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Questions and Answers
What is a common symptom of gastrointestinal virus infections?
What is a common symptom of gastrointestinal virus infections?
Which virus is associated with gastroenteritis outbreaks, especially in crowded environments?
Which virus is associated with gastroenteritis outbreaks, especially in crowded environments?
Which of the following is a preventive measure to control the spread of GIT virus infections?
Which of the following is a preventive measure to control the spread of GIT virus infections?
What is the primary treatment approach for viral gastroenteritis?
What is the primary treatment approach for viral gastroenteritis?
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Which family does the poliovirus belong to?
Which family does the poliovirus belong to?
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Which GIT virus is primarily responsible for severe dehydration in children?
Which GIT virus is primarily responsible for severe dehydration in children?
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Which of the following viruses is least likely to cause luminal disease?
Which of the following viruses is least likely to cause luminal disease?
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Which GIT virus is NOT known to cause gastrointestinal symptoms?
Which GIT virus is NOT known to cause gastrointestinal symptoms?
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What is the primary mode of transmission for the poliovirus?
What is the primary mode of transmission for the poliovirus?
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Which serotype of poliovirus is most associated with causing paralysis?
Which serotype of poliovirus is most associated with causing paralysis?
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What percentage of poliovirus cases typically present as nil or mild illness?
What percentage of poliovirus cases typically present as nil or mild illness?
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In which demographic is the risk of paralysis due to poliovirus higher?
In which demographic is the risk of paralysis due to poliovirus higher?
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What is the incubation period for poliovirus?
What is the incubation period for poliovirus?
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What type of immunity does the live attenuated poliovirus vaccine (OPV) primarily induce?
What type of immunity does the live attenuated poliovirus vaccine (OPV) primarily induce?
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Which clinical manifestation of poliovirus is considered biphasic?
Which clinical manifestation of poliovirus is considered biphasic?
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What factor is most closely associated with a higher prevalence of poliovirus?
What factor is most closely associated with a higher prevalence of poliovirus?
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What is the primary cause of acute diarrhoeal illness in infants and young children?
What is the primary cause of acute diarrhoeal illness in infants and young children?
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What is the typical duration of diarrhoea caused by rotavirus?
What is the typical duration of diarrhoea caused by rotavirus?
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Which serogroup of rotavirus is identified as the most common?
Which serogroup of rotavirus is identified as the most common?
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What is a common complication associated with severe rotavirus infection?
What is a common complication associated with severe rotavirus infection?
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How is norovirus primarily transmitted?
How is norovirus primarily transmitted?
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What is the incubation period for norovirus infection?
What is the incubation period for norovirus infection?
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Which virus is primarily responsible for the 'winter vomiting' disease?
Which virus is primarily responsible for the 'winter vomiting' disease?
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What is an important preventive measure recommended for controlling norovirus outbreaks?
What is an important preventive measure recommended for controlling norovirus outbreaks?
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What symptom is least associated with norovirus infection?
What symptom is least associated with norovirus infection?
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Which of the following viruses is known to cause gastroenteritis primarily in healthcare settings?
Which of the following viruses is known to cause gastroenteritis primarily in healthcare settings?
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What is the main purpose of the Inactivated Poliovirus (IPV) vaccine?
What is the main purpose of the Inactivated Poliovirus (IPV) vaccine?
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Which of the following is a primary strategy of the Polio Eradication Strategy 2022 - 2026?
Which of the following is a primary strategy of the Polio Eradication Strategy 2022 - 2026?
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What is the most common route of transmission for non-polio enteroviruses?
What is the most common route of transmission for non-polio enteroviruses?
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What is a characteristic of Coxsackie B viruses compared to Coxsackie A viruses?
What is a characteristic of Coxsackie B viruses compared to Coxsackie A viruses?
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Which statement about ECHO viruses is true?
Which statement about ECHO viruses is true?
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Which clinical manifestation is commonly associated with Enterovirus D68?
Which clinical manifestation is commonly associated with Enterovirus D68?
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What is the typical clinical outcome of a viral gastroenteritis infection?
What is the typical clinical outcome of a viral gastroenteritis infection?
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Which of the following viruses is NOT known to cause gastroenteritis?
Which of the following viruses is NOT known to cause gastroenteritis?
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What is a common characteristic of the incubation period for non-polio enteroviruses?
What is a common characteristic of the incubation period for non-polio enteroviruses?
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How is supportive treatment for enterovirus infections typically administered?
