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  1. Viruses are cells not particles? =
    False, viruses are particles and not cells
  2. Virus are part of taxonomic scheme?
    FALSE! They are not
  3. Classification of viruses is based on?
    • Classification is based on:
    • •  Host infected: are they plant viruses, animal viruses, bacteriophages?
    • •  Structure of the virus
    • o  Are the viruses naked or enveloped?
    • o  Do they have helical/icosahedral capsids?
    • o  Do they have DNA or RNA?
    • o  Is the nucleic acid single- /double- stranded?
  4. Main criteria for classification of virus include three important things at the detailed level?
    Main criteria for classification include virus structure, chemical composition and similarities in genetic make-up.
  5. The classification sequence is how, rearrange if neccesary.

    Family
    Order
    Species.
    Genus
    The classification sequence is from Order to Family to Genus to Species.

    O F G S
  6. Match:
    •  Order names end in – _____
    •  Family names end in – ______
    •  Subfamily names end in – ______
    •  Genus names end in – ______
    •  Species names end in disease- virus

    virus
    viridae
    virinae
    virales
    virus
    • Order names end in – virales
    • Family names end in – viridae•
    • Subfamily names end in – virinae• 
    • Genus names end in – virus• 
    • Species names end in disease- virus

    • O les
    • F dae
    • S nae
    • G rus
    • S rus

    note genus and species end the same.
  7. Is there anything we can do to prevent and control viral disease? name them
    • There are 6 approaches to prevention and control of viral disease: some that occur at the community level (education, vector control), and others that occur at the individual level (quarantine, immunization, antiviral chemotherapy etc.).
    • Quarantine
    • Hygiene & sanitation
    • Vector control
    • Change of lifestyle
    • Immunization
    • Antiviral chemotherapy
  8. Three important anti-viral immunoglobulin preparations include HBIg (hepatitis B), VZIg (Varicella zoster) and RIg (rabies). Ig preparations are also available for hepatitis A virus and CMV.

    This are associated with active or passive immunity?
    passive
  9. herd immunity is associated with active or passive immunity?
    active.
  10. Production of passive immunity is through the stimulation of antibody production? =
    F


    Production of active immunity is through the stimulation of antibody production
  11. What are the properties of a good vaccine? three points
    What are the properties of a good vaccine?

    • Stimulate a strong & protective immune response
    • Result in memory for long-term protection
    • Be safe, cost effective & easy to deliver
  12. Classification of vaccines. Name them, and tell the subcategories.
    • Classification of vaccines
    • Live Vaccines
    • Inactivated Vaccines
    • Killed whole cell
    •    Fractional (protein)
    •    Fractional (polysaccharide)
    •    Recombinant / Hybrid
    • DNA vaccinesRNA vaccines
  13. There was an example in the handout that said, this is an example of natural pathogen used as a vaccine. This is associated with which type of vaccine?
    Live attenuated
  14. ___________vaccines are mutant organisms that possess a growth characteristic that prevents the organism from replicating like the wild-type that causes disease.
    Live attenuated vaccines are mutant organisms that possess a growth characteristic that prevents the organism from replicating like the wild-type that causes disease.
  15. Are cell death or alive in live attenuated vaccine?

    Does the organism can multiply? If, yes, what it would be positive thing about this?
    the cells are alive, the organism can multiply & emulate an actual infection, thereby resulting in a stronger immunological response
  16. live attenuated vaccines induce humoral & cell-mediated immunity. =

    live attenuated vaccines do not induce  inflammatory  response.=

    live attenuated vaccines can  revert  to  wild-type  (i.e. pathogenic) =

      Usually effective with more than one dose (except those administered orally) =

    Circulating antibodies are harmless to the vaccine =

    Strong or Fragile – killed by heat & light. Must be stored & handled with great care.
    This type of vaccine can induce humoral & cell-mediated immunity§  May  cause  an  inflammatory  response;  can  revert  to  wild-type  (i.e. pathogenic)

      Usually effective with one dose (except those administered orally)

    Circulating antibodies can destroy the vaccine

      Fragile – killed by heat & light. Must be stored & handled with great care.
  17. Live attenuated Vaccines typically include killed organisms or just parts of the organisms. =
    Inactivated Vaccines typically include killed organisms or just parts of the organisms.
  18. Inactivation of inactivated vaccines can be by heat or chemical treatment (e.g. formalin or formaldehyde). =
    Inactivation can be by heat or chemical treatment (e.g. formalin or formaldehyde).
  19. Inactivated Vaccines , The organism is dead/fractionated, necessitating more antigen for immunity=

      Immunity tipically accomplished by one dose =

    Does not require boosters =

    Not recommended for immunocompromised individuals =
    Inactivated Vaccines , The organism is dead/fractionated, necessitating more antigen for immunity§  Immunity accomplished by multiple doses (usually 3-5)May require boostersq  Can be given to immunocompromised individuals
  20. Killed whole cell – dead bacteria or viruses, or both?  b-Killed whole cell is a type of what vaccine?

