1 / 58

MUMPS, MEASLES RUBELLA and human parvovirus

MUMPS, MEASLES RUBELLA and human parvovirus. MEASLES (RUBEOLA) MUMPS RUBELLA. MAN WORLD WIDE SINGLE SEROTYPE OF EACH VIRUS LIVE ATTENUATED VACCINE (MMR) CHILDHOOD DISEASES (PRE-VACCINE) NOTIFIABLE DISEASE. PARAMYXOVIRUS FAMILY MUMPS MEASLES. TOGAVIRUS FAMILY RUBELLA.

merton
Télécharger la présentation

MUMPS, MEASLES RUBELLA and human parvovirus

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MUMPS, MEASLES RUBELLA and human parvovirus

  2. MEASLES (RUBEOLA)MUMPSRUBELLA • MAN • WORLD WIDE • SINGLE SEROTYPE OF EACH VIRUS • LIVE ATTENUATED VACCINE (MMR) • CHILDHOOD DISEASES (PRE-VACCINE) • NOTIFIABLE DISEASE

  3. PARAMYXOVIRUS FAMILY • MUMPS • MEASLES • TOGAVIRUS FAMILY • RUBELLA

  4. MEASLES AND MUMPS

  5. PARAMYXOVIRUSES HN/H/G glycoprotein SPIKES pleomorphic F glycoprotein SPIKES helical nucleocapsid (RNA plus NP protein) lipid bilayer membrane polymerase complex M protein

  6. PARAMYXOVIRUS FAMILYSURFACE GLYCOPROTEINS GENUS GLYCOPROTEINS TYPICAL MEMBERS PARAMYXOVIRUS SUBFAMILY Paramyxovirus HN, F HPIV1, HPIV3 Rubulavirus HN, F HPIV2, HPIV4, mumps virus Morbillivirus H, F measles virus PNEUMOVIRUS SUBFAMILY Pneumovirus G, F respiratory syncytial virus Metapneumovirus G, F metapneumoviruses

  7. MEASLES (Rubeola) 2001 >40,000,000 infections world wide >1,000,000 deaths world wide 2004 ~20,000,000 infections world wide ~240,000 deaths world wide

  8. VACCINE EFFECTIVENESS http://www.cdc.gov/nip/ed/slides/slides.htm

  9. Measles 1996-present • Endemic transmission interrupted • Only 44 cases in US in 2002 - but 132 cases 2008 • Most cases imported or linked to importation http://www.cdc.gov/nip/ed/slides/slides.htm

  10. INFECTION • AEROSOL • VERY CONTAGIOUS

  11. viremia Adapted from Mims, Playfair, Roitt, Wakelin and Williams (1993) Medical Microbiology

  12. MEASLES - Koplik’s spots Murray et al. Medical Microbiology

  13. DISSEMINATED SPREAD • LONGER TIME FOR SYMPTOMS • IMMUNE RESPONSE • (IF SYMPTOMS DUE TO IMMUNE RESPONSE, USUALLY INFECTIOUS PRIOR TO SYMPTOMS) Adapted from Mims, Playfair, Roitt, Wakelin and Williams (1993) Medical Microbiology

  14. MEASLES - RASH CDC - B.Rice Murray et al. Medical Microbiology

  15. DISEASE • STILL INFECTIOUS AFTER SYMPTOMS START • FEVER • RESPIRATORY TRACT SYMPTOMS • rhinorrhea, cough • KOPLIK’S SPOTS • MACULOPAPULAR RASH • T-cells ->endothelial cells • CONJUNCTIVITIS • epithelial cells

  16. RECOVERY • FAIRLY RAPID • T-cell response important • agammaglobulinemia – recover • T-cell deficient, may be no rash, may be severe disease (life threatening) • DISEASE MORE SEVERE IN ADULTS

  17. COMPLICATIONS • GIANT CELL PNEUMONIA Histopathology of measles pneumonia. CDC/Dr. Edwin P. Ewing, Jr. Giant cell with intracytoplasmic inclusions

  18. COMPLICATIONS • GIANT CELL PNEUMONIA • SECONDARY BACTERIAL INFECTIONS • MORE SEVERE IF MALNOURISHED AND/OR POOR ACCESS TO MEDICAL CARE • MEASLES ENCEPHALITIS

  19. Mims et al., Medical Microbiology 1993

  20. PROBLEMS • vitamin A deficient -> low mucosal defense • low protein, calories -> impaired immunity • lack of antibiotics for secondary infections • lack of vaccination (need cold chain) • poor hygiene Deaths due to measles 2000: ~757,000 Deaths due to measles 2007: ~197,000 Case fatality rates in displaced populations can reach 25%

