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Virology-ALL- Topics

Mycology and Virology (Our Lady of Fatima University)

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LESSON 1: INTRODUCTION TO VIROLOGY  Virus measures in terms of a. Can be DNA or RNA

nanometer using scanning b. Can be Double Strand or Single
VIRUS microscope. Strand
 The smallest particle that may cause harm and  Size of viruses: 20 – 300 nm
disease to human.  Bacteriophage – viruses that infect  DNA – DS (Hepatitis B virus, Varicella
 Doesn’t belong to any kingdom. bacterial cell. – zoster virus, Human papilloma
 It’s not a plant or an animal.  Poliovirus –smallest virus recorded virus, JC virus)
 It’s not a fungi, protist or bacteria. clinically measures 25 nm.  DNA – SS (Parvovirus B – 19)
 Doesn’t have any cellular structure.  Poxvirus – largest virus measures 250  RNA – SS (Influenza virus, HIV, Ebola
nm x 350 nm. virus)
Properties of Virus  RNA – DS (Rotavirus)
SHAPE OF A VIRUS
c. Can be single molecule or
Properties Virus Cell 1. Spherical – majority of the virus. segmented
DNA or RNA, RNA and Ex. HIV, Adenovirus, Influenza o DNA – always a single molecule
Types of Nucleic Acid
never both DNA
Protein Few Many virus, Rotavirus o RNA – can be separated
Present or few or a single molecules
Lipoprotein Membrane to some Many 2. Rod – shaped
viruses Ex. Bacteriophage Ex. Multiple/Segmented – Influenza virus,
Ribosomes Absent Present
Mitochondria Absent Present
Rotavirus
Enzymes Absent or Few Many 3. Bullet – shaped
Multiplication by Ex. Rabies virus d. Linear or Circular(arrangement of
No Yes
Binary Fission/Mitosis nucleic acid)
4. Brick – shaped
Ex. Smallpoxvirus
Virus * A virus is always haploid (23 chrom.) except
 Is an infectious agent made up of nucleic acid 5. Filament Retrovirus (causes HIV), which is diploid (46
(DNA or RNA) wrapped in a protein coated Ex. Ebola virus, Marburg chrom.)
called a capsid. Virus
 No nucleus, organelles, cytoplasm or cell
membrane. 6. Tadpole – shaped Capsid
 Are parasites – an organism that depends Ex. Bacteriophage Protein coat that surrounds the nucleic acid
entirely upon another living organism (a host) and protects the gene.
for its existence in such a way that it harms ANATOMY OF VIRUS Identifies the specificity of the virus.
that organism. Can be detected serologically.
 Obligate intracellular parasite. Virion – entire/complete particleof a virus Composed of repeating subunit called
capsomere.
1. Nucleic Acid–innermost part; determine genome
Two Possible Symmetry of Virus(Capsid structure)

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a. Icosahedral –Capsomere arrange in 20  Poliovirus Rules In Naming:

triangles that in symmetry figure with the  Coxsackie virus
approximate outline of the sphere. (NAKED)  Rotavirus 1. Order – Single word with suffix “virales”.
b.Helical – Capsomere arrange in hallow coil that  Hepatitis A virus 2. Family – single word with suffix “viridae”.
arrange in rod shaped. (ENVELOPED – either  Echovirus (Enterocytopathic human 3. Subfamilies – single word with suffix “virinae”.
icosahedral or helical) orphan virus) 4. Genus – single word with suffix “virus”
 Norwalk virus 5. Species – 2 or more words with “virus”.
3. Nucleocapsid– nucleic acid +capsid
b. Direct TransmissionENVELOPED
4. Enveloped  Respiratory Droplets: Dengue
Measles virus HIV
virus
 Lipoprotein membrane compose of lipid  Varicella – zoster virus
Mononegaviral unassign
derive from host cell and specific protein. (causes chickenpox n Order
es
unassigned
ed
 Confirms the instability children) Famil Paramyxovirida Flavivirid
 Once the virus has envelope they are not  Rubella virus Retroviridae
y e ae
stable/unstable very susceptible to  Influenza virus Sub-
Paramyxovirina Orthoretrovirin
extreme conditions such as heat, dryness,  Measles virus famili
e ae
None
exposure to detergent, extreme heat and  Mumps virus es
lipid solvents like alcohol and ether Genus Morbilivirus Lentivirus Flavivirus
 Contains glycoprotein spikes c. Sexually TransmittedENVELOPED
Speci Dengue
 Human immunodeficiency virus (HIV) es
Measles virus HIV
virus
5. Naked  Herpes simplex virus
 Without lipoprotein/envelope o Type I – blisters in mouth
 Very resistant to environmental factors o Type II – genital area
SEVEN (7) ORDER OF VIRUS
 Because of their stability, they are typically  Cytomegalovirus
1. Caudovirales
transmitted by fecal-oral route
2. Herpesvirales
 Except Human papilloma virus(HPV)–
3. Ligamenvirales
6. Protein Matrix/Matrix Protein – mediates the doesn’t have envelope (Naked virus)
4. Mononegavirales
interaction between the nucleocapsid and the
5. Nidovirales
envelope. d. Insect BiteENVELOPED
6. Picornavirales
 Dengue virus
7. Tymovirales
7. Glycoprotein Spikes – spike – like protection  Yellow fever virus
found in surface of envelope used for attachment.  West Nile virus
 Chikungunya virus
VIRAL REPLICATION
Envelope/Naked can be Classify by Mode of e. Animal BiteENVELOPED
Specific Events during growth cycle of a virus:
Transmission  Rabies virus

a. Feca – oralNAKED

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2. Late protein – structural type of

A. Early Events B.Middle Events protein virus after gene
replication; capsid.
1. Attachment 4. Gene Expression
 Protein part attached to the surface  synthesis of mRNA C. Late Events
of the receptor site of the host cell  most important
in a weak and non-covalent bonding 6. Assembly
 Lock and Key Concept Factors that affect the synthesis of mRNA:  Assemble together to make a
virion – complete particle of
Viruses with Identified/Own Receptor Site: a. Types of Nucleic Acid virus.
o DNA (nucleus) except Poxviridae– gene
Virus TargetEpithelial
Cells Receptor
Poliovirus Ig – like expression in cytoplasm because they 7. Release
Epstein – Barr B cellcells C3D Complement
receptor/CD155
virus receptor growth o have polymerase.  Based on the type of virus.
Herpes Many cells Fibroblasts
HIV
simplex virus T cell CD4 receptor
factor o RNA (Cytoplasm)except Influenza virus,
type 1
Rhinovirus Epithelial ICAM – 1/CD54 HIV, Hepatitis D virus (nucleus) because of  If Envelope – budding/reverse
Rabies virus
(colds) Neuron
cells Acetylcholine
(intercellular – reverse trascriptase phagocytosis/or in lipoprotein of
receptor
adhesion molecule) the cell such as cell membrane
Influenza A Epithelial Sialic Acid
b. Polarity (nuclear membrane in Herpes
virus cells
Parvo B19 Erythroid Erythrocyte P o + polariry– using RNA itself virus).
virus precursors antigen o –polarity – carries its own  If Naked –lysis/rupture of cell
polymerase to convert membrane.
o polymerase to convert
DS RNA
2. Penetration +SS RNA - SS RNA (ambisense
 Will go inside/enter the host cell that will 5. Gene replication )
undergo several mechanism for penetration  Copying of the segment of Poliovirus Rabies virus + or -
nucleic acid into different Rhinovirus Influenza virus
Corona Paramyxoviridae Reoviridae
 Mechanisms/Type of copies/multiple pieces.
virus
Penetration: Retroviridae Filoviridae
 If Envelope virus – cell fusion/plasma Flaviviridae Bunyaviridae
membrane fusion Togaviridae Arenaviridae
o If Naked – Endocytosis (entry in Caliciviridae Deltaviridae

the vacuolated part of the cell Two Types of Protein Synthesized

1. Early Protein – necessary to
3. Uncoating replicate (enzyme non-
o Removing of protein coat to structural elements); produce  Eclipse Period –time or period where
free/release the nucleic acid before gene replication. there is no virus detected inside a cell.
o In low pH of cytoplasm