    Give examples of this viral vaccines? there are 4.

    c-This vaccine elicits humoral response =
    • Killed whole cell – dead bacteria or viruses
    •  Viral – polio (oral), rabies, hepatitis A,  rotavirus (oral)

    b- inactivated vaccines

    c-yes
  21. Which type of vaccine is more toxic killed whole cell or fractional?
    killed whole cell
  22. Fractional vaccine belongs to which category?

    Fractional vaccine is made of what?

    +Subunit – ____ or _____ antigenic proteins (generally a surface protein); Examples of this vaccines? 3 very common

    +Toxoid – activated toxin = . The entire toxin may be used if it is inactivated (heat or chemicals).

    There are NO viral toxoid vaccines. =
    Is an inactive vaccine.

    Fractional – protein-based (only parts of the organism are used)

    +Subunit – single or multiple antigenic proteins (generally a surface protein); hepatitis B, influenza, HPV

    • +Toxoid– inactivated toxin. The entire toxin may be used if it is inactivated
    • (heat or chemicals).

    There are NO viral toxoid vaccines.
  23. Fractional – polysaccharide-based (only viral vaccines and NOT bacterial) =

    +Conjugate – links the non-immunogenic or immunogenic? polysaccharide to an antigenic component (usually the B subunit of an unrelated A-B exotoxin);

    Hib, pneumococci, meningococciq 


    Pure – purified polysaccharide, is highly effective in 2 years old children. =

    pneumococci, meningococci, typhoid fever
    Fractional – polysaccharide-based (only bacterial vaccines and NOT viral)

    +Conjugate – links the non-immunogenic polysaccharide to an antigenic component (usually the B subunit of an unrelated A-B exotoxin); Hib, pneumococci, meningococciq 

    +Pure – purified polysaccharide (not consistently immunogenic in children less than 2 yoa); pneumococci, meningococci, typhoid fever
  24. what is the smallest of the herpes viruses?

    A) HSV1
    B) HSV 3 or Varicella Zoster Virus (VZV)
    C) Adenoviruses
    D) HSV2
    B) Varicella Zoster Virus (VZV)
    (this multiple choice question has been scrambled)
  25. Varicella Zoster viruses causes ________ as the primary infection and ___________ as the secondary/latent infection.
    Varicella Zoster viruses causes Chicken pox as the primary infection and Shingles (Herpes Zoster) as the secondary/latent infection.
  26. The maculopapular rash appears how many days after infection? or is it during infection ? In which part of the body starts to appear?
    The maculopapular rash appears 14 days post infection & begins on the trunk. The rash may be described as “dew drops on a rose petal”
  27. dew drops on a rose petal is associated with which disease

    A. HSV1
    B. HSV2
    C. HSV3
    D. Adenovirus
    e. none of the above
    C. HSV3 remembe HSV3 is the same as varicella zoster virus (VZV)
    (this multiple choice question has been scrambled)
  28. How does (Varicella-zoster Virus cause pathogenesis?
    The virus is generally acquired by inhalation of infectious droplets. These enter the respiratory tract and make their way to the regional lymph nodes. A key to pathogenesis is the ability of this virus to engage in syncytial formation. Fusion of virus infected host cell with neighboring cells (regardless of being infected) enables evasion of neutralizing antibodies. Virus is able to establish latency in several types of sensory neuronal cells, including trigeminal, dorsal root, and cranial ganglia.
  29. A key to pathogenesis is the ability of this virus to engage in syncytial formation. This is associated with which virus?

    A. adenovirus
    B. HSV1
    C. HSV3
    D. HSV2
    C. HSV3

    Species – Human herpesvirus 3 (Varicella-zoster Virus)
    (this multiple choice question has been scrambled)
  30. Primary infection more severe in children than in adults for HSV 3 =
    Primary infection more severe in adults than in children

    Species – Human herpesvirus 3 (Varicella-zoster Virus)
  31. These complications are associated with which virus? which patient population? and which can be lethal?

    interstitial pneumonia,encephalitis, difficulty walking, and seizures
    HSV 3

    Species – Human herpesvirus 3 (Varicella-zoster Virus)

    interstitial pneumonia can be lethal

    all of this are associated with adults.

