TORCH infection "german measles" - fever, LAD, arthralgia - maculopapular rash Pregnant contraction of virus --> congenital rubella syndrome - cardiac defects: PDA, pulmonic stenosis - cataracts - deafness

RNA Viruses Flashcards by Daniel Coquyt

Reoviruses

Rotavirus

Coltivirus

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Rotavirus

non enveloped, icosahedral, dsRNA

primary cause of fatal diarrhea in children

infection –> severe D/V, dehydration, electrolyte abnormalities

Winter
Daycares, playgroups

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Coltivirus

Colorado Tick fever

mountainous regions of Western US and Canada
Wood tick

acute, self limited, flu like illness

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Picornaviruses

Poliovirus
Echovirus
Coxsackievirus
Hepatitis A virus
Rhinovirus

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Enteroviruses

Poliovirus
Echovirus
Coxsackievirus

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Poliovirus

anterior horn lesions
motor neurons of pons and medulla

SalK vaccine - injected Killed

Savin vaccine - oral, live
“saben alive”

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Echovirus

infection –> aseptic meningitis, myocarditis, URIs

Summer out breaks

Dx: PCR of CSF

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Coxsackievirus

aseptic meningitis
myocarditis and pericarditis

vesicular papular lesions of palms and soles

herpangina
hand, foot, mouth dz

febrile pharyngitis

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Hepatitis A virus

fecal-oral transmission

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Rhinovirus

“common cold”

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Caliciviruses

Norovirus

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Norovirus

viral gastroenteritis –> V/D
diarrheal outbreaks on cruise ships and nursing homes

point source outbreaks

fecal-oral route

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Togaviruses

Rubella

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Rubella

TORCH infection

“german measles”

fever, LAD, arthralgia
maculopapular rash

Pregnant contraction of virus –> congenital rubella syndrome

cardiac defects: PDA, pulmonic stenosis
cataracts
deafness

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Coronavirus

“common cold”
SARS
MERS

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Retroviruses

enveloped RNA virus
HIV
Human T cell Leukemia Virus (HTLV)

use reverse transcriptase

Flaviviruses

Yellow Fever
Dengue fever
West Nile virus
St. Louis Encephalitis
Hep C virus

Yellow fever

50% fatal
Aedes mosquito
Subsaharan Africa, South America

high fever
hemorrhagic dz:
-hematemetis
-epistaxis
-gum bleeding
-petechia
-purpura
-coffee ground emesis - black
jaundice

Dengue fever

Most prevalent mosquito-borne viral dz worldwide
over 50M annual infections

severity mild to life-threatening

Classic dengue fever: “break bone fever” - muscle/joint pain, HA, retro-orbital pain

Hemorrhagic fever: developed by less than 20% of dengue pos - life threatening

Tourniquet test:
WHO field test for hemorrhagic fever
BP inflated to point between SBP and DBP for 5 min
If excess petechiae = increased capillary wall fragility and thrombocytopenia

West Nile virus (WNV)

Birds reservoir (amplifying host), mosquitos vectors - humans, horses, dogs incidental hosts

Usual sx: HA, malaise, back pain, myalgia, anorexia for 3-6 days

Severe sx in 1/150: meningitis +/- encephalitis including muscle weakness and flaccid paralysis (via anterior horn involvement), alterations in consciousness, possible death

Dx: serology for IgM anti-WNV Abs - serum or CSF

Tx: supportive

RNA virus encephalitis

Arboviruses - vector carried

St. Louis encephalitis virus
Eastern equine encephalitis virus
Western equine encephalitis virus
California encephalitis virus

Orthomyxovirus

enveloped, ssRNA
Hemagglutinin promotes viral attachment to host cell
Neuramindase helps release progeny virians

Influenza virus

Complications of influenza virus

viral pneumonia
secondary bacterial infections
-S. pneumo, S. aureus
–> death

Influenza virus vaccines

Trivalent vaccine: 2A, 1 B
Quadrivalent vaccine: 2A, 2B

Vaccine over 6 mo

Intranasal - live attenuated, 2-49 yo, healthy, nonpregnant

Avian influenza

H5N1 - 60% mortality spreads only from bird to human, fears of human to human spread Sx: URI, Diarrhea, fever, pancytopenia, elevated ALT, AST Dx: reverse transcriptase PCR or viral cx Tx: oseltamivir (tamiflu)

Swine flu

H1N1 Derived from 2 swine flu, 1 human, and 1 avian strain Sx: typical flu + GI sx Tx: oseltamivir or zanamivir to high risk or severely ill pts

Paramyxoviruses

``` parainfluenza virus respiratory syncytial virus rubeola virus mumps virus rabies virus ```

Parainfluenza virus

Croup laryngotracheobronchitis 6 mo - 3 yrs - leading cause of hospitalization in children younger than 4 yrs Sx: "barking seal" cough, respiratory distress - mimic asthma, inspiratory stridor Clinical dx CXR - "steeple sign" - subglottic narrowing Tx: cool mist humidifier (no proven benefit), racemic epinephrine, one dose dexamethasone, supportive, O2 as needed

Respiratory syncytial virus (RSV) bronchiolitis

enveloped virus F protein (fusion protein) -infected cells bind to uninfected cells --> syncitia of cells Primary pneumonia in hospitalized kids Bronchiolitis +/- pneumonia - young kids Winter - same as flu season Sx: characteristic brassy cough, wheezing, respiratory distress (mimic asthma) Passive immunization w/ palivizumab (monoclonal RSV immunoglobin) monthly during winter months in premies or infants w/ chronic lung dz Tx: supportive

Rubeola virus

Measles Enveloped, highly contagious head cold - coryza (runny nose), cough, conjunctivitis Koplik's spots - blue-grey speck surrounded by base of red on buccal mucosa --> widespread maculopapular rash begins on head, works way down body ``` Complications: Fetal loss premature delivery encephalitis - subacute sclerosis pan encephalitis (SSPE) -progressive --> death ``` Giant cell pneumonia - immunocompromised host

Mumps virus

enveloped parotitis - 1 or both orchitis --> sterility meningitis

Rabies virus

enveloped RNA infection after exposure to infected animal - bite virus travels through peripheral nerves to CNS negri bodies - eosinophilic cytoplasmic inclusions w/ viral nucleocapsids Bullet shaped caspid "Old Yeller took a bullet" Sx less than 1 mo up to 1 yr after exposure -fever, malaise, N/V -strange behavior, hallucinations hydrophobia coma --> death Rabies vaccine post exposure tx

Hanta virus

hemorrhagic fever pulmonary syndrome: fever, progressive pulmonary edema --> respiratory failure aerosolized mouse urine - deer mouse

Ebola virus

Prevention key Infected blood or fluids contact and droplet isolation 10^9/mL fluid 2-21 days sx 1-2 weeks Fever, HA, myalgia - -> V/D - fluid loss, electrolyte imbalances - -> multi organ failure, shock, death Tx: supportive

Marburg virus

hemorrhagic fever