Viral Diseases of the Cardiovascular and Lymphatic Systems
1. Burkitts lymphoma Stage III: The lymphoma is present in groups
a. causative aqent: Epstein-Barr virus (EB virus)
b. method of transmission:
transmitted by
insect vectors
c. symptoms:
Loss of appetite
Weight loss
Fatigue
Night sweats
Unexplained fever
d. prevention:
Prevention of the endemic form of Burkitt's
lymphoma is complicated by the high incidence
of malaria in central Africa combined with
inadequate medical care. In other countries,
some risk factors associated with the sporadic
form can be lowered, most particularly lifestyle
behaviors that increase the risk of HIV infection.
In addition, patients with Burkitt's lymphoma
may want to consider genetic counseling
because of the role of the C-myc oncogene in
their disorder.
STAGING
he most common system of staging for non-
Hodgkin's lymphomas in adults, including
Burkitt's lymphoma, is the Ann Arbor system. It
specifies 4 stages as follows:
Stage I: The lymphoma is either limited to one
group of lymph nodes either above or below
the diaphragm, or is in an organ or part of the
body other than the lymph nodes, but has not
spread to other organs or lymph nodes.
Stage II: The lymphoma is either in two or
more lymph node groups on the same side of
the diaphragm, or is in only one organ or site
other than the lymph nodes but has spread to
the lymph nodes near that organ or site.
of lymph nodes on both sides of the diaphragm.
It may involve an organ or site outside the
lymph nodes, the spleen, or both.
Stage IV: The lymphoma is disseminated
(spread) throughout one or more organs
outside the lymph nodes. There may or may not
be involvement of lymph nodes that are remote
from the affected organs.
e. treatment:
Intensive intravenous chemotherapy
drugs also may be injected directly into the
cerebrospinal fluid, a treatment known as
intrathecal chemotherapy.
Examples of drugs that may be used in various
combinations
cyclophosphamide (Cytoxan)
cytarabine (Cytosar-U, Tarabine PFS)
doxorubicin (Adriamycin)
etoposide (Etopophos, Toposar, VePesid)
methotrexate (Rheumatrex)
vincristine (Oncovin)
2. Infectious mononucleosis (Glandular
fever)/ kissing disease
a. causative aqent: EpsteinBarr virus (EBV)
b. method of transmission:
infection is spread via saliva, and has an
incubation period of four to seven weeks. The
length of time that an individual remains
contagious is unclear, but the chances of
passing the illness to someone else may be the
highest during the first six weeks following
infection. Some studies indicate that a person
can spread the infection for many months,
possibly up to a year and a half.
c. symptoms:
Common symptoms of glandular fever include:
Extreme fatigue is a common symptom of Painkillers
glandular fever Painkillers, such as ibuprofen or Tylenol
Flu-like symptoms., glandular fever often (paracetamol) which can be bought over-the-
causes fever and temperature, aches, counter (OTC) may help bring down a fever and
headaches, and feeling sick. reduce pain. Patients under 16 years of age
A skin rash can appear in some individuals. must not be given aspirin.
Widespread, red, non-itchy.
Loss of appetite. Gargling
Nausea. Pharmacists may be able to help choose a
Malaise suitable gargling solution. Some patients find
Sore throat that gargling with salt water helps sore throat
Swelling around eyes. About 1 in 5 people with symptoms.
glandular fever become quite puffy and swollen Antibiotics as prevention
around the eyes. This disappears rapidly. Glandular fever is caused by a virus, not a
Swollen glands bacterium. Antibiotics are used for killing
No symptoms. This is called a sub-clinical bacteria. However, the doctor may prescribe
infection. Many people become infected with antibiotics to prevent secondary infections.
this virus but do not develop symptoms. Steroids
The liver can be affected. In some cases, the If the tonsils are very inflamed, a short course
infection can affect the liver. This can cause of steroids may be prescribed.
jaundice (yellowing of the skin and the eyes). It 3. Myocarditis
is more common in people who are over 30 a. causative aqent: EBV, herpes,HIV, Parvovirus
years of age. b. method of transmission:
Many people with glandular fever will also transmitted by insects
experience mild inflammation of the liver or c. symptoms:
hepatitis with symptoms such as: Shortness of breath
Intolerance to alcohol Abnormal heartbeat
The symptoms of jaundice and hepatitis should Light-headedness
clear up as the patient recovers from glandular A sharp or stabbing chest pain or pressure,
fever. which may spread to your neck and shoulders
The symptoms of a sore throat and fever Fatigue
improve usually after two weeks. Fatigue and Signs of infection, such as
swollen lymph nodes may persist for longer, Fever
occasionally for several months. Muscle aches
d. prevention: Sore throat
Prevention is by not sharing personal items or Headache
kissing those infected. Diarrhea
e. treatment: Treatments for glandular fever Painful joints
Currently, there is no cure for glandular fever. Swollen joints, legs, or neck veins
However the symptoms can be controlled with: Small amounts of urine
Plenty of rest. d. prevention:
Drinking fluids
There's no specific prevention for myocarditis.
However, taking these steps to prevent
infections might help:
Avoid people who have a viral or flu-like
illness until they've recovered.
If you're sick with viral symptoms, try to
avoid exposing others.
Follow good hygiene. Regular hand-
washing is a good way to help prevent
spreading illness.
Avoid risky behaviors. To reduce your
chances of getting an HIV-related
myocardial infection, practice safe sex and
don't use illegal drugs.
Minimize exposure to ticks. If you spend
time in tick-infested areas, wear long-
sleeved shirts and long pants to cover as
much of your skin as possible. Apply tick or
insect repellents that contain DEET.
