Viral Infection 2

• Upper Respiratory Tract Infections


  Infections of the upper airway, including the nose, throat, and larynx

  
• Common Colds (Acute Rhinitis)


  A common illness in both children and adults, with seasonal occurrence
• Incubation Period (Common Colds)

  2 - 10 days
• Common Colds


  • Fever, runny nose or rhinorrhea/coryza, nasal obstruction, thick & purulent nasal secretion
• Laboratory Diagnosis (Common Colds)

  Isolation of the virus in cell culture, detection of 4-fold increase in antibody titer

  
• Treatment & Prevention (Common Colds)

  No antiviral therapy
• Croup (Laryngitis, Laryngotracheitis, Laryngotracheobronchitis)

  Denotes several respiratory illnesses involving infection of the upper airway, which obstructs breathing and causes a characteristic barking cough

  
• Croup


  • Inspiratory stridor, cough, hoarseness ("seal bark") due to obstruction in the larynx, occurs within the first 3 years of life

  
• Laboratory Diagnosis (Croup)


  Clinical signs and symptoms
• Treatment & Prevention (Croup)

  No antiviral drug, no vaccine

  
• Influenza


  A mild viral infection

  
• Incubation Period (Influenza)


  1 - 3 days
• Influenza


  • Uncomplicated influenza, pneumonia, Reye's syndrome (associated with Influenza B and varicella-zoster infections)

  
• Laboratory Diagnosis (Influenza)


  Clinical signs and symptoms, isolation of virus and identification of viral antigens in patient's cell

  
• Treatment (Influenza)


  Amantadine, Rimantadine, newer drugs: Zanamivir (Relenza), Oseltamivir (Tamiflu)
• Prevention (Influenza)


  Vaccine available given annually
• Chronic Bronchitis/Respiratory Syncytial Virus (RSV)


  A chronic inflammatory condition involving the bronchi, a recurrent bacterial infection; RSV is a major cause of bronchiolitis
• Chronic Bronchitis/RSV


  • Cough (smoker's cough), production of copious amounts of mucus, wheezing, chest discomfort
• Laboratory Diagnosis (Chronic Bronchitis/RSV)

  RT-PCR, ELISA test (checks viral antigen)

  
• Treatment (Chronic Bronchitis/RSV)


  Supportive care, mucolytic, oxygen, ribavirin (for RSV bronchiolitis), immune globulin
• Prevention (Chronic Bronchitis/RSV)


  Contact isolation, hand washing
• Pneumonia


  An infection involving the lung parenchyma, with types including typical pneumonia (lobar, interstitial, bronchopneumonia) and atypical pneumonia ("walking pneumonia")
• Pneumonia


  • Viral pneumonia (inflammation of the interstitial spaces, rales on auscultation, usually caused by RSV)

  
• Laboratory Diagnosis (Pneumonia)

  Culture of blood or sputum (gold standard), capsular swelling test (Quellung reaction), optochin sensitivity
• Treatment (Pneumonia)

  Vaccine (PPSV 23, PCV 13) especially for high-risk individuals, avoidance of risk factors, early diagnosis and administration of antimicrobial agents

  
• Viral GIT Infection - Mumps (Infectious Parotitis)


  A generalized systemic infection involving the parotid glands, usually occurs in epidemic form, a single attack causes permanent immunity if both glands were affected
• Mumps


  • Subsides in 9 days, headache, malaise, fever, loss of appetite, muscle aches, abrupt onset of pain right beneath the ear accompanied by soreness of the jaw and some stiffness of the neck, pain when chewing or swallowing, parotid gland swelling
• Mumps

  Infectious parotitis, a generalized systemic infection involving the parotid glands
• Mumps

  • Usually occurs in epidemic form
  • An acute contagious disease
  • A single attack causes permanent immunity if both glands were affected
• Causative agent of Mumps

  Paramyxo virus

  
• Period of communicability of Mumps

  Before the glands are swollen until an unknown length of time
• Mode of transmission of Mumps

  • Droplet infection
  • Direct contact with a person or articles in the environment which have been freshly soiled with secretions from nasopharynx
  • Saliva, the most infectious of all body secretions

  
• Clinical manifestations of Mumps

  • Subsides in 9 days
  • Headache, malaise, fever, loss of appetite, muscle aches
  • Abrupt onset of pain right beneath the ear accompanied by soreness of the jaw and some stiffness of the neck
  • Pain when chewing or swallowing
  • Parotid gland swells in front of the earlobe, the angle of the jaw and down the neck, including the whole the whole cheek; area is tender and doughy or hard
• Complications/Sequela of Mumps


  • Orchitis
  • Mastitis and edema of the vulva
  • Oophonitis
  • Central nervous system involvement may occur but endocarditis is rare
• Management of Mumps


  • Cortisone: 300 – 400 mg initially, then 100 mg every 6 hours for 3-4 days
  • Analgesics for pain
• Nursing care for Mumps

  • Rest for at least 4 days
  • After the age of puberty, the most important is for the patient to remain absolutely quiet in bed until all fever and swelling have disappeared to prevent glandular complications (orchitis and oophonitis)
  • Males should use well-fitting supporter, or a sling between the thighs to prevent the pull of gravity on the testes and blood vessels, thus minimizing the dangers of orchitis, edema and atrophy
  • Ice collar or cold compress over the parotid glands
  • Soft, bland diet, sour foods or fruit juices cause burning sensation
• Prevention of Mumps


  Vaccine, MMR (mumps – measles – rubella)
• Hepatitis


  Inflammation of the liver
• Causative agents of Hepatitis

  • Microorganisms
  • Bacteria
  • Viruses
  • Protozoa
  • Spirochetes
  • Too much alcohol
  • Drug intoxication
  • Chemical intoxication
• Hepatitis A


  Infectious hepatitis, Catarrhal hepatitis, Epidemic hepatitis