Ori Disclaimer The information represents my understanding only so errors and omissions are probably rampant It has not been vetted or reviewed by faculty The source is our class notes The document can mostly be used forward and backward I tried to mark questionable stuff with ID: 775288
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Slide1
Viral Disease
Slackers Facts by Mike
Ori
Slide2Disclaimer
The information represents my understanding only so errors and omissions are probably rampant. It has not been vetted or reviewed by faculty. The source is our class notes.
The document can mostly be used forward and backward. I tried to mark questionable stuff with (?).
If you want it to look pretty, steal some crayons and go to town.
Finally…
If you’re a gunner, buck up and do your own work.
Slide3What are the three types in
Orthomyxoviruses
Slide4A, B, C
Slide5Seasonal flu is what type?
Slide6Type A
Slide7Describe the genome of
orthomyxovirus
Slide8Segmented ssRNA (-)
Slide9To what do H and N refer to
Slide10Hemagglutinin and neuraminidase spikes on the viral surface
Slide11In which portion of the cell
orthomyxovirus
replicate and why?
Slide12In the nucleus because they cannot prime their RNA strands
Slide13Why is the seasonal flu shot seasonal?
Slide14A new vaccine is required each year because of antigenic drift due to polymerase errors
Slide15Why does bacterial pneumonia often follow influenza?
Slide16The virus causes destruction of ciliated respiratory epithelium in the upper respiratory tract. This degrades the mucociliary elevator and prevents efficient clearance of bacteria.
General immune system down regulation occurs as the influenza infection is controlled.
Slide17What is the basis for the increased virulence seen in H1N1 of swine origin
Slide18Antigenic shift has substantially altered the virus to reduce its antigenic similarity to previous strains and to allow it to replicate in both the upper and lower respiratory tract.
Slide19Why are people over 50 less likely to get sick from H1N1 swine origin.
Slide20An similar pandemic occurred within their lifetime.
They do not have as robust an immune system and cannot generate as much of a cytokine storm
Slide21Why is avian flu H5N1 difficult to get
Slide22Currently the strain’s H antigen interact with
sialic
acid alpha 2,3 gal receptors which are situated in the lower respiratory tract. Thus it take larger exposures to transmit the disease.
Slide23What would occur if H5N1
reassorts
in swine
Slide24Why are swine important intermediates in the assortment of avian and human influenza?
Slide25Swine upper respiratory epithelium contains
sialic
a2,3 gal and
sialic
a2,6 gal receptors thus they can be easily
coninfected
with both human and avian virus. This allows nature to tinker.
Idle goddesses are the devils workshop.
Slide26What will happen if H5N1
reassorts
or mutates to efficiently infect both upper and lower respiratory epithelium.
Slide27The potential for significant mortality
Slide28What are the requirements of a pandemic influenza
Slide29New human type A strain
Causing serious illness
Easily spreads person to person
Slide30What diseases are caused by
paramyxovirus
Slide31Mumps
Parainfluenza
and croup
Rubeola (5 day measles)
Respiratory syncitial virus
Slide32Describe the
paramyxovirus
spikes
Slide33Combined H and N on single spike (
para
=next to hence H is
para
to N)
Fusion (F) protein on second spike
Slide34What is a
syncitia
and why do they form
Slide35A
syncitia
is a giant cell that forms by fusion of multiple cells.
Paramyxovirus
tends to form
syncitia
through the action of F protein deposited on cell surfaces.
Slide36Distinguish
parainfluenza
from Respiratory syncitial virus
Slide37Parainfluenza
= bronchitis
RSV =
bronchiolitis
Slide38Describe RSV epidemiology
Slide39Occurs from the late fall to the spring. Predominantly affects small children < 1
yo
.
Slide40Describe RSV immunity
Slide41Immunity is incomplete. Repeated
infections occur with lessened
severity but its unclear if there is an immune basis.
Slide42RSV diagnosis
Slide43Immunofluorescence of nasal swabs
Slide44RSV prophylaxis
Slide45Injection of monoclonal antibody against factor F is indicated in high risk children
Slide46Its flu if?
Slide47It looks like a cold but also has
Myalgia
/
arthralgia
Fever
Slide48Adenovirus structure
Slide49Linear dsDNA
Slide50Adenovirus disease
Slide51URI particularly in children
Slide52Adenovirus persistence
Slide53DNA virus can establish latent/carrier state
Slide54What viruses are responsible for the common cold?
Slide55Rhinovirus
Coronavirus
Reovirus
Slide56What is a exanthema?
Slide57Circle the correct answer
Choose wisely grasshopper
A widespread rash
An out of date national anthem.
Last years skirt lengths
Slide58List the common
exanthem
viruses and families
Slide59Illness
Genus
family
Mumps
Paramyxovirus
paramyxoviridae
Measles
Morbillivirus
paramyxoviridae
Rubella
Rubivirus
togaviridae
Roseola
infantum
HHV6,
adenovirus,
coxackie
virus, echovirus
Erethema
Infectiosum
Parvovirus B19
Slide60What is the basis of the vaccine for these diseases
Slide61Combined attenuated vaccine for measles, mumps, and rubella. This avoids a rash of shots.