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 0 – 2 hours  Eclipse period – no (lipid, enzyme) o Hepatitis A virus

virus detected inside a cell (uncoating  Virus genome properties o Echo virus
to assembly). (RNA/DNA, ss/ds, linear/circular) o Rhinovirus
 10 hours finished their replication.  Virus protein properties o Polio virus
 2 hours (Icosahedral/helical/complex).
 Fast Replication – Picornavirus  Hepeviridae
 Slow Replication - HIV DNA VIRUS FAMILY o Hepatitis E virus
 Parvoviridae
Cytopathic Effect o Parvovirus B19  Caliciviridae
The functional or morphological o Norwalk virus (causes
rearrangement of host cell infected by  Polyomaviridae diarrhea)
a virus. o JC polyomavirus
Most important initial diagnosis for o Bkpolyomavirus  Reoviridae
viral infection. o Colorado Tick fever virus
Not all causes CPE o Rotavirus
 Papillomaviridae
Start at the end of latent period.
o HPV
 Flaviviridae
Latent Period o Dengue Virus
 Adenoviridae
time from the onset of infection to the o Japanese encephalitis virus
o Human Adenovirus
appearance of virus extracellularly o West Nile virus
starts from the appearance of virus
 Hepadnaviridae o Hepatitis C virus
o Hepatitis B virus o Yellow Fever virus
Examples of Cytopathic Effect of Viral
Infection
 Herpesviridae  Togaviridae
 Nuclear shrinking (pyknosis)
o Cytomegalovirus o Rubella virus
 Proliferation of nuclear membrane
o Herpes simplex virus o Chikungunya virus
 Vacuoles in cytoplasm
 Syncytia (cell fusion). o Human herpes virus 6, 7, 8
 Margination and breaking of chromosomes. o Epstein – barr virus  Retroviridae
 Rounding up and detachment of cultured cells. o Varicella – zoster virus, o HIV
 Inclusion bodies o Human T cell Leukemia virus
 Negri body – found in patients with Rabies Poxviridae I, II
infected such as brain cells. o Smallpox virus
o Molloscumcontagiosum virus  Orthomyxoviridae
o Vaccinia virus o Influenza A, B, C virus
Classification of Clinically Significant Viruses RNA VIRUS FAMILY  Paramyxoviridae
 Virion morphology (shape, size)  Picornaviridae o Mumps virus
 Physiochemical properties of the virion o Coxsackie virus o Measles virus

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o Respiratory syncytial virus 3. Serologic procedures to detect a vise in  Trypticase Soy Broth or Buffer Normal
o Parainfluenza virus antibody titer or the presence of IgM. Saline Solution:for avoiding drying of
4. Detection of viral antigen in blood or specimen
 Rhabdoviridae body fluids.
o Rabies virus 5. Detection of viral nucleic acid in blood  Have gelatin, albumin and serum: for
or the patient’s cells. protection of less viable virus
 Filoviridae
o Ebola virus Specimen Collection, Handling and Transport  Has antibiotics and antifungal: to inhibit
o Marburg virus  Aseptically collection the growth of bacteria and fungi
 Delayed: 1 – 6oC less than 24 hours
 Coronaviridae  Long storage: freezer at – IDENTIFICATION OF THE VIRUS IN CELL
o Corona virus (SARS) 70oC(cryoprecipitate) CULTURE
 Collect by Dacron or Rayon
 Arenaviridae  Calcium alginate – type of swab that is Methods of Viral Isolation
o Lymphocytic not allowed to be used because it may A. Cell Culture
Choriomeningitis damage or inactivate the virus B. Animal Inoculation
virus  Specimen that are aspirated during C. Embryonated egg Inoculation
o Lassa Fever virus collected for cell culture and does not
need transport medium: A. Cell Culture
o Blood  Gold standard (in culturable virus)
 Bunyaviridae
o CSF  Presumptive test
o California encephalitis virus
o Lacrosse virus o Pleural fluid
o Hantavirus o Synovial fluid
o Pericardial fluid Categories of Preparation:
 Deltaviridae o Urine
o Bone marrow aspirate 1. Primary Cell Cuture
o Hepatitis D virus
derived from an animal cell
Transport Medium Rabbit Kidney (RK)or Primary
 Viral Transport Medium except for Monkey Kidney (PMK)
LESSON 2: LABORATORY DIAGNOSIS,
TREATMENT AND PREVENTION OF VIRAL blood, urine and other body fluids.
 Specimens that need transport medium a. A tissue is treated with enzyme to
INFECTIONS
which is collected only in swabs or separate the cells (treated with
respiratory specimen trypsin).
Laboratory Diagnosis of Viral Infection
o Throat b. Cells are suspended in culture
1. Identification of the virus in cell culture.
o Nasopharyngeal medium.
2. Microscopic identification directly in the
o Vaginal c. Normal cells or primary cells grow
specimen. in a monolayer across the glass or
plastic container. Transformed cells

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or continuous cell culture do not in clusters 3. Decreased acid production by infected ,

grow in a monolayer. RSV +/– + +++ – ++ Syncytia dying cells
Variable (no
Influenza,
CPE, or CPE
 Culture medium + pH
2. Finite Cell Culture – 50 generations parainfluenza +++ +/– – – – indicator(phenol red) =
of granular
virus
Ex. Human Diploid Fibroblast (HDF) appearance)
HumanNeonatalLung (HNL) Large (+) YELLOWVirus non infected
rounded
Adenovirus + ++ +++ ++ ++
cells in
cells; Metabolism happened or Acid
3. Continuous Cell Culture clusters production
 Heteroploid – normal or (–) RED Virus infected cells;
abnormal tissue Techniques employed if there is no CPE: Alkaline; No metabolism occurred
 Phenol red has a neutral pH
Ex. A549 – Human Lung Carcinoma 1. Hemadsorption
cell line  Surface RBC adsorption
HEp2 – Human Laryngeal Carcinoma  Applicable only for enveloped Definitive Tests (Confirmatory Test) –
cell line viruses Serological Assay
 Virus from flask without CPE 
Observation of their Cytopathic Effects put in a reaction well + suspected 1. Complement fixation
1. Change in Shape known antibody = Ag-Ab reaction  Viral Ag + Ab + RBC(indicator
2. Change in Size  Reagent: BLOOD reagent) =
3. Or Syncytia – type of cell  2 types of glycoprotein spike: (+) No hemolysis
multinucleated giant cell resulted from o Hemagglutinin– found (–) Hemolysis
fusion of 2 or more cells. on the surface of
enveloped viruses; will 2. Hemagglutination inhibition
* HBV – non-culturable attach to the RBC  Viral Ag + RBC(indicator in
* M.leprae – culturable in tissue cells only o Neuraminidase reagent w/Ab) =
(+) No agglutination
Virus PMK HDF HEp2 RK A549
Cytopathic
Ex. Mumps Virus, Influenza virus, (–) Agglutination
effect
large, Parainfluenza virus
3. Neutralization – viral Ag blocks Ab that
HSV – +++ +++ +++ +++ rounded
cells 2. Interference will be directed to RBC neutralizing it
large,  Formation of CPE by a 2nd virus,
CMV – +++ – – – rounded 4. Fluorescent antibody assay
cells once it was added in the cell
culture  Labeled assay
foci or
rounded  Ag + Ab (reagent) tagged with
VZV – +++ – – +/– cells, Ex. Rubella virus + Coxsackie virus fluorescein (make use of UV light)
possible of
= CPE =
syncytia (+) Fluorescence
Enterovirus + + ++ – + Refractile
round cells
(–) No fluorescence

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C. Embryonated Egg Inoculation Ex. Negri bodies/ Purkinje cell –

1. Radioimmunoassay (RIA) – tagged  Common in industries that Rabies virus
with radio produces vaccines Guarnieri bodies – Smallpox
virus
2. Enzyme linked immonosorbent assay – Inoculations in the different parts of the Cowdry type A bodies – HSV,
tagged with enzyme egg: VZV
1) Choriallantoic membrane
inoculation  Tzanck Test/ Tszanck Smear
Viruses Isolated by Cell Culture o Rous sarcoma virus A stained smear of cells
o Herpes simplex virus from the base of skin
Problems with Cell Culture o Pox virus vesicle used to detect
1. Long period (up to 4 weeks) required for VZV or HSV inclusions
result 2) Amniotic inoculation Uses Papanicolaou stain,
2. Often very poor sensitivity, sensitivity o Influenza virus Giemsa stain,
o Mumps virus Hematoxylin& Eosin
Viruses readily Less frequently stain
 CMV  VZV Detects the
 3) Yolk sac inoculation
Adenovirus  Measles virus multinucleated giant
 Polio virus o Herpes simplex virus
 Rubella virus
cells and inclusions
 ECHO virus
 Rhinovirus
 Mumps virus 4) Allantoic inoculation
  Coxsackie A virus
Coxsackie A virus
o Influenza virus  Koilocytosis / Oval owl’s eye
 HSV Alteration of the cell
 Influenza virus o Mumps virus
 RSV o New castle disease with HPV (have no CPE)
 Parainfluenza virus o Avian adenovirus as squamous cells with
enlarged nucleus
depends on a large extent on the
MICROSCOPIC IDENTIFICATION DIRECTLY IN surrounded by non-
condition of the specimen
staining halo seen in
3. Susceptible to bacterial contamination THE SPECIMEN
Papanicolaou stain (Pap
4. Susceptible to toxic substances which
smear)
may be present in the specimen 3 Procedures:
Indication of CMV and
5. Many viruses will not grow in cell
HPV infection
culture e.g. Hepatitis B, diarrheal viruses 1. Light Microscopy
(Norwalk virus), Parvovirus,  Uses light microscope
Papillomavirus  Presence of inclusion bodies 2. Ultraviolet Microscopy
(cowdry type A bodies)
B. Animal Inoculation  Possible CPE in light microscope  Uses immunofluorescence assay
 Inoculation in a testing animal
 Adenovirus, Influenza type A & B
virus, Measles virus, RSV

