Viral respiratory illnesses Virus Common cold Viral pharyngitis In uenza Infectious agents Picornavirus Rhinovirus Ss+RNA >100 serological types Transmission S&S Complications Humans+chimpanzees Upper resp tract Respiratory droplets Control Inc: 2-4 days No antiviral Sneezing, nasal discharge, No vaccine sore throat, rough, headache Few systemic symptoms Duration: 1 week In uenza, parain uenza, Coronavirus, rhinovirus, adenovirus, enterovirus, RSV, E-B virus, HIV, HSV, metapneumovirus, Cytomegalovirus Sore throat, viral URI (nasal congestion, hoarsness, sinus tenderness, ear pain, cough) headache, malaise, +/-fever RADT for GAS Throat culture A, B, C Host: Humans Orthomyxovirus’ A- mammals, birds Enveloped ss-RNS B- seals 2 glycoproteins: C- pigs, dogs -Hemagglutinin Inc: 2 days -Neuraminidase Direct droplet spread Diagnostics: Respiratory tract -Nasopharynx swabs Rapid-antigen/genome Serodiagnosis -> titer ABRUPT onset, fever, myalgia, headache, chills, 6-12hr later: respiratory Complications: PNE, bacterial superinfection, Reye’s syndrome Antivirals Vaccines: -Killed -Spray (live, peds) S&S Complications Control Gastrointestinal Illnesses Virus Rotavirus Infectious agents Reoviridae family 11 segments of naked ds RNA 6 major stereotypes Norwalk Virus Noro virus Calciviridae family Make ss+RNA At least 2 stereotypes Transmission Host: humans, animals (calves, mice, piglets, foals) no inter species spread, Fecal oral routes Localize in duodenum and proximal jejunum, shortening of vili Cooler months Fecal-oral Contaminated food, water, uncooked shell sh Incubation: 1-3 days Abrupt onset of vomiting then copious/watery stools Low grade fever Durations: 1-3 days vomiting, 4-8 days diarrhea Complications: dehydration Live, oral rotavirus vaccine Rigorous hygiene measures Incubation: 10-51hrs Hygiene Abrupt onset V/D Duration: 2-3 days Diagnostics: RT-PCR, Enzyme immunoassay antigen detection Hepatitis A Picornaviridae, naked ss+RNA. Fecal-oral Inc: 15-45, fatigue/anorexia/N/RUQpain/clay stools/dark urine/jaundice Avoid exposure, Passive/Active immunization B Hepadnaviridae vertical/parenterally,sexual Inc:30-180 days, S-as above for months, fulminant hepatitis to liver necrosis & death, hepatitis associated with cirrhosis/liver failure/HCC D Enveloped ssRNA, Requires hepB surface antigen, Greatest risk IV drug Stimultaneous B&D Liver disease/cirrosis C Flaviviridae ss+RNA, Parenterally/sexually, Inc: 6-12 weeks, chronic carrier in 50-85%, 20yr to develop hepatitis ELISA/Con rmed with RT-PCR, No active/passive immunity E ss+RNA Fecal-oral Humans 40days, often subclinical Jaundice/anorexia/hepatomegaly/N/V/fever for 1–2 weeks Can be fatal, Serology, No active/passive immunity Exanthems (rashes) Virus Varicella Zoster Herpes Zoster Infectious agents Herpesvirus dsDNA enveloped Single stereotype See varicella Transmission S&S Complications Control Humans Inc 14-21 days, fever, malaise, Resp. Droplets & papulovesicular rash, pruritis contact w/ lesions Complications: varicella PNE, Mucosa of resp. Tract, encephalitis, Reye’s syndrome spreads via blood to Teaneck smear, PCR, uorescent antibody, viral culture, serology Antivirals: acyclovir, valacyclovir, foscarnet Live attenuated vaccines-2 Immune globulin Painful vesicles along sensory nerve of head or trunk See varicella See varicella Comp: Postheraputic neuralgia Disseminated infections (PNE) Measles Roseola Mumps Rubella Paramyxovirus Ss-RNA 2 envelop spikes: -Hemagglutinin -Cell-fusing Herpesvirus Ds DNA