VIRAL Definition/Etiology Pathogenesis Epidemiology Clinical Manifestation Diagnosis Treatment

RUBEOLA -Highly contagious -systemic dse -3rd leading cause of vaccine

Prevention/Compli:
-LAV (mono,combine)
-MC: Otitis Media
-Pneumonia
-Ecephalitis
-LTB
-SSPE
-may cause flare up of an
underlying Tb infxn
RUBELLA
CRS
-m/c, fetal death or constellation -no vector for transmission
of cong. Anomalies:
pigmentary retinopathy
micropthalmos
cong. Glaucoma
PDA
Pulmo Artery Stenosis
SHIN
-Neonatal manifestation
GR
Interstitial pneumonitis
radioluscent bone dse
hepatosplenomegaly
thrombocytopenia dermal
erythropoiesis
“blueberry muffin”
-Fam: Paramyxovirus
-Gen: Morbillivirus
-Env RNA, only 1 serotype
-inactivated by:
heat light
acidic ph
ether
trypsin
-survival time: <2hr in air
Envelop Protein:
-F (Fusion) of virus and cm’s
viral penetration and hemolysis -virus shed from nasopharynx
-H (Hemeagglutinin) adsorption starting with the prodrome until
of the virus to cells
-Mod Large
-ssRNA
-Fam: Togavirus
-present in the blood and
nasopharyngeal secretions
-sensitive to heat extr pH
-inactivated at 56C and 37C
-stable at 4C for 24hrs
-1°site of infxn-respiratory
epithelium of nasopharyx and
spread to regional lymphatics
1°veremia (2-3d)
-infxn of RES
-viral rep in regional and
distal RES
2°veremia (5-7d post infxn)
-gen. Measles with infxn
in respi and other organs
3-4d after the onset of rash
-fetal damage is unclear
-may include: cytolysis,
chromosomal breaks, reduced
cellular multiplication,
alteration of fetal BS
-persist in the fetus and NB
-excreted for mos-yrs after Birth
-IP: 10d ±2d
preventable death -rash: 7-18d after exposure
-<2y/o -prodrome: last for 2-4d
-host: human -onset:
generalized malaise
-MOT: Person to person via fever (high grade)
respi droplets coryza
-Aerosolized droplet nuclei, can conjunctivitis
stay up to 2hrs cough
-contagious from 4d before and -koplik’s spot:
4d after the onset of rash pathognomonic
-max communicability: from bluewhite pinpoint sized
the onset of prodrome upto the 1-2d before rashes
1st 3-4d of rash -maculopapular rash:
at hairline behind the ears
forehead, face, upper
neck
progresses gradually
downward and outward
(centrifugal dist)
branny desquamation
-Host: human -2-3wks after IP: last for wk
-moderately contagious low grade fever
-MOT: droplets, direct contact URTI
with infected fluid colds gen. Malaise
-transmissible before the onset lymphadenopathy
of the rash during prodromal -1-3d after prodromal: rash
period and during the rash laster for 3d:
illness phase blanchable
maculopapular
occ itchy
-joint pains
-ELISA test
IgM Ab serologic test
(single serum specimen)
IgG Ab- req 2 specimen
-Hx/PE
-Reliable evidence:
+viral culture or PCR
+rubella-specific IgM Ab
Inc. IgG Ab
Prevention/Compli:
-Live virus rubella vaccine
-MMR
-MMRV
-MCV1 (9-11mos old)
-MCV2 (12-15mos old
-Self limiting
-antibiotics are given for 2°
bacterial complications
-Vit A: OD x 2d
200K IU x ≥12mos old
100K IU x 6-11 mos old
50K IU x <6mos old
another dose: 2-4wks
later if +Vit A def.
-IG: susceptible infants
given w/in 6d of exposure
0.25ml/kg IM for IC
0.5ml/kg IM for ID
not for individuals given
measles vaccine at 12mos
unless ID.
-no specific tx
-Cong. Rubella
Supportive care
Refferal: Cong. Defects
monitor hearing imp
-Low IgG: Gamma Globulin
replacement
-Ophtha Eval:
infantile glaucoma
cataract
retinopathy
 VIRAL Definition/Etiology Pathogenesis Epidemiology Clinical Manifestation Diagnosis Treatment

ROSEOLA -Unknown -seen in <2y/o -IP: 10-16d -FEVER, and the appearace of -no specific tx
-Not an infxn caused by just 1 -host: human -High grade fever (3-5d) rash with the disappearance of -supportive and sxtic
pathogen -rash (1-2d) fever -prognosis: excellent
-rash may be due to -irritability and malaise
neutralization of virus in the -cough and colds
skin of the px at the end of -at the lysis of the fever:
veremia ash appears, maculopapular
-veremia-common in HHV6-7 and discrete
-ashes disappears in 1-2d with
desquamation or pigmentation
VARICELLA -VZV -IP:10-23d (Ave: 14d) -Source: human -fever -PCR (dxtic of choice) -IV Acyclovir for
-replicates in the nuclei of -establishes latency in the dorsal -10th leading cause of morbidity -gen. Pruritic rash (5d)-trunk, -tzank smear immunocompromised px
Prevention: onfected cells where DNA core root ganglia during primary -MOT: Airborne, direct contact head, extremities -DFA assay including those having chronic
-Airborne and contact and capsid are synthesized infection and/or breakthrough with px with vzv lesion -resolves as a series of “crops” -cell cuture using scrapings of corticosteroid tx
precaution for min of 5d varicella that may develop -highly contagious during the course of 1-2d in a vesicle base during 1st 3-4d of -Acyclovir PO or Valacyclovir
-no immunization: administer despite immunization -immunity is lifelong normal host the eruptions not recommended
with 3-5d after exposure -reactivation: Shingles -px is contagious from 1-2d
-VZIG before the onset of the rash until
-Passive immunization: all the lesions have crushed
immunocompromised
pregnant women CVS
nb (mother: 5d before or -occurs after maternal vzv in the
48hrs after delivery) 1st and 2nd trimester
Hospitalized infants: fetal death
>28wk AOG varicella embryopathy:
Mother: not vaccinated limb hypoplasia
cutaneous scarring
<28wk AOG eye abn
Bw: <1000g CNS damage
regardless of of maternal
immunity