Slide62Mumps time course
Slide6316 day incubation
7 day clinical disease
Slide64Mumps complications
Slide65Orchitis
Meningitis
Encephalitis
Slide66Rubeola (Measles) time course
Slide6710 day incubation
5 days of rash
Koplik
spots 1-2 days prior to exanthema
Slide68Rubeola epidemiology
Slide69Occurs in unimmunized people typically in childhood or teens during the winter and spring.
Slide70What is unique about
morbillivirus
spikes
Slide71Even though they are
paramyxoviridae
they lack N activity. Thus they have H and F spikes as opposed to H/N and F typical of other
paramyxoviridae
.
Slide72What are
koplik
spots
Slide73Small bluish
y
ellow spots that appear on the oral mucosa in advance of the rubeola rash
Slide74Rubeola complications
Slide75Post infectious encephalitis in near term
SSPE (encephalitis) in 2-10 years
Slide76Rubeola
sx
Slide77Progressive rash extending from head to toe.
High fever
Delirium
Photophobia
Conjunctivitis
Slide78Rubella time course
Slide79Incubation period 16 days
Exanthema for 3 days
Contagious -7 to +7 from rash
Slide80Rubella epidemiology
Slide81Occurs in unimmunized people usually in the winter and spring
Slide82Should pregnant women receive MMR vaccine?
Slide83No, MMR is a live vaccine and rubella is a
transplacental
infective agent. Reversion of rubella to a virulent form could lead to congenital rubella in the child.
Slide84Congenital rubella
sx
Slide85Cataracts
Cardiac defects
Reticuloendothelial
defects (liver, spleen, thrombocytes)
Mental retardation
Slide86What is the mechanism of spread for MMR?
Slide87All enter the respiratory tract to cause
viremia
before moving to their tropic tissue
Slide88What are the tropic tissues for MMR?
Slide89Mumps – salivary glands, testes, ovary, CNS?
Measles – skin and Lymph nodes?
Rubella – skin and lymph nodes?
Slide90What is agent for
Erythema
Infectiosum
?
Slide91Parvovirus B19
Slide92Where does the exanthema appear?
Slide93On the face. It has a characteristic slapped face appearance.
Slide94What is the alternative name for
Erythema
Infectiosum
?
Slide95Fifth disease
Slide96A child presents with a faint rash and convulsions. What is a likely diagnosis?
Slide97Roseola
infantum
Slide98Describe the structure of
Enteroviruses
Slide99They are small naked icosahedral virus with ssRNA (+) in
picornaviridae
Pico = small
rna
= RNA
Slide100What is the transmission path for
enterovirus
Slide101Fecal-oral
Slide102Describe the stability of
enterovirus
Slide103They are very stable and are resistant to acidic pH, detergents, disinfectants, and alcohol
Slide104Describe the epidemiology of
enterovirus
Slide105Summer and fall in temperate climes. Year round in the tropics. Transmitted by direct or indirect fecal-oral contact. Vectors occasionally spread the virus.
Slide106What are the
picornaviridae
genus?
Slide107Polio
Echo
Rhino
Coxsackie
Hep
A
(PERCH)
Slide108What are the three possible outcomes of polio infection
Slide109Abortive poliomyelitis
Aseptic meningitis
Paralytic poliomyelitis
Slide110What is the entry point tissue for polio
Slide111Oropharynx
. Resulting viruses swallowed and infect intestines. Then infect CNS
Slide112What vaccines are available for polio
Slide113Salk = killed
Sabin = Attenuated
Slide114Polio diagnostic
Slide115Viral visualization
Ab
titer
Slide116What is the potential contagious period for polio
Slide117Intestinal shedding can occur for weeks
e
ven in the face of effective immune response
Slide118What is the structure of
papillomavirus
Slide119dsDNA circular. Naked icosahedral
Slide120How many genotypes of HPV are known
Slide12170+
Slide122What is the transformation potential of HPV
Slide123It’s a DNA virus and thus can be stabilized in the cell. Higher stain numbers are more oncogenic (?). Malignant strains seem to insert DNA into host genome.
Slide124HPV Transmission Routes
Slide125Occupational exposure (meat packers)
Sexual contact
Public showers/swimming pools (suspected)
Perinatally
Slide126List the diseases associated with common HPV genotypes
Slide1271,2 – common warts
7 – meat handler warts
6,11 – benign genital warts
16,18,31,45 – warty lesions with malignant potential in the
nethers
Slide128What percent of females in US are HPV positive?
Slide12920%-60%
Slide130Where does HPV replicate?
Slide131Nucleus – it’s a DNA virus
Slide132How is HPV typically diagnosed in females
Slide133Detected by cytoplasmic vacuolization and nuclear enlargement on routine pap smear
Slide134What is
cryotherapy
Slide135Removing HPV infected epithelium with extremely cold substances such are liquid nitrogen
Slide136Describe PML
Slide137Degenerative brain disease that causes focal areas of
demyelination
surrounded by bizarre
astrocytes
.
Slide138What is the virus of PML?
Slide139The JC
Polyomavirus
Slide140What is a likely
comorbidity
in PML PT?