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Clin. SpecimenSputum, throat swab,

bronchial lavage Classical Techniques Newer Techniques  Ab response to infection
1. Complement fixation 1. RIA o IgM and IgG  establish
2. Hemagglutination 2. EIA/ELISA
 Herpes simplex virus, Varicella- positive current infection
inhibition tests 3. Particularly
zoster virus 3. Immunofluorescence agglutination
o Cutaneous specimens technology 4. Western Blot  Significance (Serolological Testing):
Skin biopsy, skin 4. Neutralization tests (WB) o Diagnosis of infection for non-
5. Counterimmuno- 5. Recombinant
lesion culturable viruses, ex. HBV
electrophoresis immunoblot
 Cytomegalovirus assay (RIBA), o Determination of immune
o Specimen Blood Lineimmuno status
assay o Monitoring of patients who
3. Electron Microscopy have immunosuppression or
 Directly seen structural * Western blot – RNA have bad transplant
arrangement of the virus * Eastern blot – DNA o Epidemiologic/prevalence
 Visualization/ detection of size * Northern blot - Protein studies
and shape to identify the virus
present Serological Testing
 For research purposes Viral Serology
 106 virus particles per ml  Use of antibody titer or specific  Indirect
required for the visualization, immunoglobulin M (IgM)  produced - Primary and secondary
50,000 – 60,000 magnification 2-3 days after contacting virus response to viral infections
normally used. Viruses may be o IgM ( 1st Exposure)
detected.  Titer o IgG ( 2nd Exposure)
the highest serum dilution with
 Feces  Rotavirus, Adenovirus, possible reaction
Problems with Serology
Norwalk virus To establish this : do serial
1. Long period of time required for paired
 Vesicle fluid  HSV, VZV dilution on a positive result
acute and convalescent sera
 Skin scrapping  2. Mild local infections such as HSV
Papillomavirus, 2 phases of Infection:
genitalis may not produce a detectable
Molloscum contagiosum virus a. Acute phase – happens after
humoral immune response
contracting virus with signs and
3. Extensive antigenic cross reactivity
Problems with Electron Microscopy symptoms; first to collect/signs
between related viruses e.g. HSV and
1. Expensive equipment of symptoms
VZV, Japanese B encephalitis and
2. Expensive maintenance b. Convalescence phase – 10-14
Dengue may lead to false positive results
3. Require experienced observer days after exposure to virus;
4. Immunocompromised patients often
Sensitivity often low active infection – titer should
give a reduced or absent humoral
be 4 folds increase
immune response
SEROLOGICAL PROCEDURES (active/current infection)

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5. Patients with infectious mononucleosis 3. Can be quantitative specialized training B) Inhibition of nucleic acid synthesis by
and those with connective tissue 4. Can detect viruses and facilities viral DNA and RNA polymerase
unculturable by cell
diseases such as SLE may react non- 5. Ability to detect o Most of the drugs for antiviral
specifically giving a false positive result multiple viruses o Protease inhibitors
6. Patients have given blood or blood simultaneously
products may give a false positive result 1. Acyclovir 14. Stavudine
due to the transfer of Ab. 2. Ganciclovir 15. Lamivudine
LESSON 3: TREATMENT FOR VIRAL INFECTION 3. Valacyclovir 16. Abacavir
DETECTION OF VIRAL ANTIGEN IN BLOOD OR (ANTIVIRAL DRUG) 4. Valganciclovir 17. Nevirapine
BODY FLUIDS 5. Penciclovir 18. Delavirdine
Potential Sites for Antiviral Chemotherapy 6. Famciclovir 19. Efavirenz
Respiratory syncytial virus 7. Cidofovir 20. Ribavirin
Influenza A and B virus  Inhibition of early events (entry or
Nasopharyngeal Aspirate
8. Vidarabine 21. Adenofuvir
Parainfluenza virus
uncoating of a virus) 9. Iododeoxyuridine 22. Erecavir
Adenovirus
 Inhibition of nucleic acid synthesis by viral 10. Trifluridine 23. Telbivudine
Rotavirus DNA and RNA polymerase 11. Foscarnet 24. Emtricitabine
Feces Adenoviruses  Inhibition of integrase that integrates HIV 12. Zidovudine 25. Tenofovir
Herpes simplex virus DNA into cellular DNA 13. Didanosine
Skin Varicella-zoster virus  Inhibits cleavage of precursor
Blood Cytomegalovirus polypeptides
 Inhibits protein synthesis directed by viral C) Inhibition of integrase that integrates
NUCLEIC ACID-BASED DETECTION IN CLINICAL mRNA HIV DNA into cellular DNA
SAMPLES  Inhibits release of virus
1. Raltegravir
 Gold standard (in non-culturable A) Inhibition of early events (entry or
virus) uncoating of a virus) D) Inhibits cleavage of precursor
polypeptides
1. PCR 1. Docosanal – blocks the HSV entry
2. Nucleic acid sequence based into the cell 1. Saquinavir 6. Darunavir
amplification 2. Enfuvirtide – blocks the HIV entry 2. Indinavir 7. Atazanavir
3. Flow cytometry into the cell 3. Ritonavir 8. Lopinavir
4. Nucleic acid hybridization 3. Maraviroc – blocks the HIV entry 4. Nelfinavir 9. Tipranavir
into the cell 5. Amprenavir
ADVANTAGES DISADVANTAGES 4. Amantadine – blocs the Influenza A
1. Quicker turned – 1. Detection of both virus uncoating
around times activated and 5. Rimantadine – blocs the Influenza A E) Inhibits protein synthesis directed by
2. Better sensitivity inactivated virus
virus uncoating viral mRNA
than cell culture and 2. Increased cost
DFA 3. Need for

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1. Interferon  Immunization – Process of increasing the

2. Fomivirsen concentration of antibody reactive against
3. Methiazone LESSON 4: PREVENTION OF VIRAL INFECTIONS infection

F) Inhibits release of virus IMMUNITY  Vaccination – Process of immunization

- The ability of the body to resist
1. Zanamivir against foreign materials  Vaccine – Immunizing agent
2. Oseltamivir
Types of Immunity 2 Types of Vaccines:
1. Active Immunity 1. Live vaccine / Attenuated vaccine
Sites of Antiviral Drug Action - exposure of patient to antigen 2. Killed vaccine / Inactivated vaccine
Drug(s) of for antibody production
Viruses Disease Alternative Drug
Choice - Uses live and killed vaccine Characteristics of Vaccines
Influenza (Virulent part removed)
Influenza Amantadine Rimantadine
A virus
Genital Killed
HSV Acyclovir Foscarnet Characteristics Live Vaccine
Herpes 2. Passive Immunity Vaccine
Keratitis/ Iododeoxyuridine - Antibody is introduced to the Duration of Longer Shorter
Trifluridine immunity
Conjuntivitis Vidarabine patient; uses antitoxin and
Encephalitis Acyclovir - Effectiveness of Greater Lower
immunoglobulins which protection
Neonatal HSV
Infection
Acyclovir Vidarabine provides immediate source of Immunoglobulins IgA and IgG IgG
Herpes antibody produced
Infection in Cell-mediated Yes Weakly or
immune- Acyclovir Foscarnet 3. Herd Immunity immunity produced none
compromised
host
- Sufficiently large percentage Interruption of More effective Less
of the population is transmission of effective
In normal virulent virus
VZV No therapy - immunized so that an
host Reversion to Possible No
In immune- unimmunized individual is virulence
compromised protected
Acyclovir Foscarnet Stability to room Low
host or during
temperature High
pregnancy
Natural Artificial Excretion of vaccine Possible No
Retinitis – virus and
Active Immunization/
CMV inflammation Ganciclovir Foscarnet Infection transmission to non-
Immunity Vaccination
of retina immune contacts
Breastfeeding
AIDS Dose One Multiple
Zidovudine Passive (Ab from the Giving
HIV antibody  Didanosine Immunity mother passed Immunoglobulin Used to remove Recombinant Formalin
HIV positive with Protease Stavudine to the baby) virulence factor DNA method
CD 4 count Inhibitors
<500/mm3
HBV * IgA is produced only if the route of
Hepatitis B, C Interferons -
HCV administration is

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via the original route of the virus.(Ex. 2. Adjuvant needed (Substance that Rotavirus
Rotavirus – oral) enhances immune response) Herpes simplex virus
type 2
* FDA (Food and Drug Administration) – 3. Need several doses ECHO virus
regulatory body 4. Shorter lasting immunity Congenital and Neonatal
Parvovirus B19
Diseases
vaccines Varicella-zoster virus
* Storage of live vaccine: refrigerated (dies at HIV
Hepatitis viruses
room Maternal Antibody
temperature) - Antibody present from the mother
* Virulence – degree of causing disease passed to the baby List of Viral Syndrome and Common Viral
- 1 year is given to clear out the Pathogens
LIVE (Attenuated) VACCINE maternal Ab (Adults)

