Viral diseases (Med Micro 1) Flashcards
(185 cards)
1
Q
What is the difference between positive-sense and negative-sense viral RNA?
A
Positive-sense RNA is similar to mRNA and can be directly translated into proteins, while negative-sense RNA needs conversion before translation.
2
Q
What are the main steps in a PCR reaction?
A
The main steps are:
* Denaturation
* Annealing
* Extension
3
Q
What does ELISA quantify?
A
Antigens of interest.
4
Q
What are arboviruses?
A
A group of RNA viruses transmitted by blood-feeding arthropods like mosquitoes and ticks.
5
Q
Give examples of arboviruses.
A
- Dengue
- Zika
- West Nile
- Chikungunya
6
Q
What is flavivirus?
A
A genus of single-stranded RNA viruses within the family Flaviviridae, many of which are arboviruses.
7
Q
What is Severe Fever with Thrombocytopenia Syndrome (SFTS)?
A
An emerging tick-borne viral disease that can cause hemorrhagic fever, multiple organ failure, and death.
8
Q
How many people are living with HIV worldwide?
A
40 million.
9
Q
What percentage of people living with HIV are in Sub-Saharan Africa?
A
64%.
10
Q
What is the global management goal for HIV?
A
95 / 95 / 95 - aware, treated, virally suppressed.
11
Q
What is the first stage of HIV infection?
A
Acute HIV infection: asymptomatic/generalised lymphadenopathy/fever.
12
Q
What is Kaposi’s Sarcoma?
A
The most common AIDS-defining malignancy caused by Human Herpesvirus 8.
13
Q
What is Pneumocystitis jirovecii pneumonia (PCP)?
A
The most common AIDS-defining illness in the UK/USA, caused by a fungal infection.
14
Q
What are the components of the WHO recommended regimen for adults with HIV?
A
2 x NRTI + 1 x INSTI/NNRTI/PI.
15
Q
What is the preferred first-line treatment for HIV in the Philippines?
A
Integrase inhibitor (Dolutegravir) in the TLD regimen.
16
Q
What is the preferred first-line treatment for HIV?
A
Integrase inhibitor (Dolutegravir)
This is part of the TLD regimen.
17
Q
What was established in the Philippines to address HIV and AIDS?
A
Philippines HIV & AIDS Policy Act 2018
This act aims to improve the response to the HIV epidemic.
18
Q
What does NRTI stand for?
A
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors
19
Q
Name a well-tolerated NRTI that is also effective against Hepatitis B
A
Tenofovir (TDF)
20
Q
What are the potential long-term effects of Tenofovir (TDF)?
A
Nephrotoxicity and reduced Bone Mineral Density (BMD)
21
Q
Which newer NRTI has fewer side effects compared to Tenofovir (TDF)?
A
Tenofovir Alafenamide (TAF)
22
Q
What is the backbone drug in all regimens among NRTIs?
A
Lamivudine (3TC) and Emtricitabine (FTC)
23
Q
Which NRTI is recommended for pediatrics and in cases where other NRTIs are ineffective in adults?
A
Abacavir (ABC)
24
Q
What type of reaction is associated with Abacavir (ABC)?
A
Febrile hypersensitivity reaction
25
What does INSTI stand for?
Integrase Strand Transfer Inhibitors
26
What is a recently developed INSTI that is well tolerated and low cost?
Dolutegravir (DTG)
27
List some side effects of Dolutegravir (DTG).
* Weight gain
* Sleep disturbances
* Dizziness
* Paraesthesias
* Hyperglycaemia
28
What is Cabotegravir?
A long-acting injection integrase strand transfer inhibitor
29
What does NNRTI stand for?
Non-nucleoside Reverse Transcriptase Inhibitors
30
Which NNRTI was the first line treatment before the arrival of Dolutegravir (DTG)?
Efavirenz (EFV)
31
What are some significant side effects of Efavirenz (EFV)?