    Infection in immunocompromised patients or neonates (progressive disseminated varicella) can also be fatal.
  32. Zoster means?
    Girdle or belt
  33. Dermatomes are associated with?

    A. HSV 2
    B. addenovirus
    C. HSV 3
    D. HSV 1
    C. HSV 3

    Species – Human herpesvirus 3 (Varicella-zoster Virus
    (this multiple choice question has been scrambled)
  34. Herpes zoster presentation choose.

    a. Rash appears only in multiple dermatomes.
     
    b. Rash appears only in single dermatomes.
    b. Rash appears only in single dermatomes.
  35. how long does it take for lesions to resolve in a herpes zoster outbreak?

    A. 4 weeks
    B. 10 to 15 days
    C. 15 days
    D. 7 to 10 days
    E. 3 days
    D. 7 to 10 days
    (this multiple choice question has been scrambled)
  36. Postherpetic neuralgia what is it? what produces it?
    Postherpetic neuralgia is a chronic pain syndrome that can last for months to years following the development of zoster. This occurs in over 30% of adults over the age of 65 who have developed zoster.
  37. zoster sine herpete, what is it?
    Zoster without rash is called zoster sine herpete.
  38. Based on the microbio handout what are the correct stages of HSV 3 presentation in the diagnosis?

    A. scabs to pustules to vesicles
    B. pustules to scabs to vesicles
    C. vesicles to scabs to vesicles
    D. vesicles to pustules to scabs
    D. vesicles to pustules to scabs
    (this multiple choice question has been scrambled)
  39. Since when is chickenpox and zoster contagious?
    Chicken pox and zoster are contagious. Patients are contagious from 1 – 2 days before rash appears until all lesions have dried (into scabs).
  40. How can I transmit the HSV 3 virus to others?
    How can I transmit virus to others? The virus is transmitted by respiratory droplets and by direct contact with lesions, which contains infectious virus particles.

    Species – Human herpesvirus 3 (Varicella-zoster Virus)
  41. HSV 3 has only humans known as reseirvoir =
    YES ONLY HUMANS
  42. VZV immunoglobulin is given to which patient population? Also what is it?
    Anti-viral drugs are available along with VZV immunoglobulin for immunocompromised individuals and newborns of symptomatic mothers.

    Immunocompromised patients are given VZIg (pooling of plasma from seropositive people).
  43. FDA approved for treatment of adults and immunocompromised patients with varicella/shingles. what are those three medications?
    Acyclovir, famciclovir & valacyclovir
  44. vaccination prevent chickenpox = . How about adults?
    TRUE.
  45. What are varivax and zostavax?
    vaccines for HSV 3
  46. which of the following is a live attenuated Oka strain vaccine?

    a. Varivax
    b. Zostavax
    a. Varivax
  47. ProQuad is what?
    ProQuad® (Measles-Mumps-Rubella-Varicella Virus Vaccine Live, MMRV; discontinued due to adverse reactions). this is a vaccine
  48. Choose the right one:

    a.Varivax prevents chickenpox in 30 – 60% of vaccinated individuals and prevents severity of infection in 95% of vaccinated individuals.
    b. Varivax prevents chickenpox in 70 – 90% of vaccinated individuals and prevents severity of infection in 15% of vaccinated individuals.
    c. Varivax prevents chickenpox in 70 – 90% of vaccinated individuals and prevents severity of infection in 95% of vaccinated individuals.
    d. Zostavax prevents chickenpox in 70 – 90% of vaccinated individuals and prevents severity of infection in 95% of vaccinated individuals.
    • c. Varivax prevents chickenpox in 70 – 90% of vaccinated individuals and
    • prevents severity of infection in 95% of vaccinated individuals.
  49. Zostavax (FDA approved since 2006). CDC recommends how many doses for this vaccine and for what type of population?
    Zostavax (FDA approved since 2006). CDC recommends a single dose of this vaccine, for adults 60 years of age and older even if they have had shingles before
  50. Research has shown that in this population, the vaccine lowered the cases of shingles by about 50 %. which drug?

    A. Acyclovir
    B. Zostavax
    C. Varivax
    D. ProQuad
    B. Zostavax
    (this multiple choice question has been scrambled)
  51. which of the following are the largest and most complex viruses?

