Question

LaTeisha was finally headed back from Nigeria! This trip had been transformational but she was also

glad to head back home to hot showers, familiar food, and a routine including her own car. Two weeks in

the rural countryside is a lot.... Abuja was her new favorite city! Her church had told them all about the

amazing work the medical missionaries did and she already had her CNA so why not? It would be a great

experience and look good on her application to PA school.

And it was incredible... she helped administer vaccines, culture strep throat, detect atypical pneumonia in

coughing children, just amazing. She was impressed by the resilience of the Nigerian villagers; they were

struggling with drought, the cows were spontaneously aborting the calves, and militias visited from the

north all too often but they quietly persevering all the same. . The villagers inspired her and she knew it

was international medicine she was destined to do for her whole life.

But now, just the morning after her flight landed in Atlanta, she wasn’t feeling so well. She felt it a little

on the plane but that could have just been her fear of lying. She was pretty sure she had a fever now. She

felt kinda achy too – knees and elbows and neck. Not so fun. She still had a week before school so she

could just be lazy and recover. She slept the day away.

The next day, things were worse. Her mom insisted she call a doctor. She was vomiting now and it was...

black. Her mom also said that her eyes looked funny, yellowish. They went to an urgent care clinic near

their house. As the PA on duty, you take her case history, temperature, blood and stool samples. Her

really low blood pressure and the color of the vomit were serious indicators

4.

The pathogen causing

LaTeisha’s illness is _______

5.

This organism is severely damaging LaTeisha’s body. How does it cause damage and what isONE virulence factor

Answer 1

4. From the symptoms such as yellow eye, black vomit it appears that that the disease is yellow fever. It is caused by the Flavivirus and this disease is transmitted by biting of Aedes aegypti mosquito.

5. Yellow fever affects multiple organs. It mainly affects liver . it also causes damage in heart and kidney. This virus enters through the bite of Aedes aegypti mosquito. The virus first enters into the lymph node, start replication there and infect dendritic cells. From lymph node they are transmitted to liver and affect liver cells or hepatocytes. This cause degradation of eosinophils and certain cytokines are released from these cells. Concilman bodies which is actually the apoptotic masses found in the cytoplasm of liver cells. This ultimately lead to jaundice and degradation of bilirubin and biliverdin. The main factor responsible for death due to yellow fever is this cytokine shock and failure of multiple organ.

The surface macromolecules of flavivirus are the main virulence factor which aid in penetration and cell cell interactions of the virus. E protein of flavivirus helps in binding, fusion and entry of the virus into the cells.