* Gynaecomastia
* Neuropsychiatric disorders
32
Name three potent Protease Inhibitors (PIs).
* Darunavir
* Atazanavir
* Lopinavir
33
What revolutionized antiretroviral therapy (ART) in the mid-1990s?
HAART (Highly Active Antiretroviral Therapy)
34
List some side effects associated with Protease Inhibitors.
* Jaundice
* Lipodystrophy syndrome
35
Which opportunistic infections are characteristic of Stage 2 HIV?
recurrent URTIs, papular pruritic eruptions, herpes zoster, seborrhoeic dermatitis, fungal nail infections
## Footnote
Papular pruritic eruptions are a sign of immune dysregulation and prolonged allergic reaction to insect bites.
36
What conditions are associated with Stage 3 HIV?
Pulmonary TB, oral hairy leukoplakia, severe weight loss (>10%), oral candidiasis
## Footnote
Tuberculosis is a common opportunistic infection in advanced HIV.
37
What conditions are associated with Stage 4 advanced immunosuppression in HIV?
Miliary TB, Kaposi sarcoma, oesophageal candidiasis
## Footnote
Advanced immunosuppression leads to increased risk of severe infections and cancers.
38
What is a recombinant vaccine?
Recombinant protein vaccine is composed of protein antigens which are biologically synthesised in animal cells or insect cells.
Considered safe and stable as they do not contain live pathogen.
39
What is Japanese encephalitis?
A mosquito-borne viral infection primarily affecting Asia and the Western Pacific
## Footnote
Caused by the Japanese encephalitis virus, a flavivirus.
40
What mosquitoes are primarily responsible for the transmission of Japanese encephalitis?
Culex species mosquitoes, particularly Culex tritaeniorhynchus
## Footnote
High risk in rural areas.
41
What are the reservoirs for Japanese encephalitis virus?
Pigs and birds
42
What is the gold standard for diagnosing Japanese encephalitis?
IgM in CSF
## Footnote
Takes 7 days to rise; frequently associated with thalamic lesions.
43
What are common symptoms of Japanese encephalitis?
Majority asymptomatic; fever, headache, severe encephalitis (CFR 30%); neurological or psychiatric sequelae.
44
Is there a vaccine for Japanese encephalitis?
Yes, vaccines are effective.
45
What virus causes West Nile encephalitis?
West Nile virus
46
How is West Nile encephalitis transmitted?
By Culex mosquitoes
47
What distinguishes West Nile encephalitis from Japanese encephalitis?
Geographic location; areas of JEV and WNE do not overlap.
48
Is there a vaccine for West Nile encephalitis?
No, currently under development.
49
What are the primary modes of transmission for Zika virus?
Aedes mosquitoes, sexual contact, mother to child, blood transfusions
50
What condition can Zika virus cause when transmitted from mother to child?
Congenital Zika Syndrome: microcephaly
51
What are common symptoms of Zika virus?
Asymptomatic; mild symptoms include fever, rash, joint pain, conjunctivitis.
52
How long do Zika virus symptoms typically last?
A few days to a week
53
Is there a vaccine for Zika virus?
Under development.
54
Where is yellow fever primarily found?
Africa and South America
55
What is the primary vector for yellow fever transmission?
Aedes aegypti mosquitoes
56
What are common symptoms of yellow fever?
Fever, chills, headache, back pain, body aches, nausea, vomiting
57
What severe symptoms can yellow fever lead to?
Jaundice, bleeding, organ failure
58
What is the primary method for diagnosing yellow fever?
PCR and serology
59
Is there a vaccine for yellow fever?
Yes, very effective.
60
What type of virus causes chikungunya?
Alphavirus
61
What are the primary vectors for chikungunya transmission?
Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus
62
What are common symptoms of chikungunya?
Fever, severe joint pain, muscle pain, red eyes; chronic joint pain in some.
63
Is there a specific antiviral treatment or vaccine for chikungunya?
