Childhood Diseases

Group 2
Polio
 General Characteristics
◦ Picornavirus
◦ ssRNA
◦ Capsid 4 Proteins (VP1, VP2, VP3, VP4-internal)
◦ Binds to CD155
◦ Human specific due to receptor
◦ Enterovirus
◦ Three Strains
 Serotype 1 – Most Virulent/Most Common
 Serotype 2 – Eradicated in 1999
 Serotype 3 – Sporadic Incidence
Polio
 Transmission
◦ Fecal Oral
◦ Respiratory Droplets (Very Rare)
◦ Infectious a few days before symptoms
◦ Infectious during symptoms as well as 1 to 2 weeks
after.
◦ Remains in environment for weeks.
◦ Initial implantation Pharynx (Lymphoid Tissue).
◦ Secondary Implantation Gastrointestinal Tract
GALT).
◦ Tertiary Implantation Anterior Horn or Brain Stem.
Polio
 In United States
Polio
Polio
 Symptoms
◦ 95% of all infections show no symptoms or
prodrome symptoms.
◦ Abortive Poliomyelitis (4%-8% of cases)
 Sore Throat
 Fever
 Tiredness
 Nausea
 Headache
 Stomach pain
Polio
 Symptoms
◦ Non-Paralytic Aseptic Meningitis
 Cold or Flu-like symptoms
 Stiff Neck, Back, and/or Legs
 Abnormal Sensations (Burning or Tingling)
 Symptoms last 2-10 Days
 Complete Recovery
Polio
 Symptoms
◦ Flaccid Paralysis
 Cold or Flu-like Symptoms
 Paralysis 1-10 days following
 1st stage
 Loss of superficial reflexes
 Increased deep tendon reflexes
 Severe muscle aches
 2nd Stage
 Flaccid Paralysis
 Diminished Deep Tendon Reflexes
 3rd Stage
 Strength Returns Slowly
Polio
 Paralytic Polio
◦ All cases preceded by cold or flu-like symptoms
◦ Spinal Polio
 Most Common Form
◦ Bulbar Polio
 Least Common Form
 Only Involves Cranial Nerves
◦ Bulbospinal
 Spinal Paralysis
 Cranial Nerves
Polio
 Complications
◦ Post Polio Syndrome
 30-40% of polio cases
 This is NOT a reactivation of virus
 Symptoms
 New Muscle Pain
 Exacerbation of existing weakness
 Development of new weakness
Polio
 Treatment/Prevention
◦ Supportive Therapy
◦ Vaccine Series
 2 months, 4 months, 6 to 18 Months and 4 to 6 year of
age
◦ Salk Vaccine
 Inactivated poliovirus
◦ Sabin Vaccine
 Weakened poliovirus
Varicella-Zoster
 General Characteristics
◦ Varicella = Chicken Pox
◦ Zoster = Shingles
◦ Herpes Family
◦ DNA virus
Varicella-Zoster
 Transmission (Chicken Pox)
◦ 1 to 2 days before appearance of rash
◦ Full incubation 10 to 21 days
◦ Respiratory Secretions
 Respiratory Tract or Conjunctiva
◦ Mouth contact with contaminated objects
◦ Very rare to acquire from skin lesions
◦ 4 to 5 hour survival outside of body
◦ Higher incidence winter and early spring (Crowding)
Varicella-Zoster
 Transmission (Shingles)
◦ Can only transmit as Chicken Pox
◦ Shingles is a reactivation only
◦ Factors associated with increased risk
 Aging
 Immunosuppression
 Intrauterine exposure
 Acquiring disease younger than 18 months
 Stress
Varicella-Zoster
 Symptoms (Chicken Pox-Child)
◦ Fever (102oF)
◦ Blister-Like Rash (Crops)
◦ Loss of Appetite
◦ Fatigue
 Symptoms (Chicken Pox-Adult)
◦ Fever (Precedes Rash)
◦ Joint Inflammation
◦ Blister-Like Rash (Crops)
◦ Body Aches
Varicella-Zoster
Varicella-Zoster
 Symptoms (Shingles)
◦ Pain, burning, numbness or tingling
◦ Sensitivity to touch
◦ Red Blister Rash (Commonly seen on trunk)
◦ Itching
◦ Fever
◦ Headache
◦ Sensitivity to light
◦ Fatigue
Varicella-Zoster
Varicella-Zoster
 Complications (Chicken-Pox)
◦ Skin Infections
◦ Pneumonia
◦ Encephalitis
◦ Cerebellar Ataxia
◦ Sepsis
◦ Dehydration
◦ Scarring
◦ Sterility (Adults)
Varicella-Zoster
 Complications (Shingles)
◦ Post-herpetic neuralgia (10% to 15%)
◦ Vision loss
◦ Neurological problems
 Encephalitis
 Facial paralysis
 Hearing problems
 Balance problems
◦ Skin Infections
Varicella-Zoster
 Treatment/Prevention
◦ Supportive treatment
◦ Herpes Zoster and Varicella Vaccine (Differ by Dose)
 Each 0.65-mL dose contains a small amount of: sucrose,
 hydrolyzed porcine gelatin
 sodium chloride
 monosodium L-glutamate
 sodium phosphate dibasic
 potassium phosphate monobasic
 potassium chloride
 residual components of MRC-5 cells including (DNA and
protein)
 neomycin and bovine calf serum
Fifths Disease
 General
◦ Parvovirus
◦ ssDNA
◦ Aka B19, Erythema infectiosum, or Academy Rash
Fifths Disease
 Transmission
◦ Respiratory Secretions (Saliva, sputum, nasal
discharge)
◦ Most contagious before rash appears
◦ After rash forms on rarely contagious
◦ Can be passed to developing fetus
 Mother’s Immunity Status
 Rare to see complications, even without immunity
◦ Incubation 4 to 14 days after exsposure
Fifths Disease
 Symptoms
◦ Fever
◦ Runny Nose
◦ Headache
◦ Rash – Presents as a slapped cheek affect
 Starts on face
 Secondary rashes may appear in other areas
◦ Polyarthropathy-Swollen painful Joints (Lasts up to
a month)
 Typically no long term issues
Fifths Disease
Fifths Disease
 Complications
◦ Chronic Anemia (Less than 5%)
Fifths Disease
 Prevention/Treatment
◦ No Vaccine
◦ Supportive Therapy
◦ Hygiene for prevention
Respiratory Syncytial Virus (RSV)
 General
◦ Paramyxo Family - Pneumoviridae subgroup
◦ ssRNA
◦ Lung infection only
◦ Most common cause of Bronhiolitis and pneumonia
in children under age 1.
◦ Typically exposed by second birthday
Respiratory Syncytial Virus (RSV)
 Transmission
◦ Respiratory Secretions (Coughing and Sneezing)
◦ Contaminated objects (4 hours)
◦ Can be spread for up to 4 weeks after symptoms
◦ Highest incidence: Spring and Winter
◦ High Risk Groups
 Premature infants
 Congenital heart
 Chronic Lung disease
 Compromised immune status
Respiratory Syncytial Virus (RSV)
 Symptoms
◦ Runny Nose
◦ Decrease in Appetite
◦ Coughing
◦ Sneezing
◦ Fever
◦ Wheezing
Respiratory Syncytial Virus (RSV)
 Complications
◦ Bronchiolitis
◦ Pneumonia
Respiratory Syncytial Virus (RSV)
 Prevention/Treatment
◦ No Vaccine
◦ Supportive Therapy
 May require ventilator
◦ Hygiene for prevention