CHILDHOODRASHES

(allchildhoodrashesareacquiredbyrespiratory
routeandbecomesystemic)

CHILDHOODRASHES(allsystemic)
1. Fifthdisease
Othernames:B19,Erythema infectiousum,slapcheek

Symptoms:
Brightrederythemaappearsabruptlyoverthe
cheeks
Symptomsareduetoimmunecomplexes
Virus: Parvovirus,ssDNA,naked
Targetcell:Dividingerythroid precursor
Immuneresponse:Antibody
Vaccine:none
Latency:none
*crossesplacenta
2.Chickenpox
Othername:VZV
Symptoms:Red,itchyrashontheskinthatusuallyappears
firstontheabdomenorbackandface.Therashbeginsas
multiplesmall,redbumps.Theydevelopintothinwalled
blistersfilledwithclearfluid,whichbecomescloudy.The
blisterwallbreaks,leavingopensores,whichfinallycrustover.
Virus: Herpes,dsDNA,enveloped
Targetcell:Epithelialcellsandsensoryrootganglia
Immuneresponse:Tcellmediated
Vaccine:liveattenuated
Latency:sensorytrigeminalanddorsalroot

3.Roseola
Othername:HHV6
Symptoms:feverthenrash,sparestheface
Virus: Herpes,dsDNA,enveloped
Targetcell:epithelialcellsandlymphocytes
Immuneresponse:Tcellmediated
Vaccine:novaccine
Latency:whitebloodcells

4.Measles
Othernames:Rubeola
Symptoms:
3Cs+P,Koplik spots,diffuse,confluentrash,brownin
color
Virus:Paramyxovirus;ssRNA,env.
Vaccine:Liveattenuated
Latency: none
Complicationscanbesevere

5.Rubella
Othernames:Germanmeasles
Symptoms:
Mildfever
Enlarged,tenderlymphnodes(longlasting)
Afine,pinkrashthatbeginsonthefaceandquicklyspreadstothe
trunkandthenthearmsandlegs,beforedisappearinginthesame
sequence
Shedinrespiratry secretionforalongtime
Virus:Togavirus;ss+RNA,env.
Vaccine:Liveattenuated
Latency:none
*crossesplacenta,
congenitaldefects

SKINLESIONSthatareNOT
CONSIDEREDCHILDHOOD
RASHES

SKINLESIONSthatareNOTCONSIDEREDCHILDHOODRASHES

1. Smallpox

Symptoms:
Smallredspotsonthetongueandinthemouth.
Soresbreakopenandspreadlargeamountsofthevirusinto
themouthandthroat.
Rashspreadstoallpartsofthebodywithin24hours.
Rashbecomesraisedbumps.
Bumpsfillwithfluid.
Bumpsbecomepustulessharplyraisedandfirm.
Virus: Pox,ds DNA,enveloped,replicatesinthecytoplasm
Targetcell:epithelialcellsandsystemic
Vaccine:liveattenuated,ledtoeradication
Latency:none

2.Molluscum contagiosum
Symptoms:
Smallwhite,pink,orfleshcoloredraisedbumpsorgrowthswitha
dimpleorpitinthecenter.Thebumpsareusuallysmoothand
firm.Lasts612months.
Virus: Pox,ds DNA,enveloped,replicatesinthecytoplasm
Targetcell:Epithelialcells,notsystemic
Vaccine:none
Latency:none

3.Papilloma warts(otherthanHPV16and18)
Symptoms:
Skinwarts:oftenfoundonthehandsandfeet,butcan
alsooccurinotherareas,suchastheelbowsorknees.
Haveacharacteristiccauliflowerlikesurfaceandare
typicallyslightlyraisedabovethesurroundingskin.
Plantarwarts:arefoundonthesolesofthefeet.
Flatwarts:foundonthearms,faceorforehead.They
arefleshcolored,slightlyraised,flatsurfaced.
Genitalwarts:HPV6,11
Virus: Papova,ds DNA,naked,usesOURDdDpol
Targetcell:epithelialcells,notsystemic
Vaccine:recombinantvaccineforHPV6and11(+16and
18)
Latency:epidermalepithelialcells

4.HSV1andHSV2
Symptoms:
Painoritchingwithsmallredbumpsortinywhite
blisters
Vesiclesrupture,becomingulcersthatoozeorbleed
Flulikesignsandsymptoms,suchasheadache,muscle
achesandfever
Virus: Herpes,dsDNA,enveloped
Targetcell:Epithelialcells,usuallynotsystemic
Vaccine:none
Latency:insensorynerves

5.Handfootandmouth(andothercoxsackie rashes)
Symptoms:
Blisterlikeeruptionsinthemouthand/ora
skinrash(HFMD)
Nonspecificrashes(oftenwithrespiratory
sypmtoms,GIsymptomsandconjunctivitis
Virus: Picorna,ss +RNA,naked
Targetcell:epithelialcells,systemic
Vaccine:none
Latency:none
*AlsoknowCoxsackieB

CANCERS

1.Papilloma HPV16and18
Symptoms:
Inmanycasestherearenosymptoms.
Themostcommonsymptomsinwomenwithcancerinclude
abnormalvaginalbleedingordischarge,bleedingafter
intercourseandpain.
Virus: Papova,ds DNA,naked,usesOURDdDpol
Targetcell:cervicalsquamous epithelium(sexuallytransmitted)
Vaccine:recombinantGardasil vaccineHPV16and18
Reason:E6andE7integration
Treatment/Prevention:PAPsmear,earlydetection,LEEP
2.HepatitisB
Symptoms:
Jaundice
Splenomegaly
Muscleatrophy,fatigue,weakness
Increasingabdominalgirth(portalveinocclusionbythrombus
withrapiddevelopmentofascites)
Hepaticencephalopathy
Virus: Hepadna,partialdsDNA,enveloped,withRTase
Targetcell:Liver,systemic
Reason: Liverregeneration
Vaccine:RecombinantHBsAg vaccine(3shots)
Latency:Chronicintheliver