How is supportive treatment for enterovirus infections typically administered?
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What is a significant factor in the epidemiology of gastrointestinal viruses?
What is a significant factor in the epidemiology of gastrointestinal viruses?
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Which of the following correctly describes a complication of gastrointestinal virus infection?
Which of the following correctly describes a complication of gastrointestinal virus infection?
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In viral infections of the gastrointestinal tract, which virus is particularly known for causing luminal disease?
In viral infections of the gastrointestinal tract, which virus is particularly known for causing luminal disease?
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Which laboratory diagnosis is essential for recognizing enterovirus infections?
Which laboratory diagnosis is essential for recognizing enterovirus infections?
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What is a critical preventive measure to control the acquisition of gastrointestinal virus infections?
What is a critical preventive measure to control the acquisition of gastrointestinal virus infections?
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Which of the following statements about The Poliovirus is incorrect?
Which of the following statements about The Poliovirus is incorrect?
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Which group of viruses is predominantly responsible for outbreaks in crowded settings like cruises or nursing homes?
Which group of viruses is predominantly responsible for outbreaks in crowded settings like cruises or nursing homes?
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What factor significantly increases the likelihood of severe rotavirus infection in children?
What factor significantly increases the likelihood of severe rotavirus infection in children?
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What is the primary reason for the faecal-oral transmission of poliovirus?
What is the primary reason for the faecal-oral transmission of poliovirus?
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Which of the following best describes the likely clinical outcome in 1-2% of poliovirus cases?
Which of the following best describes the likely clinical outcome in 1-2% of poliovirus cases?
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Which polio vaccination method induces secretory IgA as well as other forms of humoral immunity?
Which polio vaccination method induces secretory IgA as well as other forms of humoral immunity?
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In which situation is the prevalence of poliovirus expected to rise significantly?
In which situation is the prevalence of poliovirus expected to rise significantly?
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What is the consequence of polio's ability to remain in stool for an extended period?
What is the consequence of polio's ability to remain in stool for an extended period?
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How does the socio-economic environment impact the transmission of poliovirus?
How does the socio-economic environment impact the transmission of poliovirus?
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What is the main reason for performing a PCR test on CSF during the diagnosis of poliovirus?
What is the main reason for performing a PCR test on CSF during the diagnosis of poliovirus?
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What is the incubation period for poliovirus infection?
What is the incubation period for poliovirus infection?
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What is the primary objective of the Polio Eradication Strategy 2022 - 2026 in endemic countries?
What is the primary objective of the Polio Eradication Strategy 2022 - 2026 in endemic countries?
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Which of the following statements about Coxsackie viruses is accurate?
Which of the following statements about Coxsackie viruses is accurate?
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Which enterovirus has a greater likelihood of causing severe lower respiratory tract infection in children?
Which enterovirus has a greater likelihood of causing severe lower respiratory tract infection in children?
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What is the predominant source of infection for ECHO viruses?
What is the predominant source of infection for ECHO viruses?
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In what environment do outbreaks of rotavirus typically occur most frequently?
In what environment do outbreaks of rotavirus typically occur most frequently?
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What clinical manifestation is least commonly associated with Coxsackie B viruses?
What clinical manifestation is least commonly associated with Coxsackie B viruses?
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Which diagnostic method is typically used for confirming enterovirus infections?
Which diagnostic method is typically used for confirming enterovirus infections?
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Which statement about poliovirus vaccination is correct?
Which statement about poliovirus vaccination is correct?
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Which clinical outcome is most common among non-polio enteroviral infections?
Which clinical outcome is most common among non-polio enteroviral infections?
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What is the typical incubation period for norovirus infection?
What is the typical incubation period for norovirus infection?
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Which virus is primarily responsible for acute diarrhoea in infants and is known for requiring hospitalisation?
Which virus is primarily responsible for acute diarrhoea in infants and is known for requiring hospitalisation?
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What is a common clinical presentation of a severe rotavirus infection?
What is a common clinical presentation of a severe rotavirus infection?
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Which laboratory technique is commonly used for the diagnosis of rotavirus?
Which laboratory technique is commonly used for the diagnosis of rotavirus?
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What is the primary environmental prevention strategy emphasized for controlling norovirus outbreaks?
What is the primary environmental prevention strategy emphasized for controlling norovirus outbreaks?
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What is one potential long-term consequence of rotavirus infection in some cases?
What is one potential long-term consequence of rotavirus infection in some cases?