No specific antiviral or vaccine.
64
What is the cause of dengue fever?
Dengue virus (DENV)
65
How is dengue transmitted?
Bites of infected Aedes mosquitoes
66
What are the four distinct antigenic serotypes of dengue?
DENV-1, DENV-2, DENV-3, DENV-4
67
What are common symptoms of dengue fever?
Sudden onset of high fever, headache, muscle and joint pain, acute macular rash.
68
What is a characteristic rash associated with dengue fever?
Erythematous rash with white patches - ‘islands of white in a sea of red’.
69
What severe condition can develop from dengue fever?
Dengue hemorrhagic fever
70
What is the primary method for diagnosing dengue fever?
Rapid diagnostic test and clinical picture
71
What treatment is recommended for dengue fever?
Supportive treatment, fluid resuscitation
72
What innovative method is being used to prevent dengue transmission?
Wolbachia bacteria introduced to mosquito population
73
Who can receive the Dengvaxia vaccine?
Previously infected patients.
74
Name some warning signs of Dengue
Abdominal pain
Persistent vomiting
Fluid overload
Mucosal bleeding
Lethargy
Liver enlargement
Increased haemocrit
75
What is paradoxical IRIS?
Worsening of a previously known infection
## Footnote
Seen in 10% of TB HIV patients.
76
What is unmasking IRIS?
Appearance of a previously undiagnosed infection
## Footnote
Usually involves TB; treatment should start as soon as possible.
77
When does IRIS typically occur?
Within the first few months after starting ART, with a median of 33 days post ART initiation.
78
Why does IRIS happen?
The immune system recovers and mounts a strong inflammatory response against antigens from past or current infections.
79
What are the potential complications of IRIS?
Increased morbidity and mortality, especially in patients with advanced HIV infection.
80
What are the common pathogens involved in IRIS?
Mycobacteria, herpesviruses, cytomegalovirus (CMV), PML, cryptococcal meningitis.
81
What is the treatment for IRIS?
No specific treatment; management focuses on treating the underlying infection and may include corticosteroids in severe cases.
82
What should be continued during the management of IRIS?
ART should always continue.
83
What are the risk factors for IRIS?
* Lower pre-ART CD4 T-cell counts
* High HIV viral load at ART initiation
* Low CD4:CD8 ratio at ART initiation
* Rapid fall in viral load on ART initiation
* Low baseline body mass index
* Male
* Younger age
* Short interval between OI treatment
84
What is BSL?
Biosafety level - classified according to pathogenicity, existence of treatments etc; levels 1-4.
## Footnote
BSL stands for Biosafety Level, which is a set of biocontainment precautions required to isolate dangerous biological agents in an enclosed laboratory facility.
85
Why do we need BSL?
To protect and prevent the infection of the scientist/worker from the specimens or materials; to protect the environment from the spread of the pathogens.
## Footnote
BSL is crucial for ensuring safety in laboratories that work with infectious agents.
86
What are some of the components of BSL-4 training?
Suit check; chemical shower training; training inside the BSL-4 lab.
## Footnote
BSL-4 is the highest level of biosafety and involves rigorous training and protocols to handle the most dangerous pathogens.
87
What is the virus family of the Marburg Virus?
Filoviridae
## Footnote
The Marburg Virus is part of the Filoviridae family, which includes other viruses like the Ebola Virus.
88
What is the primary reservoir for the Marburg Virus?
Fruit bats (Rousettus aegyptiacus)
## Footnote
The Marburg Virus is primarily associated with fruit bats as its natural reservoir.
89
What is the geographic range of the Marburg Virus?
Central & East Africa
## Footnote
The Marburg Virus is predominantly found in Central and East Africa.
90
How is the Marburg Virus transmitted?
Zoonotic (bat exposure), human-to-human via blood, fluids
## Footnote
Transmission can occur through contact with infected bats or bodily fluids from infected individuals.