Viral Syndrome Viral Pathogen

Advantages: List of Viral Syndrome and Common Viral
Corona virus
1. Local and systematic immunity Pathogens Adenovirus
produced (Infants and Children) Upper Respiratory Tract Rhinovirus
2. Single dose is often sufficient to Infection Influenza virus
induce long-lasting immunity Viral Syndrome Viral Pathogens Parainfluenza virus
Epstein-Barr virus
3. Strong immune response evoked Corona virus
Hanta virus
Rhinovirus
Influenza virus
Adenovirus Pneumonia
Disadvantages Upper Respiratory Tract
Parainfluenza virus
SARS-Corona virus
1. Contraindicated in Infection Adenovirus
Influenza virus
Pleurodynia Coxsackie B virus
immunocompromised patients Respiratory syncytial
virus Gastroenteritis Norwalk virus
2. Interference by viruses or vaccines
Coxsackie A virus
and passive antibody Adenovirus List of Viral Syndrome and Common Viral
3. Possible to revert to virulence Herpes simplex virus Pathogens
4. Poor stability (based on their Pharyngitis Epstein-Barr virus
Parainfluenza virus
(All Patients)
temperature stability)
Influenza virus
5. Potential for contamination Rhinovirus Viral Syndrome Viral Pathogens
Parainfluenza virus Parainfluenza virus
KILLED (Inactivated) VACCINE Parotitis
Croup Respiratory syncytial Mumps virus
virus Coxsackie B virus
Myocarditis/ Pericarditis
Advantages: Parainfluenza virus ECHO virus
Bronchitis Respiratory syncytial Herpes simples virus
1. Constituents clearly defined
virus Keratitis/ Conjunctivitis Adenoviruses
2. Unstable to cause the infection Parainfluenza virus Varicella-zoster virus
3. Stable Bronchiolitis Respiratory syncytial Pleurodynia Coxsackie A virus
Disadvantages virus Herpangina Coxsackie A virus
1. Local reaction common Gastroenteritis Calicivirus
Febrile Illness with rash
ECHO virus
Adenovirus Coxsackie viruses

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Infectious Epstein-Barr virus 1. Infectious Agents (e.g. virus, bacteria, o Naked (resistant to ether, acid, heat
mononucleosis Cytomegalovirus parasite) at 60oC for 1 hour), icosahedral,
Coxsackie viruses
Herpes simplex virus type
2. Alcohol linear, ss RNA
2 3. Drugs (Drug – induced Hepatitis) o 28 nm
Lymphocytic
Meningitis
Choriomeningitis Forms of Viral Hepatitis  Transmission: Fecal-oral route
virus
ECHO virus
 Acute
Mumps virus  Fulminant Acute  Incubation Period:
Herpes simplex virus type ̵̵ Leads to coma because of the o 15 - 45 days
1 accumulation of ammonia. o Average of 28 days
Togaviridae
̵̵ Leads to liver failure.
Bunyaviridae
Encephalitis  Subclinical: No signs and symptoms.  Treatment: Supportive Care
Flaviviridae
Rabies virus  Chronic
Enteroviruses  Prevention/Vaccine:
Measles virus
Clinical Findings of Viral Hepatitis o Inactivated vaccine (Twinrix) 2
Hepatitis Hepatitis A, B, C, D, E, G
Adenovirus
 Fever doses with 1 month interval
Hemorrhagic cystitis  Anorexia
BK virus o Treatment of water
Herpes simplex virus  Nausea
Varicella-zoster virus  Vomiting  Diagnosis:
Enteroviruses
 Jaundice 1. HAV Ag
Measles virus
Cutaneous infection Rubella virus  Dark urine 2. IgM anti - HAV
with or without rash Parvovirus B19  Pale feces 3. IgG anti - HAV
Human papillomavirus  Elevated transaminase
Smallpox virus
Molloscum contagiosum NOTES:
virus TB: 0.2 1.0 mg/dL • Subclinical
Lassa virus Jaundice: >2 mg/DL • No Chronic Disease
Yellow fever virus
Self – limiting
Hemmorhagic Fever Marburg virus HEPATITIS A VIRUS
Ebola virus
Dengue virus  Family: Picornaviridae HEPATITIS B VIRUS
HIV – 1  Genus: Enterovirus/Hepatovirus
Generalized (no specific
HIV -2 Family: Hepadnaviridae
target organ)
HTLV-1  Other names: Genus: Orthohepadnavirus
1. Infectious Hepatitis
2. Enterovirus 72  Other names:
LESSON 5: VIRAL HEPATITIS 3. Short Incubation Hepatitis 1. Serum Hepatitis
2. Dane Particle
3 Possible Causes of Hepatitis  Morphology: 3. Long Incubation Hepatitis
4. Australian Hepatitis

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 Family: Flaviviridae
 Morphology: Disease State Healthy  Genus: Hepacivirus
o Enveloped, Icosahedral, Circular, ds

Acute Early

Late Acute

Vaccinate
DNA  Other name: Non - A Non - B Hepatitis

Resolved
Chronic
Acute
Early
o 42 nm
 Morphology:
 Transmission: Parenteral, Perinatal, Sexual o Enveloped, Icosahedral, Linear,
HBsAg + + + + + - - ssRNA
Intercourse
HBeAg - + + + - - -
o 45 nm
Anti – - - - + +/- + -
 Incubation Period: HBc
o 40 - 180 days Anti - - - - - - + +  Transmission: Parenteral, Sexual Intercourse
o Average 60 - 90 days HBs
Anti – - - - - +/- +/- +/-  Incubation Period: 30 - 50 days
HBe
 Treatment: DNA + + + + + - -
o Supportive Care virus  Treatment:
o HB immunoglobulin o Supportive care
o Interferon 2 Categories of Chronic Hepatitis o Interferon
o Lamivudine 1. Chronic Persistent Hepatitis -  LFT o Ribuvirin
o Liver Transplant 2. Chronic Active Hepatitis -  LFT o Liver Transplant
 Prevention/Vaccine:
 Vaccine: Inactivated vaccine (3 doses) General Serologic Test for Viral Hepatitis o No vaccine available
1. First Generation
 Diagnosis: ̵̵ Ouchterlony agar plate  Diagnosis:
1. HBsAg - first marker to appear during
1. Anti – HCV
HBV. 2. Second Generation 2. HCV - RNA
2. HBeAg - next to appear, HIgh infectivity. ̵̵ Counter electrophoresis
3. HBcAg - no serological significance; for (Countercurrent NOTES:
liver biopsy. immunoelectrophoresis) HCV - major cause of liver cirrhosis plus
4. IgM anti - HBc - first antibody to appear
alcoholic hepatitis
5. IgG anti - HBc - lifelong marker HBV 3. Third Generation
infection. ̵̵ RIA, ELISA, Reverse Passive
6. Anti - HBs - last to appear for immunity. Hemagglutination HEPATITIS D VIRUS
7. HBV DNA - using PCR ̵̵ Reverse Passive Latex
Agglutination  Family: Deltaviridae
NOTE: Anti - HBc - window period  Genus: Deltavirus

Serological Marker HEPATITIS C VIRUS  Other name:

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o Defective Virus - no gene or  Family:  Other name: Non - A Non - B Hepatitis

incomplete virus  Hepeviridae
 OLD: Caliciviridae  Morphology: ss RNA
 Morphology:
o Enveloped, Circular, ssRNA  Genus:  Transmission: Parenteral, Sexual Intercourse
o 37 nm  Hepevirus
 OLD: Calicivirus  Incubation Period: Not established
 Transmission:
o Parenteral  Treatment:
o Sexual Intercourse  Morphology: o Supportive care
o Co - infection with Hepa B virus o Naked, Icosahedral, Linear, ss RNA
(HBsAg needed by the virus) o 30 nm General Diagnosis
 Epidemiological Data
 Incubation Period: 15 - 150 days  Transmission: Fecal - Oral Route ̵̵ HA, HE: food, water, seasonal,
age
 Treatment:  Incubation Period: 2 - 9 weeks ̵̵ HB, HC, HC, HG: blood and blood
o Supportive care products transfusion, contact
o Interferon  Treatment: history, inoculation history.
o Ribuvirin o Supportive care  Clinical Diagnosis
o Liver Transplant o Self - limiting ̵̵ Acute Hepatitis
̵̵ Chronic Hepatitis
 Prevention/Vaccine:  Prevention/Vaccine:
o Supportive care o No vaccine available
o No vaccine but it will helped Treatment
when vaccinated with HBV  Diagnosis:  Chronic Hepatitis
1. HEV Ag ̵̵ Symptoms Therapy
 Diagnosis: 2. IgM Anti - HEV - detected by ELISA, ̵̵ Diet
o Anti - HDV - not detected by ELISA Westernblot and Fluorescence ̵̵ Rest
Antibody Blocking Assay ̵̵ Supporting Therapy
NOTES: 3. HEV RNA (Real Time PCR) ̵̵ Immunomodulator
• Positive HDV + Positive HBV (Co -  Fulminant Hepatitis
infection) ̵̵ General and Supporting Therapy
• Positive HDV + Negative HBV ̵̵ Rest: strict bed rest, diet
(Superinfection) HEPATITIS G VIRUS

 Family: Flaviviridae Prevention

HEPATITIS E VIRUS  Genus: Flavivirus  Control of source of infection

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 Cost – off the route of transmission 1. Contact 3. Coxsackie virus

