Common Viral Infections in Pediatrics 1

 Incubation period: 1–4 days  Mode of transmission: Droplet  Clinical presentation: Fever, headache, myalgia, cough, rhinitis, otitis media, myositis, croup, bronchiolitis, pneumonia  Complications: Febrile seizures, encephalitis, secondary bacterial infection, myocarditis  Management: Supportive care, Oseltamivir ASAP (especially high‑risk or hospitalized)  Prevention: Annual influenza vaccine

Influenza

 Incubation period: 8–12 days (range 7–21 days)  Mode of transmission: Droplet and airborne  Clinical presentation: Fever, cough, coryza, conjunctivitis (3 C’s), Koplik spots (prodromal), maculopapular rash spreading cephalocaudally  Complications (common): Otitis media, pneumonia (most common cause of death), diarrhea  Complications (rare): Acute encephalitis, Subacute sclerosing panencephalitis (SSPE) 7– 11 years later  Management: Supportive, Vitamin A for all infected children  Prevention: Measles vaccine

Measles (Rubeola)

 Incubation period: 12–25 days (usually 16–18)  Mode of transmission: Droplet  Clinical presentation: Subclinical (30%), fever, malaise, parotitis (uni‑ or bilateral)  Complications: Pancreatitis, orchitis (post‑pubertal), arthritis, CSF pleocytosis, meningitis (<1%)  Management: Supportive  Prevention: Mumps vaccine

Mumps

 Incubation period: 14–21 days  Mode of transmission: Droplet  Clinical presentation: Often subclinical, mild maculopapular rash, lymphadenopathy, arthritis (rare in children)  Complications: Congenital rubella syndrome (hearing loss (postauricular lymphadenopathy), CHD, eye abnormalities (cataract)), FORCHHEIMER SIGN. encephalitis, myocarditis  Management: Supportive  Prevention: Rubella vaccine

Rubella (German measles)

• Slapped cheek rash, followed by lacy/reticular maculopapular rash

• Children: usually mild

• Adults (women): polyarthropathy

• Hemolytic anemia (e.g. sickle cell): transient aplastic crisis

• Immunocompromised: chronic anemia / pure red cell aplasia

• Pregnancy (≤20 weeks): hydrops fetalis, congenital anemia

• Management: supportive (IVIG if immunocompromised)

• Prevention: no vaccine

Parvovirus B19

 Mode of transmission: Contact and droplet  Clinical presentation: URTI, pharyngitis, otitis media, conjunctivitis, pharyngoconjunctival fever, gastroenteritis  Severe disease: Pneumonia, hemorrhagic cystitis, disseminated disease in immunocompromised  Management: Supportive; antivirals in immunocompromised patients

Adenovirus

 Includes: Coxsackie A & B, Echoviruses, Poliovirus, EV‑71, EV‑D68  Mode of transmission: Feco‑oral and droplet  Clinical presentation: Asymptomatic (most common), meningitis, encephalitis, acute flaccid myelitis, myocarditis, pericarditis, HFMD, herpangina, neonatal sepsis‑like illness  Management: Supportive; IVIG in selected severe cases

Enteroviruses

 Mode of transmission: Contact  Clinical presentation: Gingivostomatitis, cold sores, eczema herpeticum, herpetic whitlow, keratitis  CNS disease: Meningitis, encephalitis  Neonatal HSV: SEM, CNS, disseminated  Management: Supportive; Acyclovir for neonatal, CNS, immunocompromised cases

HSV‑ 1 & HSV‑ 2

 Incubation period: 10–21 days  Mode of transmission: Airborne and contact  Clinical presentation: Vesicular rash in different stages  Complications: Secondary bacterial infection, pneumonia, encephalitis  Management: Supportive; oral acyclovir (selected), IV acyclovir (immunocompromised)  Prevention: Varicella vaccine; VariZIG post‑exposure in high‑risk

Varicella Zoster Virus

 Clinical presentation: Fever, lymphadenopathy, hepatosplenomegaly, exudative pharyngitis, rash with amoxicillin  Complications: Splenic rupture, hemolytic anemia, thrombocytopenia, CNS disease, myocarditis  Diagnosis: Atypical lymphocytes, Monospot, EBV serology (VCA IgM/IgG, EBNA)  Management: Supportive; corticosteroids for severe complications; avoid contact sports

EBV (Infectious Mononucleosis)

 Mode of transmission: Saliva, breast milk, sexual contact, blood products, transplacental  Clinical presentation: Mild mono‑like illness, congenital CMV, severe disease in immunocompromised  Management: Ganciclovir or valganciclovir in selected cases

CMV

 Clinical presentation: High fever followed by macular rash after fever subsides  Complications: Febrile seizures, rare meningitis or encephalitis  Management: Supportive

HHV‑ 6 & HHV‑ 7 (Roseola infantum)