91
What is the incubation period for the Marburg Virus?
2–21 days
## Footnote
The incubation period can vary widely, ranging from 2 to 21 days.
92
What are common symptoms of Marburg Virus infection?
Fever, severe headache, hemorrhage, multi-organ failure
## Footnote
Symptoms can escalate to severe conditions like multi-organ failure.
93
What is the case fatality rate for the Marburg Virus?
24–88% (outbreak-dependent)
## Footnote
The fatality rate can vary significantly depending on the outbreak circumstances.
94
What are the diagnostic methods for Marburg Virus?
PCR, ELISA, viral culture
## Footnote
These methods are commonly employed to confirm Marburg Virus infections.
95
What treatment is available for Marburg Virus infection?
Supportive only
## Footnote
There is no specific antiviral treatment; care is supportive.
96
Is there a vaccine available for the Marburg Virus?
None (candidates in development)
## Footnote
Currently, there is no approved vaccine, although candidates are under development.
97
What are the prevention strategies for Marburg Virus?
PPE, infection control, avoid bats
## Footnote
Preventive measures include the use of personal protective equipment (PPE) and avoiding contact with bats.
98
What is the virus family of the Ebola Virus?
Filoviridae
## Footnote
The Ebola Virus is also part of the Filoviridae family, similar to the Marburg Virus.
99
What is the primary reservoir for the Ebola Virus?
Fruit bats (likely Hypsignathus, Epomops)
## Footnote
Different species of fruit bats are likely involved in the transmission of the Ebola Virus.
100
What is the geographic range of the Ebola Virus?
Central, West, and East Africa
## Footnote
The Ebola Virus is found across multiple regions in Africa.
101
How is the Ebola Virus transmitted?
Zoonotic (bat exposure), human-to-human via blood, fluids
## Footnote
Similar to the Marburg Virus, Ebola can be transmitted through contact with infected fluids.
102
What is the incubation period for the Ebola Virus?
2–21 days
## Footnote
The incubation period for Ebola is also variable, ranging from 2 to 21 days.
103
What are common symptoms of Ebola Virus infection?
Sudden fever, fatigue, hemorrhage, vomiting, diarrhea
## Footnote
Symptoms can quickly progress to severe conditions, including hemorrhagic manifestations.
104
What is the case fatality rate for the Ebola Virus?
25–90% (strain- and care-dependent)
## Footnote
The fatality rate can vary based on the specific strain and the quality of medical care received.
105
What are the diagnostic methods for Ebola Virus?
PCR, ELISA, viral culture
## Footnote
Diagnostic techniques for Ebola are similar to those used for Marburg.
106
What treatments are available for Ebola Virus infection?
Supportive; monoclonal antibodies (e.g. Inmazeb, Ebanga)
## Footnote
Treatment involves supportive care and may include monoclonal antibody therapies.
107
Is there a vaccine available for the Ebola Virus?
Yes (e.g. Ervebo for Zaire strain)
## Footnote
The Ebola Virus has an approved vaccine for specific strains, enhancing prevention efforts.
108
What are the prevention strategies for Ebola Virus?
PPE, safe burial, avoid bushmeat
## Footnote
Prevention includes the use of PPE, safe burial practices, and avoiding consumption of bushmeat.
109
What is the virus family of the Lassa Virus?
Arenaviridae
## Footnote
The Lassa Virus belongs to a different family of viruses known as Arenaviridae.
110
What is the primary reservoir for the Lassa Virus?
Multimammate rat (Mastomys natalensis)
## Footnote
The Lassa Virus is primarily carried by the multimammate rat.
111
What is the geographic range of the Lassa Virus?
West Africa
## Footnote
The Lassa Virus is mainly found in West Africa.
112
How is the Lassa Virus transmitted?
Zoonotic (rodent urine/feces), human-to-human, nosocomial
## Footnote
Transmission can occur through contact with rodent excreta and human exposure.