 Protection of Susceptible Population Kissing/touching 4. Parainfluenza virus
̵̵ Active Immunity Droplets 5. RSV
̵̵ Passive Immunity Vertical transmission 6. Adenovirus
Vector (e.g. insects,flies) 7. Hanta virus
8. Influenza virus
LESSON 6: VIRAL DISEASE OF RESPIRATORY 2. Indirect Contact
SYSTEM Families (handkerchief, NOTE:
doorknobs, pens) In order of common cold viruses
2 GROUPS Oral
1. Upper respiratory system Air (aerosol, droplets) 1. Rhinovirus
Nose/Nasal cavity 2. Coronavirus
Sinus GENERAL SIGNS AND SYMPTOMS 3. Adenovirus
Ear 4. Influenza virus
Mouth 1. Common colds
5. RSV
Pharynx Runny nose
Larynx Blocked nose 6. Coxsackie virus
2. Lower respiratory system Sneezing
Trachea Sore throat
Cough RHINO VIRUS
Bronchi – attach in trachea;
composed of small tissue called Sinus pain
Ear ache  Order: Picornavirales
bronchioles.
Head ache  Family: Picornaviridae
Bronchioles
Fever  Genus: Enterovirus
Lungs
Anorexia
Tiredness  Structure: Naked, icosahedral w/ SS
INFECTION OF UPPER RESIPRATORY SYSTEM
Muscle ache and pains Linear RNA, 28 nm
Sinusitis
Ear infection
2. Conjunctivitis – Sore eyes  Host:
Tonsilitis
Keratoconjunctivitis – 1. Human
Laryngitis
inflammation in retina 2. Chimpanzee
Pharyngitis/Throat infection
 Transmission:
INFECTION OF LOWER RESPIRATORY SYSTEM
VIRAL AGENTS THAT CAUSE DISEASES OF o Person to person contact via
Bronchiolitis
Bronchitis RESPIRATORY SYSTEM respiratory droplets
Pneumonia o Inanimate objects
1. Rhino virus
PATTERN OF INFECTION 2. Corona virus

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 Disease: Most common cause of o Ab detection through PCR-

common colds  Incubation period: 2-10 days (no signs based test (SARS)
and symptoms)
 Incubation period: 2-4 days  Treatment:
 Transmission: Respiratory aerosol o No antiviral drug
 Clinical Findings: o Supportive care
o Sneezing  Disease:
o Nasal discharge o Common colds  Vaccine: No available
o Sore throat o Atypical pneumonia: SARS
o Cough (Severe Acute Respiratory
o Headache Syndrome)  China (2002) COXSACKIE VIRUS
o Middle East Respiratory
 Active in 33OC rather than 37OC Corona virus infection (MERS-  Can be respiratory or fecal oral
temperature dependent COV)  2012
 Order: Unassigned
 Acid labile  Clinical Findings:  Family: Picornaviridae
o Colds  Genus: Enterovirus
 Lab diagnosis: Viral culture Coryza  Species: Coxsackie A, B and C virus
Scratchy sore throat
 Treatment: None Low-grade fever  Structure: Naked, Icosahedral w/
Possible bronchitis SS, Linear, RNA, 28 nm
 Vaccine: None  because there’s a lot
of serotypes (>100) o SARS  Serotypes:
O
Fever (38 C) o Group A (24 Serotypes)
Nonproductive cough o Group B (6 Serotypes)
CORONA VIRUS Dyspnea
Hypoxia - deprivation of  Transmission:
 Order: Nidovirales oxygen in tissue) Fecal-oral route
 Family: Coronaviridae Chills Respiratory aerosols
 Sub family: Coronavirinae Rigors
 Genus: Beta (trembling/shaking)  Diseases:
Malaise o Group A:
 Structure: Envelope, Helical, SS, (+) Headache 1. Herpangina
polarity, Linear, RNA, 100 nm 2. Acute Hemorrhagic
 Diagnosis: Conjunctivitis
 Serotype: o Clinical signs and symptoms 3. Hand Foot and Mouth
1. 229E (COLDS) Disease
2. OC43

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o Group B:  Clinical Findings:

1. Pleurodynia  Treatment: o Croup
2. Myocarditis o No antiviral drug available o Harsh cough
3. Pericarditis o Supportive care o Hoarseness
o Pharyngitis
o Group A&B: Vaccine: No vaccine o Laryngitis
1. Common cold o Otitis Media
2. Aseptic Meningitis o Bronchitis
3. Febrile rashes PARAINFLUENZA VIRUS o Pneumonia
 Order: Mononegavirales
 Herpangina  Family: Paramyxoviridae  Lab Diagnosis:
Fever  Subfamily: Paramyxovirinae Cell Culture isolation
Sore throat  Genus: Four fold increase of
Tender vesicle in the Rubulavirus titer serologically
Oropharynx (Hallmark) Respirovirus
 Species: Human parainfluenza virus  Treatment: None, Supportive
 Hand Foot and Mouth disease care
Vesicular rash on the hands  Structure: Envelope w/ Helical,  Vaccine: No vaccine
and feet SS, Linear, RNA,150 nm
Ulceration in the mouth
(Coxsackie A)  Host: RESPIRATORY SYNCYTIAL VIRUS
o Humans  Order: Mononegavirales
 Pleurodynia o Animals  Family: Paramyxoviridae
Also known as (1) Bornholm  Sub Family: Pneumovirinae
disease, (2) Epidemic  Serotypes: 4 serotypes  Genus: Pneumovirus
Myalgia and (3) Devil’s Grip  Species: Human Respiratory Syncytial
 Transmission: Respiratory droplet Virus
 Myocarditis
Fever  Diseases:  Structure: Envelope, Helical, SS,
Severe pleuritic type chest o Serotype 1 and 2: Croup Linear, RNA, 150 nm
pain due to an infection of (Acute
the intercostal muscle of the Laryngotrachobronchitis)  Host: HUMAN
lungs o Serotype 3: Lower
Coxsackie B Respiratory Tract  Transmission:
 Lab diagnosis: Infection Respiratory Droplets
o Cell culture o Serotype 4: Common Direct contact of
o Serological Ab titer rise Cold contaminates hands with
o PCR based test of RNA nose

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 Disease:  Vaccine: Monovalent inactivated

o Pneumonia and  Disease: vaccine against serotype 4,7 and 21
Bronchiolitis in infants o Serotype 3,4,7 and 21 –
o Otitis media in children Upper and lower respiratory HANTA VIRUS
o Pneumonia tract infection  First seen its incidence  Hantaan,
o Common colds in elderly o Serotype 8, 19 – South Korea River Valley
Keratoconjunctivitis
 Lab Diagnosis: o Serotype 11, 21 –  Order: Unassigned
Antigen detection in Hemorrhagic Cystitis  Family: Bunyaviridae
respiratory secretions by o Serotype 40, 41 – Infantile  Genus: Hantavirus
immunofluorescence Gastroentiritis  Species: Hantaan virus
Cell culture inoculation by
CPE  Clinical Findings:  Structure: Enveloped, Helical, SS,
Rise of Ab titer 1. Upper Respiratory Tract Circular, RNA, 100 nm
RT- PCR Test Pharyngitis
Fever  Group: Robovirus (Rodent’s – Not
 Treatment: Virazole (Aerosol Sore throat susceptible to infection)
Ribavirin) Coryza  Transmission: Inhalation of aerosols
Conjunctivitis (pink- from rodent’s urine and feces
Vaccine: No vaccine eye)
Common Cold  Disease:
ADENOVIRUS 2. Lower Respiratory Tract o Korea Hemorrhagic Fever
Bronchitis o Hantavirus Pulmonary
 Only DNA Atypical pneumonia Syndrome
 Common cause of sore eyes 3. Hemorrhagic Cystitis
 Only virus with fiber (seen in capsid) Hematuria  Clinical findings:
for attachment Dysuria 1. Korea Hemorrhagic Fever
 Affects adenoids 4. Gastroentiritis o Headache
Non-bloody o Petechial
 Family: Adenoviridae Diarrhea Hemorrhage
 Genus: Adenovirus o Shock
 Lab Diagnosis: o Renal Failure
 Structure: Naked, Icosahedral, DS, o Cell culture isolation 2. Hantavirus Pulmonary
Linear, DNA, 75 nm o Four fold increase in Ab titer Syndrome
o Influenza – like
 Transmission:  Treatment: None symptoms followed
Fecal Oral by Acute Respiratory
Respiratory Droplet Failure

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o High Mortality  Serotypes:  Treatment:

o 16 HA Serotypes 1. Amantadine (Influenza A virus
 Lab Diagnosis: o 9 NA Serotypes ONLY)
IgM in Serum o Symetrel
PCR detection of RNA in Lung  Incubation Period: 24-48 hours 2. Rimantadine
tissue o Flumadine
 Transmission: Airborne respiratory 3. Oseltamivir
 Treatment: No antiviral drug available droplets o Tamiflu (oral)
4. Zanamivir
 Vaccine: None  Disease: o Relenza ( aerosol-
1. Human Influenza A branded)
 Rodents: 2. Avian Influenza 5. Self-treatment (if mild)
1. Beaver 3. Swine Influenza
2. Rat 4. Human Influenza B  AMANTADINE AND RIMANTADINE –
3. Gopher 5. Human Influenza C blocks ion channel uncoating
4. Chipmunk (Neuraminidase = target cell)
5. Mouse
6. Squirrel  Clinical Findings:  TAMIFLU AND RELENZA – inhibit
o Fever release
INFLUENZA VIRUS o Malaise
 Most important o Headache  Vaccine:
 Most common cause of infection o Sore throat o Inactivated vaccine
o Cough 6 months lasts
 Family: Orthomyxoviridae INTRAMUSCULARLY
 Sub Family: Orthmoyxovirinae  Complications: given
 Genus: Orthomyxovirus o Reye’s Syndrome – o Attenuated vaccine
characterized by Influenza A and B
Influenza A virus = Epidemic, encephalopathy and liver only
Pandemic - Most common in PIG, SWINE, degeneration Given in nose
HORSE (AEROSOL)
Influenza B virus = Epidemic  By seasonal = more on rainy days
Influenza C virus = Mild lower respiratory tract PARTS OF INFLUENZA
infection  Lab Diagnosis:
Viral Culture 1. Hemagglutinin
 Structure: Envelope , Helical, SS, Serological assay Use to bind to the cell surface
Linear Segmented, (-) polarity, RNA, Direct fluorescent Ab test receptor (sialic acid)
80 - 120 nm PCR assay Agglutinates with RBC
Target of neutralizing antibody

