is a DNA Virus 

is the family of the B19 virus

it is the exception being the only single stranded DNA virus

DNA virus

Papillomavirus

Hepatitis B

enveloped virus

DNA enveloped

herpes simplex

varicella

zoster

Epstein Barr

CMV

what are the herpes viruses recently discovered?

Human Herpes 6-roseola

Human Herpes 7-child herpes

Kaposi's Sarcoma often seen in patients with AIDS

lesions

each has a distinct type specific envelope

Glycoprotein C

-acute gingivostomitis

-cold sores(herpes labialis)

-conjuctivitis

-Encephalitis

-Herpetic Whitlow(in all Herpes infections)

-Disseminated infections

Coxsackie virus(hand, foot, and mouth  disease) always shows similiar sxs so lab tests must be done to distinguish between the two

What diseases are associated with HSV-2?

-neonatal Herpes

-genital herpes

-septic meningitis

-sunlight

-hormonal changes

-trauma

-stress and fever

**will migrate down the neuron to the skin and replicate-lesions

cell mediated immunity(T and B cells)

will have circulating IgG

when talking about the HSV-1 form what sx is primarily seen in children along fever and irritability?

-gingivostomatitis-vesicular lesions of the mouth

heal spontaneously in 2-3 weeks

**could also be cocksakie so will have to do labs

corneal ulcers and lesions of the conjunctival epithelium

can scar and cause blindness

FEVER

headache

vomiting

seizures

altered mental status

which one of the clinical features of encephalitis distinguishes it from a neuro problem?

MRI of temporal Lobe

examination of the spinal fluid showing increase in lymphocyes and moderate elevation in the amound of protein but will have normal glucose

fever and inguinal adenopathy (swelling or enlargement of the lymph nodes)

chiefly from contact with the vesicular lesion within the birth canal

the mother may never show sxs and still pass it on

why isnt there a useful dx of recurrent infections?

vacuole: elevation with fluid

papule: elevation of the skin with NO pus or fluid

macule: part of the skin discolored but with no elevation

sexual transmission

also transmitted in transplanted organs such as kidneys and appears to be the cause of transplantation associated KS

1. smallpox virus-Variola

2.  vaccinia virus-used for the vaccine

3.  molluscum contagiosum virus

**they are the largest and most complex virus

for HSV-1 what nucleoside analogue is used for the treatment of eye infections?

across the placenta,milk, and birth canal

 via saliva

sexually

blood transfusions and organ transplants

in what trimester will you see congenital malformations from CMV?

microcephaly

seizures

deafness

jaundice

purpura

hepatosplenomegaly is very common****

fever

lethargy

abnormal lymphocytes in peripheral blood smears

ganciclovir (cytovene) is moderately effective in the tx of CMV retinitis and pneumonia in patients with AIDS

foscarnet but causes more side effects

unlike HSV and VZV-CMV is largely resistant to acyclovir

-fever

-sore throat

-lymphadenopathy

-splenomegaly

-anorexia and lethargy

-hepatitis is frequent-encephalitis may occur

saliva - during kissing

blood transmission is very rare

where does the EBV infection first occur and spread to?

atypical lymph

**CMV also has atypical lymph

burkitt lymphoma in african children

other b cell lymphomas

nasopharyngeal carcinoma

hairy leukoplakia in people with AIDS

AIDs associated non hodgkins lymphoma

thymic carcinoma

-single stable serotype

-no animal resevoir

-antibody response is prompt

-easily recognized clinically

small, pink, papular, wartlike benign tumors of the skin and mucous membranes are characterisitic of what virus?

