1. Viral infections polio ,mumps ,dengue fever

2. mumps Mumps is acute self limited infection .
Mumps virus exist as a single immunotype and human are the only natural host .
Mode of spread : person to person by respiratory droplets .
Virus appear in saliva from up to 7 days before to as long as 7 days after onset of parotid swelling
Period of maximum infectiousness is 1-2 days before to 5 days after onset of parotid swelling

4. Clinical picture Incubation period prodrome : last 1-2
Swelling:Tender parotid ,ear pain on the epsilateral side .
Swelling subside in 7 days
Submandibular glands may be involved

5. MUMPS

6. Differential diagnosis of parotid swelling?

7. complication ?

8. Diagnosis and treatment
Clinically…………….
Investigation : leukopenia with relative thrombocytosis was a common finding, elevated serum amylase value , isolation of virus ,serologic tests .
Long lasting immunity
Prognosis excellent
Treatment : no specific antiviral therapy , symptomatic treatment
prevention : MMR vaccine

9. Aedes aegypti, the mosquito that spreads Dengue fever.

10. Do you know…
Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF) are the most common mosquito-borne viral disease in the world.
It can be fatal.
Dengue fever and dengue haemorrhagic fever are the most common diseases spread by the Aedes mosquitoes. The mosquitoes can carry 4 different types of dengue viruses hence you can be infected with dengue fever more than once. If you had dengue fever before and are infected again, you are more likely to develop the more deadly and serious dengue haemorrhagic fever.

11. Characteristics of the Aedes Mosquito
One distinct physical feature – black and white stripes on its body and legs.
Bites during the day.
Lays its eggs in stagnant water.
Close-up of an Aedes mosquito
Now I’ll tell you about the Aedes mosquito which spreads dengue.
1) You can identify an Aedes mosquitoe from other mosquitoes by the black & white stripes on its body and legs. Because of this, it is also known as the ‘tiger mosquito.
2) It usually bites during the day.
3) The Aedes mosquito lays its eggs in clean, stagnant water. A pool of water as small as a twenty cent coin is all that is needed for it to breed. 

12. And passes the virus to healthy people when it bites them.
How Do Aedes Mosquitoes Transmit Diseases...
Mosquito bites and sucks blood containing the virus from an infected person.
And passes the virus to healthy people when it bites them.
We all know by now that the Aedes mosquito spreads the dengue virus, but how exactly do they do it? Mosquitoes cannot transmit the dengue virus amongst themselves, they need to first bite a person who is already infected with the dengue virus. The infected mosquito will then carry the dengue virus and pass it onto a healthy person when it bites him/her and causing them to fall sick. The cycle then continues with the new victim.

13. Symptoms of Dengue Fever
Example of a skin rash due to dengue fever
How do you know if you have dengue fever? You have dengue fever if you have a fever that does not go away even after a few days; You may also experience headaches, muscle and joint pains, skin rash, and vomiting.

14. Laboratory finding : Pancytopenia
Clotting time , bleeding time ,prothrombine time ,and plasma fibrinogen value are within normal
Mild acidosis
Mild Elevated transaminases ,decrease protein value

15. Subcutaneous hemorrhage in child with DHF
Dengue Hemorrhagic Fever
Subcutaneous hemorrhage in child with DHF
Hemorrhagic conjunctivitis
NASAL HEMORRHAGING

16. Laboratory finding : Hemoconcentration ≥ 20% Decrease protein value
Prolonged bleeding time ,decrease prothrombine level
Fibrin degradation products increased
Elevated transaminases
Complement consumption
Metabolic acidosis
Elevated BUN
Decrease Na ,CL level
X ray chest : pleural effusion

17. Diagnosis of dengue fever
High index of suspicion and knowledge about geographical distribution .
Increasing antibody titer (Ig G) to four folds or more .
Isolation of virus by PCR, complement fixation ,enzyme immunoassay .

18. WHO criteria for diagnosis of dengue hemorrhagic fever:
1- fever 2-7 days
2-platelets < 100,000
3-haematocrit ≥ 20% ,pleural effusion ,ascites or hypoalbuminemia
Dengue shock fever:
Those for dengue hemorrhagic fever , hypotension ,tachycardia ,narrow pulse ≤ 20 and sign of poor perfusion .

19. treatment Treatment of dengue fever is supportive
Prevention: control of breeding sites for the mosquitoes is key to control of the disease through control of the vector .
Treatment of dengue fever is supportive
Treatment of dengue hemorrhagic fever and shock:
Check vital sign, HCT, S/E
Close monitoring in h
IV fluid ,correct electrolyte
Fresh blood ,platelets , FFP may be needed
Aspirin is contraindicated

20. What is Poliomyelitis? polio= gray matter
Myelitis= inflammation of the spinal cord
This disease result in the destruction of motor neurons caused by the poliovirus.
Polio is causes by a virus that attacks the nerve cells of the brain & spinal cord although not all infections result in sever injuries and paralysis.

21. Sequelae of polio infection
Inapparent infection
Clinical poliomyelitis
Abortive polio
(minor illness)
Involvement of CNS
(major illness)
Paralytic
polio
Non-paralytic
polio
Spinal polio
Bulbar polio
Bulbospinal polio

23. Complications and case fatality?

24. Diagnosis and laboratory testing (cont.)
Virus isolation
The likelihood of poliovirus isolation is highest from stool specimens, intermediate from pharyngeal swabs, and very low from blood or spinal fluid.
Serologic testing
A four-fold titer rise
Cerebrospinal fluid (CSF) analysis

25. Prevention General prevention:
Health promotion through environmental sanitation.
Health education (modes of spread, protective value of vaccination). Active immunization:
Salk vaccine (intramuscular polio trivalent killed vaccine).
Sabin vaccine (oral polio trivalent live attenuated vaccine).