113
What is the incubation period for the Lassa Virus?
6–21 days
## Footnote
The incubation period for Lassa Virus is typically between 6 and 21 days.
114
What are common symptoms of Lassa Virus infection?
Fever, sore throat, chest pain, vomiting, hearing loss
## Footnote
Symptoms can vary, with some cases resulting in hearing loss.
115
What is the case fatality rate for the Lassa Virus?
~1% overall; up to 15–20% hospitalized
## Footnote
The overall fatality rate is low, but it can be higher in hospitalized patients.
116
What are the diagnostic methods for Lassa Virus?
PCR, ELISA, viral isolation
## Footnote
Diagnostic approaches for Lassa Virus are similar to those for Marburg and Ebola.
117
What treatments are available for Lassa Virus infection?
Ribavirin (if early), supportive care
## Footnote
Early administration of Ribavirin can be effective in treating Lassa Virus.
118
Is there a vaccine available for the Lassa Virus?
None (candidates in development)
## Footnote
There are no approved vaccines for Lassa Virus, though candidates are being developed.
119
What are the prevention strategies for Lassa Virus?
Rodent control, food hygiene, PPE
## Footnote
Preventive measures focus on controlling rodent populations and maintaining food hygiene.
120
What is HTLV-1?
A human retrovirus that infects T lymphocytes
121
What family does HTLV-1 belong to?
The same family as HIV
122
List the primary modes of transmission for HTLV-1
* Mother to child (especially via breastfeeding)
* Sexual contact
* Blood transfusion
* Needle sharing
123
What is adult T-cell Leukemia/Lymphoma (ATLL)?
A rare but aggressive cancer of T cells
124
What does HAM/TSP stand for?
HTLV-1-associated Myelopathy / Tropical Spastic Paraparesis
125
Describe HTLV-1-associated Myelopathy / Tropical Spastic Paraparesis (HAM/TSP)
A chronic, progressive disease of the spinal cord
126
Name other diseases associated with HTLV-1
* Uveitis
* Infective dermatitis
* Pulmonary disease
127
Identify endemic regions for HTLV-1
* Japan
* The Caribbean
* Central/South America
* West Africa
128
How is HTLV-1 diagnosed?
Serological testing (ELISA, Western blot) to detect antibodies; PCR to confirm and quantify viral DNA
129
What is the current treatment for HTLV-1?
No cure; treatment is supportive and disease-specific (e.g., chemotherapy for ATLL)
130
True or False: HTLV-1 has a cure.
False
131
Fill in the blank: HTLV-1 is primarily transmitted from mother to child via _______.
[breastfeeding]
132
What is the causative agent of Polio?
Poliovirus (an enterovirus, single strand RNA virus)
## Footnote
Poliovirus has 3 serotypes: Type 1 (most virulent), Type 2 (eradicated), Type 3 (eradicated)
133
How is Polio primarily transmitted?
Fecal-oral route (main), occasionally via oral-oral route (saliva)
## Footnote
This mode of transmission highlights the importance of sanitation.
134
Which regions are endemic for Polio as of 2024?
Afghanistan and Pakistan
## Footnote
These countries report the majority of cases.
135
What is the age group most affected by Polio?
Children <5 years
## Footnote
The disease primarily targets young children.
136
What are the symptoms of abortive poliomyelitis?
Fever, sore throat, malaise, GI upset
## Footnote
This is considered a minor illness.
137
What characterizes non-paralytic polio?
Aseptic meningitis (neck stiffness, headache)
## Footnote
Symptoms can mimic viral meningitis.
138
What is the hallmark symptom of paralytic polio?
Acute flaccid paralysis, usually asymmetric, no sensory loss
## Footnote
This is the most severe manifestation of the disease.
139
What is bulbar polio?
Respiratory failure due to cranial nerve involvement
## Footnote
This form can lead to severe respiratory complications.
140
How is Polio diagnosed?