    A. Adenoviruses
    B. Herpes Viruses
    C. Poxviruses
    D. Morbillivirus
    e . Rubivirus
    C. Poxviruses

    Poxviruses are the largest, most complex viruses
    (this multiple choice question has been scrambled)
  52. Which of the following virus was eradicated ?

    A. Herpes Virus
    B. Chickenpox
    C. Smallpox
    D. Molluscum Contagiosum
    E. Parvovirus
    C. Smallpox

    The 1stlive vaccine was developed in 1796; worldwide distribution led to small pox eradication in 1980.
    (this multiple choice question has been scrambled)
  53. What is the name of the virus that causes smallpox?

    A. Rubella virus
    B. Variola virus
    C. HS3
    D. HS4
    E. Measlesvirus
    B. Variola virus

    The variola virus causes smallpox.
    (this multiple choice question has been scrambled)
  54. People most likely to have side effects are those with skin conditions, (especially eczema or atopic dermatitis) and weakened immune systems, (transplant patients, patients with HIV or cancer). This can be a lethal illness.

    this statement is associated with which virus?

    A. Chickepox
    B. Rubella virus
    C. Smallpox
    D. MC
    E. HS3
    C. Smallpox
    (this multiple choice question has been scrambled)
  55. transmission rarely occurs before rash asso. with?

    A. Herpes Zoster
    B. Human Herpes virus 6
    C. Smallpox
    D. Chickenpox
    C. Smallpox

    Chicken pox and zoster are contagious. Patients are contagious from 1 – 2 days before rash appears until all lesions have dried (into scabs).
    (this multiple choice question has been scrambled)
  56. Fomites can help in the transmission of which of the following viruses? Write down the letters.

    a. Human Adenovirus
    b. Smallpox
    c. HHV6
    d. Rubella
    e. HPV
    f. Molluscum Contagiosum
    g. Human B19 virus
    Human Adenovirus, Smallpox, HPV, Molluscum Contagiosum

    smallpox = variola virus
  57. Which of the following vaccines are used for smallpox?

    1. Dryvax
    2. Zostavax
    3. ACAM 2000
    4. Varivax

    A. 3 only
    B. 1 and 3
    C. 4 only
    D. 1 only
    E. 2 and 3
    B. 1 and 3

    Dryvax and ACAM 2000

    Varivax and Zostavax are used for chickepox not smallpox
    (this multiple choice question has been scrambled)
  58. There is NO treatment for smallpox =
    TRUE
  59. How do you distinguish between chickenpox and smallpox? Match by writing in paper for the blanks:

    a. Smallpox
    b. Chickenpox


    All pocks of the ____1____ rash are in the same stage of development on any given part of the body and develop slowly. In ___2___, the rash develops more rapidly, & vesicles, pustules, scabs may be seen at the same time.


    Most of the _____3____ lesions are small (1 - 5 mm), while ____4___ lesions are larger (5 -10 mm). By day 7, most of the ___5____ lesions have already formed scabs. By day 7, scabs over the ___6___ lesions have not yet formed. In ___7____, more pocks usually occur on the arms and legs than on the trunk. In ___8____, more pocks occur on the trunk. In ___9___, lesions are commonly found on the palms and soles. In ____10___, however, there are very few or no lesions on the palms and soles.
    • 1- a
    • 2-b
    • 3-b
    • 4-a
    • 5-b
    • 6-a
    • 7-a
    • 8-b
    • 9-a
    • 10-b

    How do you distinguish between chickenpox and smallpox? All pocks of the smallpox rash are in the same stage of development on any given part of the body and develop slowly. In chickenpox, the rash develops more rapidly, & vesicles, pustules, scabs may be seen at the same time. Most of the chickenpox lesions are small (1 - 5 mm), while smallpox lesions are larger (5 -10 mm). By day 7, most of the chickenpox lesions have already formed scabs. By day 7, scabs over the smallpox lesions have not yet formed. In smallpox, more pocks usually occur on the arms and legs than on the trunk. In chickenpox, more pocks occur on the trunk. In smallpox, lesions are commonly found on the palms and soles. In chickenpox, however, there are very few or no lesions on the palms and soles.
  60. rubeola is  which disease?
    measles
  61. The three C's and P, are associated with which virus? and what does stands for?
    Cough, Coryza which is acute rhinitis, and conjuctivitis. The P is for photophobia
  62. Photophobia is associated with which virus?

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  63. Koplik’s spots appear on the mucous membrane in the inside of
    the cheek, across from the molars. The lesions are described as “grains of salt surrounded by a
    red halo”.


