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How are mumps spread?: Airborne droplets, salivary secretions, urin
What is the classic sign of mumps?: Swollen, painful parotid gland
What vaccine is used against mumps?: MMR, live attenuated vaccine
What is a common name for Rubella?: German measles
How is Rubella spread?: droplet infection
Why is infection with Rubella during pregnancy a concern?: Congenital rubella --> cataracts, MR, deafness

High mortality rate in utero
Is there a vaccine for Rubella: Yes. Live attenuated vaccine
What is the largest human herpes virus?: CMV
cytomegalovirus infection
What is another name for CMV?: salivary gland virus
How is CMV spread?: urine, semen, cervical secretions, STD, blood transfusions, organ transplant
Where does a CMV infection localize?: epithelial cells of the salivary glands, kidney tubule, cervix, epididymis, testes
What are the symptoms of CMV?: usually asymptomatic, though young adults may have fever
what is the most common viral cause of congenital defects in the US?: CMV, cytomegalovirus infection
What defects does CMV cause?: fetal malformations, small size, microcephaly, MR, hearing loss, jaundice
What disease does CMV cause in an immunodeficient patients?: interstitial pneumonia
What kind of virus is Epstein Barr (EBV)?: It is a herpes virus
How is EBV transmitted?: saliva exchange, kissing
What causes the symptoms of EBV?: action of released cytokines; immunologic response; T lymphocytes respond to infected B cells.
How does the EBV virus replicate?: In B lymphocytes binding to C3d receptor on the cells.
What is the EBV triad?: 1. Sore throat
2. lymphadenopathy
3. splenomegaly
What disease develops in older children and young adults with EBV?: infectious mononucleosis
Which two diseases result in Burkitt's lymphoma?: EBV and malaria;

malaria weakens the T cell control of EBV
What virus plays a role in 30-50% of Hodgkins disease?: EBV
What 2 ways is smallpox spread?: 1. Contact with skin lesions
2. Respiratory tract
What was the 1st disease controlled by immunization?: smallpox
What makes disease eradication possible (4 factors)?: 1. no subclinical infections
2. no carrier
3. no animal reservoir
4. effective vacine
What causes smallpox (variola)?: poxvirus (variola major or minor)
What are the 3 characteristics of vector-borne infections?: 1. able to transmit to sparse pop
2. virus survives in vector and host
3. sufficient # of vectors to infect large enough pop
What are arboviruses?: arthropod-borne: ticks, mosquitoes, sandflies

can cause fever, rash
What mosquito carries yellow fever person-person? . . . monkey-person?: p-p Aedes aegypti ("urban" yellow fever)

m-p Haemagogus ("jungle" yellow fever)
What are symptoms of yellow fever, and what is mortality rate?: -Sudden onset of fever, headache, muscular aches
-Severe --> shock, liver damage, death
- 50%
What is the prevention of yellow fever?: - Live attenuated vaccine

- Control of mosquitoes
What is the principal vector for dengue fever?: Aedes aegypti mosquito
What is a common name for dengue fever?: "break-bone" fever
What is the severe form of dengue called?: Dengue hemorrhagic fever syndrome.

Occurs in children in endemic areas. Mortality up to 10%
What are the symptoms of dengue fever?: Malaise, fever, nausea, vomiting, maculopapular rash.
What are the symptoms of dengue hemorrhagic fever syndrome?: Vascular damage, shock, hemorrhage in GI tract and skin due to cytokines
What is the treatment for dengue fever?
What are rickettsia?: - Small bacteria
- Obligate parasite
List 4 rickettsial infections: 1. Rocky mountain spotted fever
2. Mediterranean spotted fever
3. Epidemic typhus
4. Endemic typhus
What bacteria causes rocky mtn spotted fever?: R. rickettsii
What bacteria causes Mediterranean spotted fever?: R. conorri
What bacteria causes epidemic typhus?: R. prowazeckii
What bacteria causes endemic typhus?: R. typhi
Which is worse, epidemic or endemic typhus?: Epidemic. Fever, headache, flu-like, maculopapular rash, maybe sever meningoencephalitis w/delirium and coma.