Clinical suspicion in endemic/travel areas; stool or throat swab PCR for poliovirus; CSF: normal glucose, mildly raised protein, lymphocytic pleocytosis
## Footnote
Diagnosis often relies on symptoms and laboratory tests.
141
What is the management strategy for Polio?
Supportive only (no antiviral treatment); ventilatory support if respiratory muscles affected; rehabilitation for long-term disability
## Footnote
There is no specific antiviral treatment for Polio.
142
What are the two types of Polio vaccines?
OPV (oral polio vaccine), IPV (inactivated polio vaccine)
## Footnote
Each vaccine has different safety profiles and uses.
143
What is the primary concern with OPV?
Risk of Vaccine-associated paralytic poliomyelitis (VAPP)
## Footnote
OPV is a live attenuated vaccine which can cause paralysis in rare cases.
144
What are Vaccine-Derived Polioviruses (VDPVs)?
Strains of poliovirus that originally come from the live attenuated virus used in OPV
## Footnote
VDPVs can mutate and revert to a neurovirulent form.
145
What is mOPV2?
Monovalent Oral Polio Vaccine Type 2
## Footnote
It targets only one strain of poliovirus — type 2.
146
What is nOPV2?
Novel Oral Polio Vaccine Type 2
## Footnote
A genetically stabilised version of OPV2 that reduces the risk of reversion.
147
What virus causes Rabies?
Rhabdovirus
## Footnote
Rhabdovirus attacks the central nervous system.
148
How is Rabies transmitted?
Saliva of infected animals, most commonly through bites or scratches
## Footnote
Contact with infected saliva in open wounds can also transmit the virus.
149
What are the symptoms of Rabies?
Fever, headache, fatigue, anxiety, irritability, seizures, hallucinations, paralysis, difficulty swallowing
## Footnote
Rabies leads to coma and death with a 100% case fatality rate in humans.
150
What is the incubation period for Rabies?
1-3 months
## Footnote
The length can vary based on the site of the bite and other factors.
151
What characterizes furious rabies?
Hyperactivity and agitation
## Footnote
This form is contrasted with paralytic rabies.
152
How is Rabies diagnosed?
Clinical (aerophobia and hydrophobia); biopsy/saliva to confirm, however usually not used
## Footnote
Diagnosis often relies on clinical signs.
153
What are the WHO categories in rabies treatment?
WHO Categories:
Category I: Touching, no treatment.
Category II: Minor scratches → vaccine.
Category III: Bites/saliva in mucosa → vaccine + RIG.
154
What is the prevention strategy for Rabies?
Post-exposure prophylaxis (PEP)
## Footnote
PEP involves immediate wound care and administration of HRIG.
155
What is the treatment for Rabies?
Supportive, palliative - quiet, isolated room, anxiolytics, antipyretics
## Footnote
There is no effective treatment once symptoms appear.
156
What family does the measles virus belong to?
Paramyxovirus family
157
How is the measles virus transmitted?
Airborne droplets; highly contagious
158
What is the incubation period for measles?
~10–14 days
159
What was the child mortality rate from measles in some areas of Africa before the 1980s?
≈ 50%
160
What occurs during the first week of measles infection?
Acute viral infection
161
What secondary complications can occur in the second week of measles?
Secondary bacterial pneumonia (S. pneumoniae, Staph. aureus), secondary viral infections (RSV, herpes simplex, adenovirus)
162
What are Koplik spots?
Diagnostic feature of measles
163
Describe the rash associated with measles.
Maculopapular, starts on face → trunk
164
What are some complications of measles?
* Immediate or delayed death
* Blindness (especially with Vitamin A deficiency)
* Malnutrition
* Immunosuppression (post-measles)
165
In which countries is measles linked to possession or cultural practices?
Ethiopia and Fiji
166
What is the current situation regarding measles outbreaks up to 2025?
Large outbreaks are still occurring
167
Which countries are expected to have the highest incidence of measles in 2024–25?