Slide141HIV
Slide142A bone marrow transplant patient presents a few weeks after discharge with hemorrhagic cystitis. What is the likely agent
Slide143BK
polyomavirus
Slide144What is the tropic tissue for BK virus?
Slide145Kidney
Slide146What are the general
sx
of
arbovirus
Slide147Encephalitis
Hemorrhagic fever
Slide148What is the characteristic of an
arbovirus
?
Slide149They are all transmitted via insect vectors such as mosquitoes or ticks.
Slide150What is the family for
arboviruses
involving horses?
Slide151Togavirus
Slide152What commonly
togavirus
is commonly vaccinated for?
Slide153Rubella
Slide154What is the distribution of western, eastern and St
Loius
encephalitis
Slide155Western – western us
Eastern – Eastern US
St Louis – central US?
Slide156Describe a typical WEE,EEE victim
Slide157People in association with horses where mosquitoes are present
Slide158What is the age range for St
Loius
and West Nile Virus
Slide159St
Loius
> 40
West Nile > 50
Slide160What is the classic distribution for yellow fever
Slide161Caribbean and south and central
america
Slide162What is the classic distribution of Dengue
Slide163World wide.
Middle east, far east, Africa, Caribbean
Slide164What is the vector for yellow fever and dengue
Slide165Aedes
aegypti
Slide166Describe Yellow Fever SX
Slide167Fever, chills, headache, hemorrhage, jaundice, and shock
Slide168Describe Dengue
sx
Slide169Severe back and joint pain, fever, rash.
Slide170What is the reservoir for west
nile
Slide171Birds
Slide172What is the vector for west
nile
?
Slide173Mosquitoes
Slide174West
nile
sx
Slide175Flu-like, Rash on torso and upper extremities
Slide176Describe the morphology of
bunyavirus
Slide177ssRNA (-) , enveloped, spherical, segmented
Slide178California virus family and
sx
Slide179Bunyavirus
Encephalitis with seizures
In north central mid west states
Slide180Hantavirus family
Slide181Bunyavirus
Slide182Hantavirus epidemiology
Slide183Direct exposure to rodent feces. Occurs in the southwestern US
Slide184Hantavirus
sx
and mortality
Slide185Fulminant
respiratory disease with > 50% mortality.
Slide186Reovirus
arbovirus
disease
Slide187Colorado tick fever
Slide188Arenavirus
morphology
Slide189Spherical enveloped ssRNA (+/-) segmented
Slide190Arenavirus
unique characteristics
Slide191Ambisense
(+/-) RNA
Presence of host cell ribosomes within virus
Slide192Filovirus
morphology
Slide193Enveloped ssRNA (-)
Slide194Filovirus
sx
Slide195Hemorrhagic disease
Slide196Famous
filovirus
diseases
Slide197Marburg and
ebola
Slide198What disease is cased by a
rhabdovirus
Slide199Rabies
Slide200Rabies virus morphology
Slide201Bullet shaped enveloped helical ssRNA (-)
Slide202What is the initial
tx
for rabies
Slide203Injection of IgG near bite. Vaccination with killed attenuated virus.
Slide204Describe the
timecourse
of rabies
Slide205Occurs from 10 days to one year depending on inoculum size
Slide206Classify the final stages of rabies infection
Slide207Prodrom
Acute neurologic phase
Coma
Death
Slide208What is the mortality of rabies
Slide209100%
(only a few exceptions are known)
Slide210What is the furious phase of rabies infection?
Slide211Occurs during the acute neurologic phase. Patients are often aggressive and disoriented
Slide212What is the
d
umb phase of rabies infection
Slide213Occurs during the acute neurologic phase. Patients are lethargic and paralytic.
Slide214Why isn’t everyone vaccinated against rabies
Slide215The vaccine is a killed attenuated vaccine so people receiving it are double protected form conversion but the protection does not last long so repeated vaccine would be necessary. Rabies is uncommon with proper precautions
Slide216Rotavirus family
Slide217Reoviridae
Slide218Rotavirus structure
Slide219Small wheel shaped ssRNA (+). 1 segments
Slide220What are the segmented virus
Slide221Bunya
Orthomyxo
Arena
Reo
(BOAR)
Slide222What is the epidemiology of rotavirus
Slide223Infection during cooler months in children < 2 years old. Highly contagious and spreads rapidly in institutions and families
Slide224Describe Rotavirus disease
Slide2251-3 day incubation period followed by abrupt onset of vomiting. Subsequent diarrhea lasting 5-8 days. Virus shedding for 2-12 days
Slide226Rotavirus prevention
Slide227Hand washing. Vaccine in development.
Slide228Rotavirus death factors and numbers
Slide229Malnutrition and
immunodeficient
children
600K die worldwide
Slide230Norwalkvirus
family
Slide231Calcivirus
Slide232Calcivirus
morphology
Slide233Naked small round ssRNA (+)
Slide234Norwalk disease
Slide2351-2 day incubation
1-2 day vomiting and diarrhea
Slide236Other diarrhea agents
Slide237Astrovirus
(star shaped naked)
Adenovirus