-inner core (DNA or RNA)

-prtein coat-delivery for entry of viral genetic info/protection as well

-maybe a lipid envelope

-glycoprotein spikes

1. attachment to receptor on the host cell

2.   penetration of the virus into the host cell

3.  uncoating of the viral capsid

4.  replication-this is to put viral proteins into the capsid-makes enzymes- synthesis of viral mRNA

5. assembly-capsids forming around nucleic acid

6. release-either by budding (enveloped) or cytolysis

yes except for the reovirus

nucleus even though it is a RNA virus which typically has replication in the cytoplasm

composed of viral nucleic acid and proteins and cant replicate without a HELPER virus

it has a mutation or a deletion of their genetic material

contain host cell DNA instead of viral DNA within the capsid

fomed when the host cell DNA is fragmented and pieces of it are incorporated within the capsid protein

can infect cells but DONT replicate

consist solely of a single molecule of circular RNA

without a protein coat or envelope

infectious particles that are compsed solely of protein

contain no detectable nucleic acids

transmissable spongiform encephalopathies

creutzfeldt jakob disease

scrapie in sheep

mad cow in humans

curu in humans

by hypochlorite, NaOH, and autoclaving

1. oral -saliva

2. direct skin contact

3. transplacental

4. droplet transmission

5. direct inoculation- injections/bites

6. sexual transmission

change in  the base sequence of DNA or insertion of a different amino acid into a protein and the appearance of an altered phenotype

-base substitution

-frame shift mutation

-when transposons or inserted sequences are integrated into DNA

adenovirus

papillomavirus

parvovirus

adenovirus is associated with what diseases or problems

pharyngitis

ARDS

keratoconjunctivitis-swimming pool

bronchitis and atypical pneumonia

enteric strains-diarrhea

gastroenteritis with nonbloody diarrhea occurs mainly in childrean younger than 2

nonenveloped

DS linear DNA

it is the only virus with a fiber protruding from each of the 12 vertices

highly oncogenic in animals-only part of the virus integrated

aerosol droplets

fecal oral route

direct inoculation of the conjunctivis  by tonometers or fingers

**fecal oral route is the most commmon in the young children

second most common cause of pediatric gastroenteritis

adenovirus infect the mucosal epithelium of several organs

resp tract, the GI tract, and the conjunctivas

non enveloped, DS circular

genital warts

cervical, vulvar, and penile cancers

**2 early genes are E6 and E7

HPV-16 and 18

also 31 and 45 but are less common

non cancerous are 1,6,11,2

parvovirus-B19 virus

fifths disease is what kind of virus

respiratory route

transplacental

transfusions

red blood cell precursors in the bone marrow, which accounts for the aplastic anemia

endothelial cells in the blood vessels which accounts for the rash

immune complexes composed of virus  IgM and IgG also contribute  to the pathogenisis of the rash tand to the arthritis 

**HYDROPS FETALIS- massive edema in the fetus-secondary to congestive heart failure

a.  erythema infectiosum-slapped cheek syndrome, fifth disease

-bright red rash that is most prominent on the cheeks

-acute arthritis

b.  aplastic anemia-children with chronic anemia, such as sickle cell anemia

c.  fetal infections-infection during the first trimester causes fetal death

-in the second and third trimester  leads to hydrops fetalis

d. chronic B19 infection

-ppl with immunodeficiencies-AIDS, chemo, or translplant patients have chronic anemia, leukopenia as a result

usually diagnosed by detecting IgM antibodies

although in immunocompromised patients you wont see an elevation of the IgM so you would want to perform a PCR assay

orthomyxoviruses-influenza

paramyxovirus-measles,mumps, resp synctial, parainfluenza viruses

Togavirus- Rubella**

Rhabdovirus- Rabies

Coronavirus- SARS

influenza virus A-worldwide epidemics

influenza B-major outbreaks

influenza C- much milder does not cause outbreaks

more in elderly

neonates at high risk

more immunosuppressed patients

through the HA spikes attaching to the neurimidase (acid) containing receptors

host proteases cleave HA1 and HA2

virus enters the cell via the endosome

replication occurs in the nucleus**

viral NA at the cell surface removes the neuraminic acid from the virions facilitating virus release

low levels of IgG and little IgA

vaccine lasts 6 months

antibodies to bothe the HA and NA important-HA antibodies can neutralize

fever

headache

MYALGIA-due to cytokines

cough

rhinitis

occular sxs

why is influenza limited to the upper and lower resp tracts

becuase of the protease that cleaves the HA are located there

viremia rarely occurs-interstitial pneumonia

**is more severe in the young, elderly, and immunosuppressed

CROUP (parainfluenza virus)