* Kyrgyzstan
* Romania
* Kazakhstan
* Yemen
168
What are some challenges faced in measles management?
* Decreased US global health support
* Need for earlier vaccination strategies
* Development of better vaccines (e.g., birth-dose vaccines)
* Improved outbreak management
169
What advice should be given travellers who are trying to conceive during a Zika outbreak?
Prevent mosquito bites during travel and use condoms or abstain from sex for 3 months
Zika virus persists in the semen for several months following infection
170
What vaccination should be advised to patient travelling to Mecca?
quadrivalent meningococcal vaccine (MenACWY) - protection against 4 strains
171
What family and genus does Monkeypox belong to?
Family: Poxviridae; genus: Orthopoxvirus
## Footnote
This classification places Monkeypox within a group of viruses known for causing skin lesions.
172
List the clades of Monkeypox and their characteristics.
* 1a, 1b: Central Africa - Zoonotic, limited human-to-human spread
* 2a: West Africa - Zoonotic; low human-to-human spread
* 2b: Global since 2022 - Human-to-human spread via sexual contact (GBMSM); global outbreaks
## Footnote
Each clade represents different epidemiological patterns and geographic distributions.
173
What are the reservoirs for Monkeypox?
African rodents; NOT monkeys!!
## Footnote
This highlights the misconception about the role of monkeys in the transmission of the virus.
174
How is Monkeypox transmitted?
* Direct contact with lesions/scabs
* Contaminated materials - barrier nursing/cleaning isolation rooms
* Respiratory droplets
* Vertical transmission
## Footnote
Understanding the transmission routes is crucial for implementing prevention strategies.
175
What is the incubation period for Monkeypox?
5-21 days
## Footnote
This period varies among individuals and is important for understanding the disease's progression.
176
What are the clinical features of Monkeypox?
* Prodrome: fever, lymphadenopathy
* Rash: maculopapular → vesicular → pustular → crusts (infectious until fully re-epithelialised)
## Footnote
The clinical progression of the rash is characteristic of the disease.
177
What complications can arise from Monkeypox?
* Proctitis
* Pharyngitis
* Pneumonia
* Bacterial superinfection
* Encephalitis
## Footnote
These complications can be severe and may require medical attention.
178
Who is at risk for severe disease from Monkeypox?
Advanced HIV (CD4<100)
## Footnote
Immunocompromised individuals are at higher risk for severe outcomes.
179
What is the gold standard for diagnosing Monkeypox?
PCR from lesions - genome sequencing for clade data
## Footnote
PCR testing provides accurate identification and information on the viral clade.
180
What is the treatment for Monkeypox?
* Supportive care
* Analgesia
* Tecovirimat - some evidence for use in severe immunocompromised; resistance can develop with single mutations
## Footnote
Treatment focuses on symptom relief and may include antiviral medication.
181
What vaccine is used for Monkeypox and what are its dosing requirements?
MVA - 2 doses, 4 weeks apart; limited global access
## Footnote
The vaccine's availability can impact public health strategies.
182
What is the efficacy of the Monkeypox vaccine pre-exposure and post-exposure?
* Up to 80% efficacy pre-exposure
* 20-60% efficacy post-exposure
## Footnote
The timing of vaccination plays a critical role in its effectiveness.
183
List the prevention strategies for Monkeypox.
* PPE, cover lesions
* Home isolation
* Contact tracing and PEP
* Ring vaccination
## Footnote
These strategies are essential for controlling outbreaks.
184
What is ring vaccination?
Public health strategy to control outbreaks by vaccinating close contacts of a confirmed case (the “ring” around the case), and then their contacts if needed
## Footnote
This method aims to contain the spread of the virus effectively.
185
Give causes of umbilicated papules in HIV
MPOX
Molluscum
Bacillary angiomatosis
Histoplasmosis
Cryptococcosis
Talarmomycosis