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Novel H1N1 (Mexico) Swine Influenza  Serotypes: 6 serotypes

2. Neuraminidase become pandemic
Cleaves sialic acid to release WHO = 208 Countries were infected  Transmission: Fecal-oral route
(late events) progeny virus 2009 including Philippines
from the infected cell Level 6 Pandemic  Disease: Gastroenteritis/ diarrhea in
young children
9,596 total death
3. Matrix Protein 1
Locate between the internal of  Clinical Findings:
the nucleoprotein and the o Nausea
envelope LESSON 7: OTHER VIRUSES o Vomiting
Provides structural integrity o Watery and non-bloody
VIRAL DISEASE OF DIGESTIVE SYSTEM diarrhea
4. Matrix Protein 2 - Gastrointestinal infection
Forms an ion channel between - Massive loss of electrolyte
the interior of the virus and
the external part VIRAL AGENTS THAT CAUSE DISEASE IN  Lab diagnosis:
Used in uncoating of the virion DIGESTIVE SYSTEM - Antigen detection in stool
after it enters the cell 1. Rotavirus (ELISA)
Transports proton in the virion 2. Norwalk virus - Four fold increase of Ab titer
causing the disruption of the 3. ECHO virus - Isolation in culture
envelope 4. Adenovirus
 Treatment:
5. NS 2 - No anti-viral drug available
Inhibit the production of ROTA VIRUS - Rehydration:
interferon Mrna  They called it “ROTA” because of o Orasol (infant)
its “wheel’s appearance” in o Gatorade (adult)
HISTORICAL POINT OF VIEW OF INFLUENZA microscope.
 Vaccine:
Spanish influenza  Order: Unassigned 1. Rotarix (1 serotype)
6. More Americans died in World  Family: Reoviridae (Reo – RESPIRATORY
1918
War 1, World War 2, Korean 2. Rotateq (5 serotype)
war and Vietnam war
ORPHAN) 3. Rotashield – recalled because it
1968 Asian Influenza, Influenza Pandemics  Sub Family: Sedoreovirinae gives complication to the patient
1997 Avian Influenza, Outbreak in Hongkong  Genus: Rotavirus and can cause intussusception.
 Species: Rota virus A to F
2003- Asian Avian Influenza Outbreak
2004 7. 254 dead chicken
 Structure: Naked, Icosahedral, with DS, NORWALK VIRUS
H5N1 spread from Asia to Siberia to
2005 Segmented (2), Linear, RNA, 75 nm
Europe

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 Norwalk because first case in 1969, it is a o Hand washing, proper sewage  When Ag detection = S protein/ Soluble
place in OHAIO ( there’s an outbreak in a disposal, proper hygiene protein
school)
ECHO VIRUS (+) Current infection
 Order: Unassigned
 Family: Caliciviridae (Enteric Cytopathic Human Orphan)  When Ab detection = HN/ Hemagglutinin
 Genus: Norovirus Neuraminidase
 Species: Norwalk virus  Orphan – because there is no permanent
site of infection; causing different (+) Previous infection
 Structure: Naked, Icosahedral , diseases.
with SS (+) polarity, Linear, RNA,
38 nm  Order: Picornavirales
 Family: Picornaviridae
 Transmission: Fecal-oral route  Genus: ParECHOvrius

 Disease: Viral Gastroenteritis in  Structure: Naked, Icosahedral, with VIRAL AGENTS OF PAROTID GLAND
adults SS, Linear, RNA, 28 nm
 Where: School, camping MUMPS VIRUS
and cruise ship (often  Serotypes: More than 30 Serotypes  It is name because of the disease it
places) causes.
 Transmission: Fecal-oral route
 Clinical Findings:  Order: Mononegavirales
o Sudden onset of vomiting  Disease:  Family: Paramyxovirdidae
and diarrhea o Infantile diarrhea  Sub family: Paramyxovirinae
o Low-grade fever (not o Aseptic meningitis  Genus: Rubulavirus
over 380C) o Upper Respiratory Tract
o Abdominal cramping Infection  Structure: Enveloped, Helical, with
o Febrile illness with or w/o rash SS, Linear, RNA, 150 nm
 Lab diagnosis: o Hemorrhagic conjunctivitis
- PCR based test on stool  Serotype: 1 serotype
 Lab diagnosis: Cell culture
 Treatment:  Transmission: Respiratory droplets
- No anti-viral drugs  Treatment: No anti-viral drugs
available available  Disease: Mumps
- Rehydration
 Vaccine: NO VACCINE  Incubation period: 18-21 days (3
 Vaccine: weeks)
o NO VACCINE Note:

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 Clinical Findings:  RETRO – means backwards or in past o Horse Radish Stain

o Fever times
o Malaise - Viral Isolation (GOLD
o Anorexia  Order: Unassigned STANDARD)
o Tender swelling of parotid  Family: Retroviridae
gland (either unilateral or  Sub family: Orthoretrovirinae - CD4 and CD8 count
bilateral)  Genus: Lentivirus
 Treatment:
 Complications:  Species: 1. Entry Inhibitors
o Orchitis – inflammation of - HIV 1 – came from chimpanzee 2. Protease Inhibitors
epididymis; **Very rare; - HIV 2 – came from Sooty 3. Integrase Inhibitors
occurs only if there is a mangabey (spp. of a monkey) 4. Reverse Transcriptase Inhibitors
bilateral swelling.
 Structure: Enveloped, Icosahedral,  Vaccine: NO VACCINE
 Lab diagnosis: with SS, Linear, Diploid RNA, 100 nm
- Cell culture Other Names for HIV
- Serological test (Ab or Ag  Serotypes: 2 serotypes
detection) Names Particulars
 Transmission: GRID Disease Gay Related Immunedeficiency
 Treatment: - Sexual Contact (1981) Disease
- Blood Transfusion 4H Disease (1981) Haitans, Homosexuals,
- No anti-viral drugs
Hemophiliacs and Heroin users
- Self-limiting resolves in 1 week - Perinatal Transfusion
Disease

 Vaccine:  Disease: HIV infection, AIDS **Haitans - Place in America

- Measles, Mumps, and AIDS (1982) Acquired Immune Deficiency
 Incubation Period: 2-4 weeks Syndrome
Rubella (MMR) vaccine – HTLV-III Human T-Lymphotrophic Virus
attenuated (1982) Type III
 Lab diagnosis:  Robert
- Western Blot - Screening test Gallo
VIRAL AGENTS OF BLOOD AND VISCERA
LAV (1983) Lymphadenopathy Associated
 Luc Virus
1. HIV (Human Immunodeficiency Virus) - Serological Testing (Ag and Ab Montaigner
2. EBV (Epstein Barr Virus) detection) HIV (1984 - Human Immunodeficiency Virus
3. EBOLA VIRUS current)
4. MARBURG VIRUS - PCR assays – detecting Ag
5. HUMAN T-CELL LYMPHOTROPHIC molecularly GENES AND PROTEINS OF HIV
VIRUS
- Immunohistochemical Stains: STRUCTURAL GENES
HUMAN IMMUNODEFICIENCY VIRUS o Peroxidase Stain

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A. gag o Transports late mRNA from nucleus to  Short flu-like illness occurs 1-6 weeks
o Group Specific Antigen cytoplasm after infection.
o p24, p7, p17  No symptoms at all
o Nucleocapsid matrix protein ACCESSORY GENES: infectivity of a virus  Infected person can infect other
people.
B. pol A. nef  Most likely false negative result under
o Reverse transcriptase o Negative Replication Factor ELISA.
o p64 o Nef
o Transcribe RNA to DNA o Decreases CD4 proteins and Class I MHC STAGE 2 – ASYMPTOMATIC
proteins on surfaces of infected cell;
o p32 decreasing CD4 and killing CD8  Lasts for an average of 10 years.
o Protease  This stage is free from symptoms
o Cleaves precursor polypeptide  There may be swollen glands
B. vif  The level of HIV in the blood drops to
o p10 o Viral Infectivity Factor very low levels
o Vif  HIV Ab are detectable in the blood
o Integrase
o Integrate viral DNA host cell DNA o Enhances infectivity by inhibiting the
action of APOBEC3G (produced by STAGE 3 – SYMPTOMATIC
C. env immune system that we used for
combating the viruses.)  The symptoms are mild
o gp120
 The immune system detoriates
o DNA Attachment to CD4
C. vpr  Emergence of opportunistic infection
o Viral Protein R and cancers
o gp41
o Fusion with host cell o Vpr
o Transports viral core from cytoplasm into STAGE 4 – HIV  AIDS

REGULATORY GENES – important during nucleus in non dividing cells.