Enveloped Humans, person to person, resp. Droplets, URT, epidemics winter and spring Mainly saliva Paramyxovirus Ss- RNA 2 envelop spikes: -Hemagglutinin, neuraminidase -Cell fusing Humans, resp. Droplets, direct contact or fomites, URT (spread thru blood to infect salivary glands Togavirus Ss+RNA 2 envelop glycoproteins Humans, resp droplets, URT (spreads thru blood to lymphoid tissue, skin, organs Transplacental spread to fetus Parvovirus Naked, ssDNA Humans, respiratory route, direct contact or fomites, blood or blood products, vertical transmission Fifth disease Inc: 7-18days, fever/cough/ coraza/conjunctivitis. 1-3 days later: Koplik spots for 1-2days. 1 day later, rash lasts 3-4 days. Comp: Bacterial superinfection, PNE, enceph Fever x3 days, then faint masculopapular rash from trunk to extremities Inc: 18-21 days, fever/ malaise/anorexia, tender salivary gland swelling for 1 week. Comp: orchitis, meningitis Viral culture, RTPCR, Serology Live Attenuated Vaccine, immune serum Serology, PCR Viral Culture, PT-PCR, Serology Live attenuated vaccine NO passive or antivirals Inc: 14-21 days, Low grade fever, Upper Resp symptoms, lymphadenopathy. Within 24hrs-macular rash, fain over head/neck/trunk, petechial lesions over soft palate for 1-3 days Comp: arthritis (days-3weeks), thrombocytopenia purpura, encephalitis, risk of fetal damage (malformation, Viral culture, RT-PCR, serology Live attenuated vaccine Inc: 4-12 days, feve/malaise/headache/ NAAT to detect myalgia/pruritis. Rash- con uente, DNA, serology infuriated on face then 1-2 days later, macular, reticular rash of arms and legs. Immunoglobulin Lymphadenopathy, spleen omega lymph, mild leukopenia, anemia, 1-2 weeks Comp: hepatitis, nephritis, enceph, in pregnancy profound anemia of fetus Central Nervous System Diseases Virus Enterovirus Infectious agents Picornaviridea Ss+RNA naked Transmission Fecal-oral, Infects GI & URT, spreads to target organs: CNS, heart, vascular endothelium, liver, pancreas, lungs, gonads, skeletal, ects Arboviruses 3 families: Togavirus: ss+RNA, alpha viruses and rubiviruses Flavivirus: ss+RNA Bunyavirus: 3 segments of -RNA Rabies Encephalitis Rhabdoviridae Ss-RNA Infected bloodsucking insects (mosquitoes, ticks, sand ies) Primarily in tropics Infected secretions- bite Site of entry: multiplies in muscle cells, then travels to CNS to replicate in brain cells All animals S&S Complications Control Inc: 2-10days Poliovirus: abortive poliomyelitis, aseptic meningitis, paralytic poliomyelitis Coxsackievirus: aseptic meningitis, paresis/paralysis, URIs, pharyngitis, minor febrile illness -Group A- herpangina, hand-footmouth disease -Group B: pleurodynia, myocarditis Echovirus: aseptic meningitis, URI, febirile illness, +/- rash, infantile hepatitis, hemorrhagic conjunctivitis Other enteroviruses: 68, 78, 71 Acute febrile illness, Encephalitis, Meningitis RT-PCR, viral culture, serology Inactivated poliovirus vaccine Immunizations for yellow fever, dengue fever, Japanese B encephalitis Inc: 10days-1year Fever, headache, malaise, N/V, dysethesia at inoculation site, Encephalitis-progressive excess of motor activity, agitation, Hallucinations, combativeness, muscle spasms, seizures, focal paralysis, Coma, ANS involvement-increased salivation, brain stem/CN dysfunctiondiploid, facial palsies, hydrophobia , resp paralysis Median survival after symptomatic- 4 days max 20 days. Pre-exposure: inactivated vaccine Postexposure: Human hyper immune anti rabies globulin plus rabies vaccine