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Which group is noted for having the highest susceptibility to rotavirus infections?
Which group is noted for having the highest susceptibility to rotavirus infections?
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What clinical findings are less likely to occur in rotavirus infections?
What clinical findings are less likely to occur in rotavirus infections?
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Astroviruses are known to have which characteristic in their clinical presentation?
Astroviruses are known to have which characteristic in their clinical presentation?
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How are caliciviruses like norovirus primarily transmitted?
How are caliciviruses like norovirus primarily transmitted?
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Study Notes
Clinical Implications of Viral Infections of the Bowel
- Gastrointestinal Tract (GIT) Viruses cause diarrheal illness or illness elsewhere.
- Enteroviruses are a family of viruses that include Polioviruses, Coxsackie A and B viruses, ECHO viruses, and other Enteroviruses.
- Poliovirus is transmitted via the faecal-oral route.
- Poliovirus infection has three possible clinical presentations: nil or mild illness (90-95%), influenza-like illness (4-8%), and biphasic illness (1-2%).
- Paralytic poliomyelitis is a rare complication of poliovirus infection, occurring in 1 in 1000 cases.
- Poliovirus is eradicated in high-income countries, but still a major source of illness and death in low-income countries.
- Non-polio enteroviruses are transmitted via the faecal-oral route, direct contact, indirect contact, oral-oral route, and peri-natal transmission.
- Non-polio enteroviruses can cause a wide range of symptoms, including: fever, sore throat with rash, meningitis, diarrhea, rubella-form rash, pericarditis, and myocarditis.
- Enterovirus D68 is a non-polio enterovirus that can cause mild upper respiratory tract infections and severe lower respiratory tract infections (LRTI).
- Viral Gastroenteritis is a significant cause of morbidity and mortality worldwide, particularly in overcrowded areas with a low socioeconomic status.
- Rotavirus is the most common cause of acute diarrheal illness in infants and young children.
- Norovirus is a very common cause of gastroenteritis worldwide and "winter vomiting bug".
- Astrovirus causes symptoms similar to norovirus but with a longer incubation period.
- Adenovirus can cause infantile diarrhea, respiratory infections, meningitis, and conjunctivitis.
- Caliciviruses and Astroviruses are associated with outbreaks of acute diarrhea and vomiting in bivalve shellfish.
- Outbreaks of Rotavirus are most common in crèches and children's hospitals.
- Hand hygiene, good environmental cleaning, and disinfection are essential measures to prevent the spread of Norovirus.
- Surveillance, isolation, and cohorting are important measures to control Norovirus outbreaks in healthcare settings.
- Vaccines are available to prevent Rotavirus infection, but they are not effective against Norovirus.
Gastrointestinal (GIT) Viruses and Infections
- Viruses can cause diverse illnesses, including those affecting the gastrointestinal tract.
- The focus is on viral infections that cause diarrhoeal illness, particularly those transmitted via the faecal-oral route.
- Key GIT viruses: Rotavirus, Caliciviruses (including Noroviruses), Astroviruses, and Adenoviruses.
- Enteroviruses, a family of viruses within the Picornavirus, are also discussed. This includes Poliovirus, Coxsackie A and B viruses, ECHO viruses, and other Enteroviruses.
Poliovirus
- Epidemiology: Human-only reservoir, incubation period typically 7 days, transmitted via the faecal-oral route, and highly infectious.
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Clinical Manifestations: Three main presentations:
- Asymptomatic: Most common, exhibiting mild or no symptoms.
- Influenza-like Illness: Fever, lack of energy, and pharyngitis.
- Biphasic Illness: Initial GIT symptoms followed by fever, headache, aseptic meningitis, and occasionally paralytic poliomyelitis.
- Diagnosis: Early in illness, viral culture from throat and faeces; CSF PCR.
- Treatment: Supportive care, including pain relief, physical therapy, mechanical ventilation if necessary, and monitoring for autonomic dysfunction.
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Vaccines: Two types:
- Oral Poliovirus Vaccine (OPV): Live attenuated virus, administered orally, induces IgA and humoral immunity.
- Inactivated Poliovirus Vaccine (IPV): Contains inactivated polio serotypes administered via injection, produces antibody immunity, and induces little IgA.
Non-Polio Enteroviruses
- Epidemiology: Human-only infection, incubation period and clinical presentation vary with virus type, can be detected for several weeks in faeces.