 The immune system weakens
replication  The illnesses become more severe
D. vpu
o Viral Protein U leading to an AIDS diagnosis
A. tat  Request for CD4 counting for
o Transactivator o Vpu
prognosis
o Tat o Enhances virion release from cell.
o Activation of transcription of viral gene
STAGES OF HIV INFECTION
OPPORTUNISTIC INFECTION IN HIV
B. rev
o Regulation of expression of virion STAGE 1 – PRIMARY
SITE OF DISEASE OR CAUSATIVE
o Rev INFECTION SYMPTOMS AGENTS
Lungs Pneumonia P.jiroveci,

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CMV b) Immunologic Approach

Tuberculosis M.  Host: Human
tuberculosis c) HeterophilAb (Monospot
Thrush C.albicans
 Transmission: Test)
Hairy leukoplakia EBV
Mouth - Kissing (direct contact w/
Ulcerations HSV-1,
H.capsulatum saliva) d) EBV Specific Ab Test
Thrush C.albicans - Blood transfusion (rare) - IgM Anti-viral Capsid
Esophagus
Esophagitis CMV, HSV-1 Antigen
Diarrhea Salmonella  Disease: - Anti- Early Antigen
spp.
Intestinal Shigella spp.
o Infectious mononucleosis - Anti EB Nuclear
Tract CMV o Kissing’s Disease Antigen
C.parvum
G.lamblia  Vaccine: NO VACCINE available
Meningitis C.neoformans
 Clinical Findings:
Brain Abscess T.gondii
CNS o Fever EBOLA VIRUS
PML (Primary Multi JC virus
Focal Encelopathy o Sore throat  First isolated in Ebola river in Zaire
Eye Retinitis CMV o Lymphadenopathy (1976)
Kaposis’s sarcoma HHV-8 o Splenomegaly
(cancerous)  In Africa, a particular spp. of Fruit
o Anorexia
Skin Zoster (shingles) VZV
o Lethargy bat considered the possible host for
Subcutaneous C. neoformans
nodules o Hepatitis Ebola virus.
Reticulo-
M.avium,
Endothelial Lymphadenopathy
 Other related diseases:  Order: Mononegavirales
EBV
System  Family: Filoviridae
1. Hairy Leukoplakia
2. Burkitt’s lymphoma  Genus: Ebolavirus
3. Nasopharyngeal Carcinoma  Species: Ebola virus
EPSTEIN BARR VIRUS 4. Thymic Carcinoma
 Structure: Enveloped, Helical, with SS,
 Named by Epstein and Barr (1964)  Treatment: No anti-viral drugs Linear, RNA, 80nm

 Order: Herpesvirales  Lab Diagnosis:  Transmission: Direct contact w/ body

 Family: Herpesviridae fluids
 Sub Family: Gammaherpesvirinae a) Hematologic Approach
 Genus: Lymphocryptovirus - Absolute  Disease: Ebola Hemorrhagic Fever
 Species: HHV-4 Lymphocytosis
- Atypical Lymphocytes  Signs and Symptoms:
 Structure: Enveloped, Icosahedral, o Headache
with DS, Linear DNA, 100nm o Red eyes

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o Systemic  Family: Filoviridae  Structure: Enveloped, Icosahedral,

Fever  Genus: Margburgvirus with SS, Linear, RNA, 100nm
- Lack of appetite  Species: Marburg Marburg virus
- Internal bleeding  Transmission:
o Muscular - Sexual Contact
- Aches  Structure: Enveloped, Helical, with SS, - Blood Transfusion
Weakness Linear, RNA, 80nm - IV Drugs User
o Joints
- Ache  Transmission: Direct contact of body  Disease:
o Intestine fluids of infected person o Adult T-Cell Leukemia/
- Diarrhea Lymphoma
o Pharynx and Lungs  Incubation period: 3-9 days o Tropical Spastic Paraparesis/
- Hiccups Chronic Progressive
- Sore throat  Disease: Marburg Hemorrhagic Fever Myelopathy
- Difficulty breathing
- Difficulty swallowing *Green Monkey source.  Clinical Findings:
o Chest pain o Lymphadenopathy
o Stomach  Clinical Findings: o Hepatosplenomegaly
- Pain o Diarrhea o Hypercalcemia
- Vomiting o Abdominal Pain o Tropical Spastic Paraparesis –
o Skin o Nausea weakness of the lower limbs
- Rash o Headache and low back pain also loss of
- Bleeding o Irritated motor function
 Lab Diagnosis: o Throat Bleeding
o Cell culture  Lab Diagnosis:
 Treatment and Vaccine: No anti-viral - Ab detection (ELISA)
 Treatment: No anti-viral drugs and vaccine available. - Western blot
- PCR assay (RNA or DNA
 Vaccine: NO VACCINE detection)
HUMAN T-CELL LYMPHOTROPHIC VIRUS
 Treatment & Vaccine: No available
MARBURG VIRUS  Also known as Human T-Cell vaccine & anti-viral drugs
Leukemia
 First case in 1967 in Marburg,
Germany  Family: Retroviridae IMPORTANT GENES OF HTLV
 Genus: Retrovirus
 Order: Mononegavirales  Species: HTLV – 1 (1980), HLTV – 2
VIRAL AGENTS OF NERVOUS SYSTEM

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o Painful  Disease: Poliomyelitis

RABIES VIRUS o Spasm of Throat muscle  Clinical Findings:
1. Inapparent – Asymptomatic
 HALLMARK: Microscopic  Lab Diagnosis: GENES FUNCTION
appearance of Negri Body - Direct Microscopic Exam
gP 46 &gP  Envelope Protein
- Viral Cell Culture 41
 Order: Mononegavirales - Serological Ab titer Gag , pol,  Structural genes
 Family: Rhabdoviridae env
 Genus: Lyssavirus  Treatment: Immunoglobulin, No Tax  Transcriptional activator required for
malignant transformation of T cells
 Species: Rabies virus antiviral drug
 Responsible for changing normal T-
cell to malignant cell
 Structure: Enveloped, Helical, with SS,  Vaccine:
Linear, RNA, 75x180 nm - Pre- exposure immunization
Rex  Governs processing of viral mRNA by
(People who needed the most determining which viral mRNA’s can
 Reservoir host: are VETERINARIAN, exit the nucleus and enter the
o Skunks ZOOKEEPERS AND FUN OF cytoplasm to be translated
o Raccoons GOING MOUNTAINS infection replicate in large
o Foxes intestine; no complication
o Bats 2. Abortive Poliomyelitis –
- Post exposure immunization fever, headache, sore throat,
 Transmission: Bite of Rabid animal nausea, vomiting;
POLIO VIRUS disseminated in blood
 Order: Unassigned stream.
 Disease: Rabies  Family: Picornaviridae 3. Non – paralytic poliomyelitis
 Genus: Enterovirus – Aseptic meningitis with
 Incubation Period: 2 – 16 weeks or  Species: Human Polio virus
longer. ***Depends on the location poliomyelitis, fever, headache
of bite. and stiff neck; self – limiting
 Structure: Naked, Icosahedral, (+) 4. Paralytic Poliomyelitis –
polarity, SS, Linear, RNA, 28 nm Flacoid paralysis – blocking
 Clinical Findings:
o Fever the info coming in the brain.
 Host: Primates
o Anorexia
o Changes in Sensation in the  Lab Diagnosis:
 Serotypes: 3 serotypes - Serological Ab titer
bite site
- Isolation of virus from
o Hydrophobia  Incubation period: 10-14 days culture
o Confusion
o Lethargy  Transmission: Fecal – Oral route  Treatment:
o Increase Salvation
- No antiviral drugs

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- Symptomatic relief, o Sexual contact is also  Family: Poxviridae

respiratory support and possible  Sub Family: Chordopoxvirinae
physiotheraphy  Genus: Molloscipox virus
 Disease: Papilloma or Warts
 Vaccine:  Structure: Enveloped, Complex with
1. Salk Vaccine (Killed)   Types: DS, Linear DNA, 250x400 nm
Intramuscular 1. Skin warts – caused by HPV–1
2. Sabin Vaccine (Live)  Oral to HPV–4  Transmission:
2. Genital warts – caused by - Close personal contact with
VIRAL AGENTS OF SKIN AND EYES HPV–6 and HPV – 11 lesions
3. Carcinoma (cervix and penis) – - Sexual contact (rare)
VIRAL AGENTS: caused by HPV –16 and HPV–18
1. Human Papillomavirus  Disease: Molloscum contagiosum
2. Molloscum contagiosum virus  Lab diagnosis: (benign type)
3. Vaccinia virus - Direct microscopic exam
4. Small pox virus using lesion  Clinical Findings:
5. Varicella Zoster virus - DNA hybridization – o Small lesion (2-5 mm), flesh
6. Herpes Simplex virus molecular assay detecting colored papule on the skin or
7. Measles virus - Hallmark – Koilocytes mucous membrane
8. Rubella virus o Painless, non-pruritic and
 Treatment: non inflamed
HUMAN PAPILLOMA VIRUS 1. Liquid nitrogen – for skin o Lesions have a charachteristic
lesion cup shaped crater w/ a
 Hallmark – Koilocytes 2. Podophylin – for genital white cone
lesions
 Order: unassigned 3. Salicylic acid – plantar  Lab Diagnosis: Made clinically
 Family: Papillomaviridae lesions
 Genus: Papillomavirus 4. Alpha interferon – use for  Treatment and Vaccine:
 Species: Human Papilloma virus cervical cancer and genital - Skin curettage
lesion No anti-viral drugs and vaccine available
 Structure: Naked, Icosahedral, with
DS, Circular, DNA, 55nm  Vaccine:
- HPV – 6 and HPV 11, HPV - SMALL POX VIRUS / VARIOLA VIRUS
 Serotypes: 100 serotypes 16 and  Order: Unassigned
HPV – 18  Family: Poxviridae
 Transmission:
o Direct contact of skin or MOLLOSCUM CONTAGIOSUM VIRUS  Structure: Enveloped, Complex with
genital lesions  Order: Unassigned DS, Linear DNA, 250x400 nm

