Herpes Virus

how does herpes spread?

world-wide, no seasonal variation

requires immediate contact

how long does herpes incubate for?

4-6 days

how long is herpes virus excreted for?

up to 23 days - average 7-10

what does HSV 1 infect?

intraoral or lip lesions

what does HSV 2 infect?

genitals

where does HSV infect?

gingivostomatitis

esophagitis

pneumonia

encephalitis

ophthalmic

hepatitis

how are latent herpesviruses treated?

no treatment

no synthesis of early or late viral polypeptides during latent infection

what causes reactivation of HSV infections?

stress (physical or emotional)

ultraviolet light

tissue damage

how does HSV reactivation progress?

pain, tingling, itching for 6 hours

3 to 5 vesicles appear on vermillion border of lips ~48 hours

pustules or ulcers crust in ~72-96 hours

heals in 8-10 days

how is HSV1 treated in neonatals?

acyclovir (high dose IV; 10-20mg/kg q8h x 14-21 days)

how is HSV1 orally treated?

acyclovir

valacyclovir

famciclovir

how is HSV1 recurrent labial treated?

topical penciclovir within 1 hour of symptoms then q2h x 4 days

oral acyclovir (topical not effective)

what is herpetic keratoconjuncuvitis?

unilateral or bilateral conjunctivitis “red eye”

cause pain/ocular irritation, photophobia and epiphoraare, vision may or may not be affected

what is HSV encephalitis?

most common form of sporadic form of encephalitis

what does cytomegalovirus (CMV) cause?

pneumonitis

ophthalmic infections

enteritis

hepatitis

viremia and disseminated infection

what is preemptive cytomegalovirus (CMV) therapy?

surveillance

what are prophylactic options for cytomegalovirus (CMV)?

acyclovir

ganciclovir

what are treatment options for cytomegalovirus (CMV)?

ganciclovir or valganciclovir

foscarnet

cidofovir

maribavir

what is the primary infection of varicella zoster virus?

chickenpox

what is the secondary infection of varicella zoster virus?

shingles

how is varicella zoster transmitted?

respiratory route

where does varicella zoster lay dormant?

dorsal root ganglia

how long is varicella zoster contagious for?

2 days before rash and ~1 week after rash onset

what is varivax; proquad?

live vaccine for varicella zoster

indicated for immunocompetent children >12 months with no history of varicella

how do zoster viruses appear?

pain and buring followed by rash 48-72 hours later

unilater vesicular rash in dermatomal pattern

where is the most common zoster infection?

flank

how long does zoster last?

10-15 days

how is varicella zoster treated?

symptomatic treatment

valacyclovir, famciclovir, acyclovir

how soon should antiviral therapy be started for varicella zoster?

48-72 hours after symptom onset

what is Shingrex?

recominant zoster vaccine approved for >50 years old

when can someone receive the zoster vaccine?

as soon as active case clears up

8 weeks after receiving zostavax

what is retroviruses?

enveloped, single-stranded, positive sense RNA virus

what is retrovirus encode enzyme?

revere transcriptase

what does reverse transcriptase do?

converts RNA genome into a DNA copy which then becomes integrated into the host chromosome

what are the subgroups of retroviruses?

oncoretroviruses

• human t-cell lymphotropic virus type I

• human t-cell lymphotropic virus type II

  • associated with leukemias/lymphomas

Lentiviruses

• Human immunodeficiency virus

what does HIV-1 attack?

attacks and destroys CD4+ t-lymphocytes

what does HIV-1 infect?

monocytes/macrophages

dendritic cells

langerhans cells

some cells of the nervous system

what hepatitis’s have vaccines?

a and b

therapy options available for c

what is paramyxovirus?

measles and mumps

what is togavirus?

rubella

what is lyssavirus?

rabies

what is orthopoxvirus?

small pox/Mpox

what is filoviridae?

ebola

varburgvirus

what is flavivirus?

west nile viruse

yellow fever

dengue virus

St Louis encephalitis virus

Zika virus

what is enteroviruses?

poliovirus