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Viralchildhooddisease

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vashti's version from 2016-11-08 01:13

Section 1

Question Answer
many viral childhood diseases belong to _ familyparamyxo- which is nonsegmented neg RNA and enveloped
paramyxo- includesmeasles, mumps, respiratory syncytial virus, and parainfluenza / also includes human metapneumovirus
rubella familyToga- which is enveloped +RNA
other childhood virusesvaricella ad human bocavirus (parvo- which is DNA naked)
newcomershuman metapneumovirus which ia a paramyxo- amd HBo which is parvo- which looks like cold+ diarrhea, conjunctivitis, and rash
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Section 2

Question Answer
genome of RSV similar tomeasles and mumps
sturcture/replication of RSV typical ofmononegavirales
RSV name due toinduction of cell-cell fusion which prodcues giant multinucleated cells called syncytia
RSV genome contians10 genes of which F and G are main target of immune response
RSV is highly contagious and cause frequent outbreaks in pediatric pop targeting children under 2 and the elderly
RSV spread byaerosol and contact with hands and fomites
infections can beasymptomatic
incubation period5 days
typical symptoms aresimilar to commonc old with sig rhinorrhea / expiratory wheezes are very diagnostic
shedding of virus continues for as long as3 weeks after acute phase
diagnosisdepends on observation of syncytia and/or indirect IF
pathogenesisaffects lower resp tract causing lung damage including necrotizing bronchiolitis mediated by immune response and peribronchial infiltration resulting in interstitial pneumonia
infected children must beisolated
vaccinenone
treatment consists ofsupportive care including oxygen and fluids / Ribavirin has some effect but limited to treat bronchiolitis or patients with pre-exisiting conditions / passive immunization for premature babies
palivizumabmonoclonal Ab that bidns F protein and blocks fusion
complicationslong term problems of resp system
Ribavarinfirst drug used to treat RNA viruses
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Section 3

Question Answer
PIV types4 (PIV1-4)
PIV often associated withcroup (brassy, bark-like cough)
more common inboys
pathogensis, immune response, epidemiloogy, and diagnositics similar toRSV
affects children under5
reinfection ispossible
_ helps with symptomsnebulized steam
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Section 4

Question Answer
measles virus genome contains6 ORFs of which M, F, and NH are main target of immune response
infection starts inrespiratory tract or eye mucous
structure/replication typical ofmononegavvirales (-RNA, enveloped, nonsegmented)
characterized bymaculopapular rash that starts on face and spreads to trunk and limbs
2-3 days before rashprodrome->runny nose, coughing, and high fever (>40) and mouth mucosa often covered by whitish-bluish spots called Koplik spots
measles testingELISA but not usually done
infection spread through bodygeneralized infection->viral progeny releasted at portal of entry and spreads to lymph nodes and replicate sin mononuclear cells->bloodstream
rash is not caused by direct viral damage but by immune response particularily CTLs
replication in immune cells leads totransient immunosuppression which favors secondary infections which are main cause of morbidity and mortality
virus shed inbody fluids during prodrome and acute phase
also foudn aresyncytia
babies prevented of infectionby materal Ab until 6 months
passive protection achieved withIg
compications includecroup, bronchitis, conjuntivitis, otits media, enteritis, and febrile convulsions / also giant cell pneumonia particularily in those with deective immunity
sig cause ofmortality in developing countries
SSPErare but fatal complication occuring many years after leading to problems with motility and behavior caused by demleination and neuronal degeneration
measles virus isolated from SSPE brains inhypermutated wit extensive deletions and exceedingly high A->G substituions / defects cluster in F, HN, and specially M genes
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Section 5

Question Answer
Mumps genome7 ORFs of which F an dG are main immune targets
virus transmitted viaaresol and contact with saliva and secretions of resp tract and also shed in urine
portal of entry isresp tract
common areunapparent infections
incubation2-3 weeks after which there is generalized malaise and fever / within 24 hours parotid glands swell
diagnosisculture and IgM determination in ELISA
pathogenesisgeneralize dinfection and affects multiple organs / acute phase characteruzed by high viremia
prophylaxis and treatmentlive-attenuated vaccine given in MMR / one symptoms set in there is no specific treatment
compicationsorchitis (testicle swelling) and may lead to sterility / meningitis and encepalitis
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Section 6

Question Answer
rubella beling stotoga- famil and is similar to flavivirues but more pleomorphic
rubella virion/genome structuress +RNA and is encapsidated in isocahedral structures that are enveloped
enters viarespiratory route
symptomsmild febrile illness in children characterized by pink rash and low fever (<38)
incubation14-16 days
often there isenlargement of lympoh nodes and rash appears 1-2 days after nset of symptoms
diagnsoisIgG by ELISA
main concern of rubella isinfection of fetus during first 16 weeks of preganncy
prognosis is worse theearlier the infecion with mortality close to 100% during the first month
outcome of fetal rubella infectionlow birth weight, CV and CNS defects, liver enlargement, sight and hearing defects, bone defects, insulin dependent diabetes, and mental retardation
complicationsencephalitis is rare / polyarthritis is relatively commin if infection of adutls, especially women
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Section 7

Question Answer
MMR dose2, one at 12-15 months and one at 406 years or ASAP afterwards
immunizations before12 months do not count
adverse effectsrare is encephalopathy and anaphylaxis / most commona re fever, local allergic reaction, transient thrombocytopenia
contraindicationsimmunospupressed patients, first trimester of pregnany
HIV isnot a contraindiciation unless immunosuppression is sevre
efficacy95% for 12 onth old, 98% for >15month
post-exposure treatment for measlesIg within 6 days of exposure, vaccination delayed 6 months
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