    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  64. Koplik's spots usually precede the smallpox rash & may be seen for the 1stday or 2 after the rash appears.
    Koplik's spots usually precede the measles rash & may be seen for the 1stday or 2 after the rash appears.

    remember koplik's spots are an indication for measles not smallpox, we don't see those spots in smallpox
  65. A maculopapular rash appears within 24 hours of the appearance of the Koplik’s spots. TAW?


    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  66. 1. pneumonia, which could be fatal in young children
    2. bacterial secondary infections such as ear infections (this occurs in about 1 in 10 cases and could result in permanent loss of hearing)
    3. diarrhea (reported in about 8% of cases)

    TAW?

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus

    This are complications of measles.
  67. diarrhea (reported in about 8% of cases) TAW?




    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesviru
  68. pneumonia, which could be fatal in young children TAW?

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  69. 1 child in every 1,000 who get measles will develop _________, leading to deafness or mental retardation

    A. Conjunctivitis and Epidemic Keratoconjunctivitis
    B. CRS
    C. Blindness
    D. Exanthema Subitum
    E. SSPE
    E. SSPE


    Blindness due to herpes is the leading infectious cause of blindness in the U.S.

    Conjunctivitis and Epidemic Keratoconjunctivitis is caused by adenoviruses

    The most serious complication OF MEASLES is SSPE (subacute sclerosing panencephalitis).

    CRS is Congenital Rubella Syndrome and is the most serious outcome due to RUBELLA infection, which is the rubella virus.

    Exanthema Subitum = roseola, and this is produced by the HHV6 and HHV7 viruses which are not measles. This exanthema is not a complication but the typical disease.
    (this multiple choice question has been scrambled)
  70. For every 1,000 children who get _______, 1 or 2 will die from it

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  71. ________ in pregnant women can also lead to miscarriages, premature births or low-birth-weight babies.

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus

    • f- Measlesvirus
  72. In developing countries, where malnutrition and vitamin A deficiency are common, ________kills as many as 1 out of 4 people.

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  73. It is the leading cause of blindness among African children.

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  74. Worldwide, ______ used to kill almost 1 million children each year.

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  75. Clinical manifestations (Koplik’s spots)
    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  76. RT-PCR of Throat or nasopharyngeal swabs / blood / urine (samples are collected as soon after rash as possible)

    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  77. Staining of respiratory cells or cells from urine reveal multinucleated giant cells
    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    f- Measlesvirus
  78. Which of the following viruses are spread by respiratory droplets, write in a paper.


    a. Human Adenovirus
    b. HSV 1
    c. HSV 2
    d. Varicella-Zoster Virus
    e. Variola Virus
    f- Measlesvirus
    g- Rubella Virus
    h- Human B 19 virus
    i- HHV6 and HHV7
    J- Human Papilloma Virus
    k-Molluscum Contagiosum
    Human Adenovirus: has various other forms of transmissions.

     HSV 1 orally,

    HSV 2: sexually mostly,& by placement into eyes and breaks in skin

    zoster : The virus is transmitted by respiratory droplets and by direct contact with lesions, which contains infectious virus particles.

    Variola (smallpox) = The smallpox virus is spread by respiratory route usually requiring close contact (transmission rarely occurs before rash). Fomites can also aid in transmission.

    Measlesvirus : Measles is highly contagious and is spread from person toperson via respiratory droplets.

    Rubella: Rubella is spread from person to person via infectious respiratory droplets and occasionally urine.

    Human B 19 virus: Transmission of the virus occurs by inhalation of infectious respiratory droplets.

    HHV6 and HHV7: Transmission of HHV-6 is via saliva and possibly vertically (from mother to child). Sexual transmission is also possible. HHV-6 has been detected in skin as well, suggesting transmission by direct contact.

    HPV: via direct contact. Warts are also transmitted from one body part to another via autoinoculation. The viruses are fairly stable in the environment, allowing their transmission via fomites (surfaces of countertops/furniture, shower stalls, towels and medical equipment), surfaces of furniture, bathroom floors, and inadequately chlorinated swimming pools.

    Molluscoum: Transmission is related to poor hygiene, and climatic factors such as warmth and humidity. Transmission is by direct contact (includes sexual) or fomites. Fomites for MC transmission include towels and clothing that come in contact with thelesions. MC transmission has been associated with swimming pools and sharing baths with aninfected person. In adults, sexual transmission is the most common mode of transmission.The virus occurs worldwide, including the US. Genital lesions are considered a marker for sexual activity.

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