primary influenza virus pneumonia

secondary bacterial infetion

-strep pneumoniae

-staph aureus

-hemophilus influenzae

myositis-rare

cardiac complicatipns

liver and CNS - Reyes syndrom

peripheral nervous system -guilllian barre syndrome

:seen from vaccine

fatty deposits in the liver

brain edema

vomiting

lethargy

coma

**risk factors-youth,certain viral infections, aspirin

most common acute parlalysis in the US

Ab will form against myelin protein

demyelination

1976/77  swine flu vaccine**

35,000,000 doses-with 354 cases with 28 GBS deaths

what are the major causes of influenza related deaths

bacterial pneumonia

cardiac failure

90% of deaths are in those 65 and above

isolation of nose, throat smear

tissue culture or eggs

serology

rapid tests*** FLU OIA and quickvue-based on the detection o viral antigen using monoclonal antibodies

minor changes based on mutaiton in the denome RNA

drift variants occur every year

HA and NA accumulate mutations***

immune response no longer protects

sporadic outbreaks

influenza B undergoes the DRIFT but not the shift

killed influenza A and B

typically 2 A strains(recent H1N1 and H3N2) and one B strain

*protectection only lasts 6 months

what does the vaccine for influenza induce?

-Rinanstadine-Type A only-elderly

-amantadine-Type A only

-zanamivir(relenza)- Type A and B-NI inhibitor-inhaled

-Oseltamivir-tamiflu-Types A and B-NI inhibitor

Tx within the first 48 hours most effective

how would you diagnose influenza?

-30% infections subclinical

-serology or isolation

-Dx usually made clinically

-meales virus-Rubeola

-mumps virus

-Respiratory Syncytial virus

-parainfluenza virus-CROUP

prodromal phase- fever, conjunctivitis running nose, and cough

KOPLIKS SPOTS- bright red lesions with a white central dot that are located on the buccal mucosa and virtually diagnostic

a maculopapular rash appaears on the face and proceeds down the whole body to the lower extremities, including palms and soles

after rash it is no longer contagious

measles encephalitis-most serious

loss of PPD skin test reactivity because of transient depression of cell mediated immunity

**estimate that measles kill a million a year worldwide

inlammatory disease of the brain

mild changes in personality and will end with dementia and death

early infection with measles is a risk factor

live attenuated vaccine in combination with mumps and rubella vaccines

MMR is given at about 15 months

Mumps-mumps, orchitis(after puberty)-how is it transmitted?

fever, malaise, and anorexia

tender swelling of the parotid glands

complications of mumps is orchitis and meningitis

Bronchitis

**PNEUMONIA IN INFANTS

enveloped virus

helical nucleocapsid

SS

negative RNA

Parainfluenza virus is associated with what diseases?

Bronchiolitis in infants

CROUP in young children

common cold in adults

2 types envelope spikes, one with both hemagglutinating activity neurimidas activities and the other fusing with cell

fusion protein causes cells to fuse forming the multinucleated giant cells

Rubella virus-german measles

sore throat, runny nose, cough

fever

RASH, minor, irregular

-lasts 12hrs to 5 days

-not always seen

ARTHRALGIA, ARTHRITIS

posterior cervical lymphadenopathy

IgG, IgA

IgM-many persist

hearing loss

congenital heart defects

neurological - psychomotor and/or mental retardation

opthalmic-CATARACT,GLAUCOMA, RETINOPATHY

nasopharynx

urine and feces

diabetes

thryoid probs

deficiency in growth hormone

difficult

serology - in the pregnant women exposed to rubella the presence of IgM antibody indicates recent infection

-amniocentesis

animal bite-wild animals

nonbite - most important example is exposure to aerosolsof bat secretions

*rarely - corneal transplants

viral receptor AcH on neuron

replication then ascension up the nerve to the CNS

after replication in brain it goes to the salivary gland

what are the clinical findings of the Rhabdovirus

incubation-2 to 16 weeks or longer

(shorter if bit in the head)

fever,anorexia, and changes in sensation at the bite

***PAINFUL SPASMS OF THE THROAT MUSCLES on swallowing

siezures, paralysis, and coma

preexosure

postexposure