3.EBV Burkitts lymphoma

Symptoms:
Swellingofthelymphnodes(glands)inthe
neck,groin,orunderthearm.These
swollenlymphnodesareoftenpainless,but
cangrowveryrapidly.
Itmayinvolvethebonemarrow,spleenand
liver.
Mayspreadtothebrainandspinalcord.
Othersymptomsincludesweatingatnight,
unexplainedhightemperaturesandweight
loss.
Virus: Herpes,dsDNA,enveloped
Targetcell:Bcells,epithelialcells
Reason: Bcellactivation
Vaccine:none
Latency:Bcells
(maybeinthebonemarrowofjawbones)

HepatitisLiverdisease

HepatitisB
Virus:Hepadnavirus,
partiallydsDNA,env,has
RT
Vaccine: HBsAg subunit

HepatitisA
Virus: Picorna,ss+RNA,naked
Vaccine: killed
notchronic
nocancer

Chronic
in70%

HepatitisC
Virus:Flavi,ss+RNA,
envelope
Vaccine: none

Chronic
in70%

Incubation
period
Hep. A

Hep.B

Spread

Symptoms

Vaccine

Who
is atrisk?

CENTRALNERVOUSTISSUE
Rememberthatmostoftheviruseslisted
belowonlyrarely causenervoustissue
damage.
However,rabies ispreciselyneurotropic
andHSV1,2andVZVarelatentinthe
peripheralsensorynerves

1.PML
Symptoms:
Demyelinatingdisease,inwhichthemyelinsheath
coveringtheaxonsofnervecellsisgradually
destroyed,impairingthetransmissionofnerve
impulses.
Itaffectsthewhitematter,whichismostly
composedofaxonsfromtheoutermostpartsof
thebrain.
Causesweaknessorparalysis,visionloss,impaired
speech,andcognitivedeterioration.
Virus:Polyomavirus,dsDNA,naked
Vaccine: none
*MostHerpesvirusescan
2.HSV1and2
rarelycauseencephalitis
Symptoms:
Highfever,headacheandstiffneck
Confusion
Discomfortwhenlookingintobrightlights
Nausea
Vomiting
Sleepiness
Virus:Herpes,dsDNA,enveloped
Vaccine: none

normal

Encephalitis
Usuallyin
temporal
lobes

3.Polio
Symptoms:
Viralmeningitis
Paralysis
Destructionofmotorneuronswithinthe
spinalcord,brainstem,ormotorcortex
Variousformsofparalysis
Deeptendonreflexesareabsentor
diminished;sensation(theabilitytofeel)in
theparalyzedlimbs,isnotaffected
Virus:Picornavirus,ss +RNAnaked
Vaccine: SalkandSabine(knowdifference)

4.CoxsackieAandB
Symptoms:
Highfever,headacheandstiffneck
Confusion
Discomfortwhenlookingintobrightlights
Nausea
Vomiting
Sleepiness
Virus:Picornavirus,ss +RNAnaked
Vaccine: none

Spinalpolio

Bulbarpolio

5.SSPE
Symptoms
Gradual,progressivepsychoneurological deterioration
Personalitychange
Seizures
Photosensitivity
Ocularabnormalities
Spasticity,andcoma
Pathologically,thewhitematterofbothhemispheresand
brainstemareaffected,aswellasthecerebralcortex,and
eosinophilic inclusionbodiesarepresentinthecytoplasmnucleiof
neuronsandglialcells.
Virus:
Paramyxovirus,ssRNA,enveloped
Vaccine: livemeaslesvaccine

6.Arboviruses
Symptoms:
Virus:
Vaccine:

7.Rabies
Symptoms:
Virus:
Vaccine:

Congenitaldefects:
Cataracts,cardiacanomalies,mentalretardation,cerebral
palsy,deafness,microcephaly,thrombocytopenia,
hepatosplenomegaly,intrauterinegrowthrestrictions
1. CMV mostcommon
Symptoms:
Hearingloss
Visionloss
Mentaldisability
Smallheadsize
Lackofcoordination
Seizures
Hepatomegaly
Virus:Herpes,dsDNA ,enveloped
Vaccine:none

2.Rubella
Virus:Togavirus,ss+RNA,enveloped
Vaccine:liveattenuated

Hemorrhagicfevers

1. Denguefever
DHF/DSS
Symptoms:
Virus:
Vaccine:

2.Yellowfever
Symptoms:
Virus:
Vaccine:

Typesofinfections:

Disease
(examples)

Disease

Virus

Persistent/La
tent

Coldsores

HSV/Herpes

Shingles

VZV/Herpes

Cervical Cancer

HPV 16and18/Papilloma

LiverCancer

HBV/Hepadna

SSPE

Measles/Paramyxo

Common cold

Rhino/Picorna

Influenza

Orthomyxo

Polio

Picorna

Persistent/
Chronic

Acute

Modeof viraltransmission

Examples

Respiratory

Paramyxo,Influenza,Picorna
(entero),Rhino,VZV,EBV,B19,
HHV6,Adeno,Rubella

Fecaloral

Picorna,Adeno

Contact

HSV,Rhino,Molluscum,HPV

Zoonoses (animals,insects)

InfluenzaA,Rabies,
Arboviruses

Viablood

Hep B,Hep C,CMV

Sexualcontact

HSV,HPV,Molluscum

Maternalneonatal

CMV, Rubella,B19,HSV,VZV