Endemic is similar by less severe.
What are the special symptoms of Rocky Mtn spotted fever?: Splenomegaly, neurologic involvement, disseminated intravascular coagulation, shock, and death if not treated immediately.
What is the treatment for Rocky mtn spotted fever?: Immediate tetracycline IV
Where does rash develop in Mediterranean spotted fever?: On palms and soles of feet
What is the mortality rate of Mediterranean spotted fever?: 50%
What creature transmits epidemic typhus?: A louse -- Pediculus corporis
Why is epidemic typhus associated with poverty and war?: Clothes and bodies are washed less often.
What causes Lyme disease?: Borrelia spirochete
What transmits Lyme disease?: Ticks of genus Ixodes
What is the classic sign of bite from Lyme disease infected tick?: Bull's eye lesion.

erythema chronicum migrans
What are the effects of untreated Lyme disease?: - neurologic: meningitis, encephalitis, peripheral neuropathy
- cardiologic: congestive heart failure, myopericarditis
- arthritis
What is the leading vector-borne disease in US?: Lyme disease
What protozoa cause malaria?: Plasmodium

- P. falciparum = most virulent

- P. vivax = most common
What vector carries malaria?: female anopheles mosquito
What is the life cycle of the malaria parasite?: - sporozoites in saliva
- liver - mature into merozoites --> bloodstream
- mer's enter red blood cells, multiply, burst (when fever shivering occur)
What is the sexual cycle of Plasmodium (malaria)?: - form male/female gametocytes in RBC
- mosquito feeds on RBC
- gametocytes form zygote
- sporozoites migrate to salivary glands of mosquito
* zygote forms in mosquito, NOT human host
What are symptoms of malaria?: Fever to fatal cerebral or renal disease.

Also headache, vomiting, muscle spasms.
Describe the synchronous cycle times of malaria.: 48 or 72 hour periodicity of fever

1. cold & shivering
2. hot, dry stage
3. profuse sweating
Why is P. falciparum malaria fatal during 1st 2 or 3 weeks?: Complications:
- cerebral malaria - headache, neck stiffness, convulsions, coma
- severe anemia due to bursting RBC's
- clots from destroyed RBC's
- hypoglycemia & lactic acidosis - parasites consume glucose
What is the treatment for malaria?: Chloroquinine.

Drugs are strain specific.
What is the common name for African trypanosomiasis?: Sleeping sickness
What protozoa cause trypanosomiasis?: - Trypanosoma brucel gambiense
- Trypanosoma rhodesiense
What is the trypanosomiasis vector?: Tse-tse fly
What are the symptoms of trypanosomiasis?: - chancre
- lymph node enlargement
- fever
- splenomegaly
- CNS involvement
- voracious appetite
- weight loss
- coma
How does T. brucei (trypsanosomiasis) survive so well in the blood?: Antigenic variation
How do you treat sleeping sickness?: arsenical and non-arsenical drugs
What protozoa causes Chaga's disease: T. cruzi
What is another name for South American trypanosomiasis?: Chaga's disease
How is Chaga's disease transmitted?: reduviid bug -- kissing bug
What systems does Chaga's disease affect?: Heart and GI

Major cause of death = myocarditis
What is the treatment for Chaga's disease?: arsenicals

* one of the hardest protozoal infections to cure
What are leishmania?: - Intracellular parasites that inhabit macrophages

- Cause leishmaniasis
Which are the leishmania that cause leishmaniasis?: - L. donovani --> visceral

- L. tropica --> cutaneous
Name two types of leishmaniasis.: 1. visceral, aka kal-azar -- liver and spleen

2. cutaneous -- skin
What are the symptoms of visceral leishmaniasis (kal-azar)?: Fever, weight loss, then years of hepatomegaly, splenomegaly.