Get your vaccines. Stay up to date on the
recommended vaccines, including those
that protect against rubella and influenza
diseases that can cause myocarditis.
e. treatment:
Usually, youll be prescribed medicines to help
your heart work better.
Examples include:
ACE inhibitors
Calcium channel blockers
Diuretics
4. Yellow fever
a. causative aqent: Flavivirus fibricus
b. method of transmission:
typically spread to humans from bites by
infected mosquitoes. People cannot spread
yellow fever among themselves through casual
contact, although the infection can be
transmitted directly into the blood through
contaminated needles.
A few different species of mosquitoes transmit
the yellow fever virus; some breed in urban
areas, others in jungles. Mosquitoes that breed
in the jungle also transmit yelllow fever to
monkeys, who, in addition to humans, are a
host for the disease.
c. symptoms:
Yellow fever has 3 stages:
Stage 1 (infection): Headache, muscle and joint
aches, fever, flushing, loss of appetite, vomiting,
and jaundice are common. Symptoms often go
away briefly after about 3 to 4 days.
Stage 2 (remission): Fever and other symptoms
go away. Most people will recover at this stage,
but others may get worse within 24 hours.
Stage 3 (intoxication): Problems with many
organs may occur, including the heart, liver, and
kidney. Bleeding disorders, seizures, coma, and
delirium may also occur.
Symptoms may include:
Fever, headache, muscle aches
Nausea and vomiting, possibly vomiting blood
Red eyes, face, tongue
Yellow skin and eyes (jaundice)
Decreased urination
Delirium
Irregular heartbeats (arrhythmias)
Bleeding (may progress to hemorrhage)
Seizures
Coma
d. prevention:
Vaccine
A safe and highly effective vaccine prevents
yellow fever
is the single most important measure for
preventing yellow fever.
Personal protection and the environmental
management of mosquitoes are very important
in preventing infection in regions where the
virus is present. See Fight the Bite for tips how
to protect yourself and your family from
mosquito borne diseases.
e. treatment:
there is no cure for the viral infection itself,
medical treatment of yellow fever focuses on
easing symptoms such as fever, muscle pain,
and dehydration. Because of the risk of internal
bleeding, avoid aspirin and other nonsteroidal
anti-inflammatory drugs if you suspect you have
yellow fever. Hospitalization is often needed.
5. Cytomegalovirus Infections
a. causative aqent: Cytomegalo virus
b. method of transmission:
shed (pass) the virus in body fluids, such as
urine, saliva, blood, tears, semen, and breast
milk. CMV is spread from an infected person in
the following ways: From breast milk. Through
transplanted organs and blood transfusions.
c. symptoms:
If you do experience symptoms, they'll be
similar to flu symptoms or symptoms of
glandular fever. They can include:
a high temperature of 38C (100.4F) or above
extreme tiredness
sore throat
swollen glands
muscle and joint pain
loss of appetite
hepatitis (inflammation of the liver)
These symptoms will usually last for a couple of
weeks.
d. prevention:
Good hygiene
Maintaining high levels of hygiene is a simple
measure that may help prevent a CMV infection
spreading. For example, always wash your
hands with soap and warm water:
before preparing, serving or eating food
after going to the toilet
after changing a babys nappy
after coming into contact with bodily fluids,
such as semen or urine
You should clean any surfaces that have come
into contact with bodily fluids, and wear
disposable gloves while doing this.
e. treatment:
Mild CMV infection is usually not treated. It
subsides on its own. When the infection
threatens life or eyesight, an antiviral drug
(valganciclovir,ganciclovir, cidofovir, foscarnet,
or a combination) may be given.
6. Chikungunya fever
a. causative aqent: Alpha virus
b. method of transmission:
Through mosquito bites
Chikungunya virus is transmitted to people
through mosquito bites. Mosquitoes become
infected when they feed on a person already
infected with the virus. Infected mosquitoes can
then spread the virus to other people through
bites.
Chikungunya virus is most often spread to
people by Aedes aegypti and Aedes albopictus
mosquitoes. These are the same mosquitoes
that transmit dengue virus. They bite during the
day and at night.
Rarely, from mother to child
Chikungunya virus is transmitted rarely from
mother to newborn around the time of birth.
To date, no infants have been found to be
infected with chikungunya virus through
breastfeeding. Because of the benefits of
breastfeeding, mothers are encouraged to
breastfeed even in areas where chikungunya
virus is circulating.
Rarely, through infected blood
In theory, the virus could be spread through a
blood transfusion. To date, there are no known
reports of this happening.
c. symptoms:
 Symptoms usually begin 37 days after
being bitten by an infected mosquito.
The most common symptoms are fever
and joint pain.
Other symptoms may include
headache, muscle pain, joint swelling,
or rash.
Chikungunya disease does not often
result in death, but the symptoms can
be severe and disabling.
Most patients feel better within a week.
In some people, the joint pain may
persist for months.
d. prevention:
There is no vaccine to prevent or
medicine to treat chikungunya virus.
Treat the symptoms:
o Get plenty of rest.
o Drink fluids to prevent
dehydration.
o Take medicine such as
acetaminophen (Tylenol) or
paracetamol to reduce fever
and pain.
o Do not take aspirin and other
non-steroidal anti-inflammatory
drugs (NSAIDS until dengue can
be ruled out to reduce the risk
of bleeding).
o If you are taking medicine for
another medical condition, talk
to your healthcare provider
before taking additional
medication.
If you have chikungunya, prevent
mosquito bites for the first week of
your illness.
o During the first week of
infection, chikungunya virus can
be found in the blood and
passed from an infected person
to a mosquito through
mosquito bites.
o An infected mosquito can then
spread the virus to other
people.