
Q

What is antigenic variation?

A

Recombination of RNA segments of 2 antigenic types simultaneously infecting same cell

Major antigenic change of both surface components

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11
Q

What is antigenic drift?

A

Spontaneous mutations leading to minor changes in haemagglutinin

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12
Q

Management of influenza virus infection

A

Differential diagnosis (flu-like illness)

Symptomatic treatment

Recognise and treat complications

Neuraminidase inhibitors -> -mivir

Polymerase inhibitors -> baloxavir

Minimise spread by respi route

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13
Q

Types of vaccination avail for influenza

A

Inactivated vaccine comprising of antigens from circulating A/H1N1, A/H3N2 and B strains
- quadrivalent -> cover B/Victoria and B/Yamagata lineages

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14
Q

Who are at risk of complications for influenza vaccine?

A

Elderly

Indivs w/ chronic cardiorespiratory conditions

Pregnant women

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15
Q

Issues w/ influenza vaccination

A

Timely preparation

Short-lived immunity -> strain of virus might have changed

Incomplete protection

Guillain-Barre syndrome

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16
Q

Features of paramyxovisruses

A

Enveloped helical RNA virus

No genetic recombination

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17
Q

Eg of pathogenic paramyxovisruses

A

Parainfluenza virus

Measles

Mumps

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18
Q

Clinical features of parainfluenza virus

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A

Infection acquired by age of 5

4 serotypes

19
Q

Disease associations w/ the various serotypes of parainfluenza virus

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A

Type 1 -> croup in infants

Type 2 -> epidemics (winter)

Type 3 -> bronchiolitis and bronchopneumonia in young infants/croup in older infants

Type 4 -> minor respi infection

20
Q

Common symptoms across the 4 serotypes of parainfluenza virus

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A

Febrile common cold
- sore throat
- cough
- hoarseness

Croup

Bronchiolitis

Bronchopneumonia

21
Q

Features of croup

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A

Acute laryngo-tracheo-bronchitis

Cough, hoarseness

Severe -> dyspnoea, stridor, cyanosis

22
Q

Lab diagnosis of parainfluenza virus infection

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A

Tissue culture

Antigenic detection -> IF

RT-PCR

Serology
- early -> S antigen
- late -> V antigen

23
Q

Treatment and control of parainfluenza virus infection

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A

Ventilatory support

Antibiotics for sec bacterial infection

Sedation and hydration

24
Q

Is there vaccine for parainfluenza virus?

25
Features of respiratory syncytial virus (RSV)
No haemagglutinin and neuraminidase Commonest cause of bronchiolitis in young children - wheezing is vry characteristic Immune-mediated and/or mechanical obstruction of narrow bronchioles by inflammatory process URTI in older children and adults due to larger bronchiole
26
Complications of RSV infection
Sec bacterial infections Otitis media Cardiac failure Apnoea
27
Lab diagnosis of RSV infection
Tissue culture Viral antigen demonstration -> IF RT-PCR Serology - 1 serotype
28
Characteristic histological feature for RSV infection
Refractile syncytium (cells fusing) formation of multinucleated giant cells
29
Treatment and control of RSV infection
Ribavirin aerosol therapy Ventilatory support Isolation of infected RSV monoclonal Ab to protect infants at risk of severe RSV disease
30
What are some things metapneumovirus associated w/?
Infants and children w/ acute respi disease Asthma in children -> acute wheezing attacks
31
Symptoms of metapneumovirus infection
Similar to RSV infections
32
Features of adenovirus
DNA virus More than 50 serotypes Infect URT, mucosa and lymphoid tissue
33
Symptoms of adenovirus infection
Pharyngoconjunctival fever -> associated w/ swimming pool URTI w/ fever Pneumonia Acute follicular conjunctivitis Keratoconjunctivitis (shipyard eye) Haemorrhagic cystitis Enteritis - mesenteric adenitis - intussusception Chronic infection of tonsils and adenoids
34
Lab diagnosis of adenovirus infection
Tissue culture PCR Serology -> IF/serotyping
35
Histological features of adenovirus infection
Swelling and clustering of infected cells w/ intra-nuclear inclusions -> bunch of grapes
36
Control of adenovirus infection
Vaccine (for certain serotypes)
37
Features of rhinovirus
More than 100 serotypes Genetic/antigenic variation Inhabit URT Causative agent of common cold May precipitate asthmatic attacks and aggravate chronic bronchitis Readily spread by close contact and respi secretions Neutralising Ab protective against same serotype -> can get common cold many times
38
Symptoms of rhinovirus infection
Rhinorrhoea Sneezing Sore throat Cough Mild fever Hoarseness Headache NOTE: essentially symptoms of common cold
39
Lab diagnosis of rhinovirus infection
Tissue culture Serotyping -> NT RT-PCR
40
Features of coronavirus
Enveloped RNA virus Crown-like projections on surface Haemagglutinate RBCs Multiple antigenic types Cause common colds
41
Is tissue culture possible for coronaviruses?
No
42
Treatment and control of coronavirus
No specific treatment No routine vaccines except for Covid-19
43
Eg of coronaviruses
SARS (severe acute respiratory syndrome) MERS (middle east respiratory syndrome)

Respi (16 decks)

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