Death from liver failure if untreated
What are the symptoms of cutaneous leishmaniasis?: Ulcers, scarring
How do you treat leishmaniasis?: antimonial compounds
What type of infections are schistosomiasis and filariasis?: helminth infections
What is the basis for the pathology of schistosomiasis?: Schistosome eggs: body becomes hypersensitive to antigens as they pass thru tissue or get trapped in organs
What is urinary schistosomiasis?: Schistosome eggs move thru bladder --> hemorrhage, polyps, possible cancer
What is another common name for filiariasis?: Elephantiasis
What causes filiariasis?: filarial nematodes
Describe lymphatic filiariasis.: - Larvae enter skin
- Develop into long worms in lymph nodes & lymphatics of limbs and groin
- Fever, rash, chronic lymphatic obstruction
What is an arenavirus infection?: - parasite of rodents
- harmless to rodents; severe, lethal in humans
What virus is most common in Sierra Leone hospitals?: - Lassa fever virus

- Contracted from infected rats or their urine.

- If tranferred from patient to caretaker via blood, body fluids, more severe
What virus causes Korean Hemorrhagic fever?: Hantaan virus
Where have there been recent outbreaks of Korean hemorrhagic fever?: SW US. Severe pulmonary disease.
What causes Marburg and Ebola viruses?: filoviruses -- long filamentous single strand RNA
What are the symptoms of Marburg and Ebola viruses?: fever, hemorrhage, rash, disseminated intravascular coagulation
How are Marburg and Ebola viruses treated?: No known treatment
Are there carriers of Marburg and Ebola viruses?: Yes, there appears to be subclinical infection. Found AB's in 18% of one pop
What causes Q (query fever)?: a rickettsia bacteria, Coxiella burnetii
How is the rickettsia Coxiella burnetii (Q fever) different from other rickettsia?: 1. not transmitted by arthropods
2. transmission by inhalation
3. main action in lungs; not vascular endothelium
If Q fever becomes chronic, what is the result?: Endocarditis. Can be fatal
What bacteria causes anthrax?: Bacillus anthracis, a spore forming bacteria
What are the 2 types of anthrax?: 1. cutaneous

2. pulmonary
What is an eschar? How does it develop?: An eschar is an ulcerated papule caused by anthrax toxin that has an edema factor. Center is black and necrotic
What is the mortality rate of pulmonary anthrax?: 100% if not treated
How does pulmonary anthrax begin?: Inhalation of anthrax spores, which enter macropohages.

--> pul edema, hemorrhage, and spread of lethal toxin
How do you treat pulmonary anthrax? How do you prevent it?: treat - Penicillin -- early and lots

prevent - Vaccine of purified protective antigens
What is the real name for wool sorters disease?: Pulmonary anthrax
What is the cause of plague?: Yersinia pestis
What is the vector for bubonic plague?: Rat flea
What is the difference between bubonic and pneumonic plague?: Bubonic trfr rat-to-human.

Pneumonic trfr human-to-human by droplets if lots of bacteria in lungs
What is clinical path/signs of bubonic plague?: 1. bacteria enter skin
2. spread to lymph nodes of armpit, groin
3. form buboes w/ hemorrhagic inflammation
4. spread to blood, septicimia, hemorrhagic
5. multisystem - spleen, liver, lungs, CNS
What causes tularemia, a multisystem zoonosis?: Franchisella tularensis
How are humans infected with tularemia?: Contact w/infected animals or by arthropod vector.

*There is no person-to-person spread
How does tularemia develop in the body?: Febrile illness, lymphatic spread;

Lungs, GI tract, and liver via blood
What is the cause of leptospirosis?: leptospira, spirochetes
How are humans infected with leptospira?: ingestion of contaminated food/water (rat urine), swimming
What are the complications of leptospirosis?: Hepatitis, bacteriuria, meningitis, hemorrhage, kidney and liver failure.

But 90% resolve okay

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