  21. MEASLES ENCEPHALITIS • 1/1000 cases • sequelae • deafness • seizures • mental disorders

  22. SSPE • sub-acute sclerosing panencephalitis • inflammatory disease • defective virus (often lacking M protein) • early infection with measles is a risk factor • rare (7/1,000,000 cases of measles) • decrease since vaccination program

  23. IMMUNOSUPPRESSION AND MEASLES • TEMPORARY DEPRESSION OF IMMUNE RESPONSE • Tuberculin +ve individuals may temporarily become -ve • MAY GET REACTIVATION OF HERPES, TUBERCULOSIS • Don’t see with vaccine strain

  24. DIAGNOSIS • Serodiagnosis • Significant increase in IgG (need two samples) • Positive for IgM • Isolation • RT-PCR • All suspect cases should be confirmed by laboratory

  25. EPIDEMIOLOGY • ALMOST ALL INFECTED INDIVIDUALS SHOW DISEASE • ONE SEROTYPE • NATURAL INFECTION GIVES LIFE LONG PROTECTION • MOST CONTAGIOUS BEFORE RASH IS EVIDENT

  26. PREVENTION • LIVE ATTENUATED VACCINE • Does not spread to contacts • Can cause problems in immuno-suppressed • IMMUNE SERUM GLOBULIN

  27. TREATMENT • SUPPORTIVE CARE

  28. PARAMYXOVIRUSESMUMPS

  29. Total reported cases 4,602 Mumps Outbreak United States 2006* 4 193 1 650 85* 1,921 349 501 3 134 782 1 2 *In PA, 14 of the 85 cases are considered outbreak-associated. *Provisional Number of Cases by State as of June 20, 2006

  30. MUMPS CDC - B.Rice

  31. Mims et al., Medical Microbiology 1993

  32. Mims et al., Medical Microbiology 1993

  33. RECOVERY • CELL MEDIATED IMMUNITY

  34. DIAGNOSIS • 30% INFECTIONS SUB-CLINICAL • SEROLOGY OR ISOLATION • RT-PCR

  35. EPIDEMIOLOGY • MAN ONLY HOST • ONE SEROTYPE • SUB-CLINICAL INFECTIONS • CONTAGIOUS BEFORE AND AFTER SYMPTOMS

  36. PREVENTION • LIVE ATTENUATED VACCINE • DOES NOT SPREAD TO CONTACTS • Contradindicated in • immune-suppressed • pregnant women

  37. RUBELLA VIRUS glycoprotein icosahedral nucleocapsid RNA (single-stranded positive-sense) lipid bilayer membrane

  38. RUBELLA VIRUS • TOGAVIRUS FAMILY • Alphavirus genus • Rubivirus genus • AEROSOL • CHILDREN, ADULTS • mild • FETUS • can be severe

  39. RUBELLA (German measles) Murray et al. Medical Microbiology

  40. SYMPTOMSchildren and adults • SORE THROAT, RUNNY NOSE, COUGH • FEVER • RASH, MINOR, IRREGULAR • lasts 12hour to 5days • not always seen • ARTHRALGIA, ARTHRITIS • especially in adults, especially women • LYMPHOADENOPATHY

  41. COMPLICATIONS • ENCEPHALITIS (RARE)

  42. RECOVERY • T-CELL

  43. PROTECTION • IgG, IgA • IgM may persist

  44. EFFECTS ON FETUS • HEARING LOSS • CONGENITAL HEART DEFECTS • NEUROLOGICAL • PYSCHOMOTOR AND/OR MENTAL RETARDATION • OPHTHALMIC • CATARACT, GLAUCOMA, RETINOPATHY

  45. EFFECTS ON FETUS • thrombocytopenia • hepatomegaly • splenomegaly • intrauterine growth retardation • bone lesions • pneumonitis

  46. EFFECTS ON FETUS • First trimester • 65-85% of neonates have sequelae

  47. EFFECTS ON FETUS • 1964-65 season (pre-vaccine) • congenital rubella syndrome (CRS) cases ~20,000 • Deaf ~11,600 • Blind ~3,580 • Mentally retarded ~1,800 • Abortions (spontaneous/surgical) ~11,250 • Neonatal deaths ~2,100 • 1969 to present • maximum of 67 cases congenital rubella/yr • usually fewer than 10

  48. CONGENITAL INFECTIONS • SHED VIRUS FOR A YEAR OR MORE AFTER BIRTH • nasopharynx, urine, feces

  49. CONGENITAL INFECTIONS • EYE PROBLEMS • GLANDULAR COMPLICATIONS • diabetes • thyroid problems • deficiency growth hormone

More Related