- Transmission: Faecal-oral route (e.g., direct contact, contaminated water), oral-oral route (less common), and Peri-natal transmission.
- Pathogenesis: Replicate in the upper respiratory and GI tracts, multiplying in the intestinal tract, and spreading to lymphoid tissue. Viraemia is common, leading to damage to target organs.
- Clinical Presentation: More common in children, with most cases being asymptomatic. Can cause a wide range of symptoms, including mild flu-like illness, pharyngitis, respiratory infections, headache, conjunctivitis, rash, meningitis, and paralysis.
- Diagnosis: Enterovirus PCR from stool or clinical specimens.
- Treatment: Supportive treatment, including rehydration and analgesia. Antivirals are not indicated.
Coxsackie Viruses
- Epidemiology: Numerous antigenic types, divided into two groups (A & B), transmitted via the faecal-oral route, inhalation, and direct contact.
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Clinical Manifestations:
- Coxsackie A: Fever, common cold, rash, herpangina (vesicular lesions around the soft palate and uvula).
- Coxsackie B: Fever, rash, meningitis, epidemic myalgia (Bornholm’s disease), respiratory infections, myocarditis, and pericarditis.
ECHO (Enteric Cytopathogenic Human Orphan) Viruses
- Epidemiology: At least 33 antigenic types, spread via the faecal-oral route or oropharyngeal secretions.
- Clinical Manifestations: Usually asymptomatic, but can cause fever, sore throat with rash, meningitis, diarrhoea, rubella-form rash, pericarditis, and myocarditis.
Enterovirus D68
- Epidemiology: Non-polio enterovirus, cases peak in summer and autumn, affecting children predominantly, often associated with underlying respiratory illness.
- Transmission: Via inhalation of infected particles and manual transfer of infected material.
- Clinical Manifestations: Mild upper respiratory tract infection to severe LRTI, and acute flaccid paralysis.
- Diagnosis: PCR from throat swabs, nasopharyngeal swabs, BAL, or CSF.
- Treatment: Supportive care, antivirals are not indicated.
Viral Gastroenteritis
- Epidemiology: Significant cause of morbidity and mortality worldwide, especially in crowded, lower socioeconomic regions, transmitted via the faecal-oral route and sometimes by droplets.
- Key Viruses: Rotavirus, Caliciviruses (including Noroviruses), Astroviruses, and Adenoviruses.
Rotavirus
- Epidemiology: Group A is the most common serogroup, a major cause of acute diarrhoeal illness in infants and young children, often causing outbreaks in childcare settings.
- Pathogenesis: Multiplies in the small intestine, damaging cells, shortening villi, and causing malabsorption, resulting in hyperosmotic diarrhoea.
- Clinical Presentation: Diarrhoea lasting about 5 days (ranging from mild to severe watery diarrhoea with dehydration), vomiting, and rarely CNS complications.
- Diagnosis: Stool antigen detection or PCR.
- Management: Rehydration, post-gastroenteritis lactose intolerance is common, and a vaccine is available for infants.
Caliciviruses
- Epidemiology: Small RNA viruses, most well-known is Norovirus (common cause of gastroenteritis worldwide).
- Pathogenesis: Replication occurs in the small intestine, asymptomatic excretion is common.
- Clinical Presentation: Short incubation period (12-72 hours), nausea, abdominal cramps, malaise, myalgia, headache, acute vomiting, and less frequently diarrhoea. Spontaneous resolution within 24-48 hours, but rehydration is important.
- Diagnosis: Based on clinical presentation and faeces PCR.
Astroviruses
- Epidemiology: Star-shaped appearance, similar symptoms to Noroviruses but with a slightly longer incubation period.
- Clinical Presentation: Watery diarrhoea and vomiting, more prominent in Calicivirus infections.
- Outbreaks: Can occur in bivalve shellfish (oysters, clams, mussels).
Adenovirus
- Epidemiology: Double-stranded DNA virus, over 40 serotypes, transmitted via the faecal-oral route, respiratory route, or direct inoculation.
- Clinical Presentation: Commonly asymptomatic, but some serotypes cause infantile diarrhoea, respiratory infections, meningitis, and conjunctivitis.
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Description
Explore the clinical implications of viral infections affecting the gastrointestinal tract, specifically focusing on enteroviruses including poliovirus. Understand transmission routes, clinical presentations, and the impact of these infections in different socioeconomic contexts. This quiz covers critical aspects of gastrointestinal viral pathogens and their associated illnesses.
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