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 Genus: Orthopoxvirus
 Host: Human with single serotype  Incubation period: 14-21 days (for
 Structure: Enveloped, complex, with Varicella only)
 Transmission: DS, Linear, RNA, 250x400 nm
- Respiratory aerosol  Clinical Findings: Fever, Malaise,
- Direct contact with skin  Transmission: Respiratory aerosol Pruritus rashes
lesions or infected fomites
 Disease: Vaccinia
 Disease: Small pox  FACTORS TO ACTIVATE VIRUSES:
 Clinical Findings: Asymptomatic but 1. Stress
 Incubation period: 7-14 days may cause mild rash and fever 2. Mechanical Injury
 Clinical Findings: 3. Too much exposure to sun
o Fever  Lab Diagnosis: Ab titer 4. High fever
o Malaise
o Followed by RASH evolving  Vaccine: Live, attenuated vaccine  Complications
through stages from: (1) o Encephalitis
Macules, (2)Papules, (3) o Varicella Pneumoniae
Vesicles, (4) Pastules,(5) Crusts VARICELLA ZOSTER VIRUS
in 2 weeks  Order: Unassigned  Lab Diagnosis:
 Family: Herpesviridae - Tzanck smear (Presumptive
 Treatment: No anti – viral drugs  Genus: Herpesvirus test)
- Viral Culture
 Vaccine: Live, Attenuated vaccine  Structure: Enveloped, Icosahedral - Ab titer
with DS linear DNA, 100 nm
INCIDENCE OF SMALL POX  Treatment:
 Host: Human and only 1 serotype - Acyclovir – moderate to severe
YEAR INCIDENCE cases
1960 Small pox is widespread in Africa, Asia and  Transmission: Respiratory droplet & - For immune compromised
South America Direct contact with lesions patient:
1967 WHO had vaccine campaign that led to
eradication of smallpox 1. Foscarnet - Acyclovir
1977 Last naturally occurring cause in Somalia  Disease: resistant strains of VZV
o Varicella/Chicken pox – 2. Famcyclovir and
primary Valacyclovir – for Zosters
VACCINIA VIRUS o Zoster / Shingles – recurrent  Vaccine:
infection 1. Varivax – ages 1-12 years old
 Order: unassigned (Varicella)
 Family: Poxviridae NOTE: Varicella - most common in children 2. Zostavax – 60 years old and
 Sub Family: Chordopoxvirinae Shingles - in adults above (Zoster).

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3. Varicella Zoster Ig – for Valacyclovir (Valtrex and

4. o Deafness
prophylaxis Famcyclovir, Famvir) – Genital o Mental Retardations
herpes o Stillbirth
HERPES SIMPLEX VIRUS MEASLES VIRUS/ RUBEOLA VIRUS
 Order: Unassigned  Lab Diagnosis:
 Family: Herpesviridae/ Herpetoviridae  Childhood disease - Four fold increase of titer
 Genus: Herpesvirus - Viral cell culture
 Species:  Order: Mononegavirales  Treatment: No anti-viral drug
- Herpes Simplex Virus Type 1  Family: Paramyxoviridae  Vaccine: Live, attenuated vaccine
- Herpes Simplex Virus Type 2  Sub Family: Paramyxovirinae (MMR)
 Genus: Morbilivirus
 Structure: Enveloped, Icosahedral with RUBELLA VIRUS
DS, Linear, DNA, 100nm  Structure: Enveloped, Helical with SS,  Rubella means “red” because of
Linear, RNA, 150nm red manifestation.
 Host: Human with 2 serotypes
 Transmission:  Transmission:  Order: Unassigned
- HSV 1 – Respiratory secretions - Respiratory droplets  Family: Togaviridae
and saliva (lesions above the - Transplacental  Genus: Rubivirus
waist)
- HSV 2 – Sexual contact ,  Incubation Period: 10 – 14 days  Structure: Enveloped, Icosahedral,
perinatal (lesions below the with SS, Linear, RNA, 60nm
waist; usually genital)  Disease: Measles/Rubeola
 Transmission
 Lab Diagnosis:  Clinical Findings: - Respiratory droplet
- Tzanck smear o Fever - Transplacental
- Viral culture o Conjunctivitis (photophobia)
- PCR assay (CSF for encephalitis) o Coryza  Incubation period: 2 – 3 weeks
- Serological Tests o Coughing
o Maculopapular rash appears on  Disease:
 Treatment: the face and proceeds gradually o Rubella/ German Measles
1. Acyclovir – Encephalitis, down the body to lower o 3 days Measles
primary and recurrent genital extremities
herpes, neonatal infection. o Koplik’s Spot – bright red lesion  Complication:
2. Foscarnet – For resistant with a white central dot that are o CRS (Congenital Rubella
mutant against acyclovir located on the buccal mucosa. Syndrome) Common in
3. Trifluridine (Viroptic) – Topical pregnant women
eye infection  Complications:
o Encephalitis  Clinical Findings:

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o Low grade fever CYTOMEGALIC INCLUSION DISEASE

o Posterior cervical  Order: Herpesvirales - Many organs are affected and
lymphadenopathy with rash  Family: Herpesviridae widespread congenital abnormalities
beginning on the face which  Sub Family: Betaherpesvirinae - Microcephaly, seizures, deafness,
spreads with the rest of the  Genus: Cytomegalovirus jaundice and purpura
body  Species: Human CMV - Hepatomegaly and mental retardation
 Lab diagnosis:
 Lab Diagnosis:  Structure: Enveloped, Icosahedral, - Ab titer – most of the time
- IgM serological assay with DS, Linear, RNA, 100nm - Direct microscopic exam
- Ab titer - Culture isolation
- Cell Culture  Serotype: Single serotype - Can be secreted through urine
- PCR in tissue and body fluids
 Treatment: No anti-viral drugs  Host: Human (amniotic fluid)
 Treatment:
 Vaccine: Live attenuated vaccine  Transmission - Gancyclovir
(MMR) - Early life - Valgancyclovir
o Via placenta - Foscarnet
o Passage through birth - Citofovir
CONGENITAL RUBELLA SYNDROME canal - Fomivirsed
- Compromises cardiac, cerebral, o Breast milk
ophthalmic and auditory defects - Children  Vaccine: NO VACCINE
- First trimester may cause miscarriage o Saliva
If baby survives, it can be born with severe - Later in life BK VIRUS
heart disorders, blindness deafness or life o Sexual transmission
threatening organ disorders. o Blood transfusion and  Order: Unassigned
organ transplant  Family: Papoviridae
 Genus: Polyomavirus
VIRAL DISEASE OF UROGENITAL SYSTEM  Disease:  Species: BK virus
o Cytomegalic inclusion disease
VIRAL AGENTS: in neonates  Structure: Naked, Icosahedral with DS,
1. CMV o Pneumonia in immune Circular, DNA, 45nm
2. BK VIRUS compromised patient
3. HSV o Heterophile – negative  Transmission: No established clear
mononucleosis transmission possible fecal oral route
CYTOMEGALOVIRUS o Retinitis in AIDS patients blood transfusion
leading to blindness
 because of inclusion bodies  Disease: Neuropathy in renal
cytoMEGAlo transplant patients

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o Hydrops Fetalis  Clinical Findings:

o Visual field defects
 Clinical Findings:  Clinical Findings: o Mental status weakness
o Impair sensation, movement, o Bright red prominent on the o Progress to blindness
and other organ functions. cheeks o Dementia
o Low grade fever o Coma
 Treatment and Vaccine: NO ANTI- o Coryza o Patient dies within 6 months
VIRAL DRUGS AND VACCINE o Sore throat
AVAILABLE o Maculopapular rash  Lab Diagnosis:
(HALLMARK) - PCR assay of CSF or brain
biopsy
PARVO VIRUS B19  Lab Diagnosis
- IgM Ab  Treatment and Vaccine: NO
 On a B well, accidentally in 19th - Culture of throat swabs TREATMENT AND VACCINE AVAILABLE
position of the well there is a - PCR
reaction. o Blood – immune NOTE:
compromised patient In order causing rashes in U.S
 Order: Unassigned o Amniotic fluid – 1. Measles
 Family: Parvoviridae hydrops fetalis 2. Rubella
 Sub Family: Parvovirinae 3. Scarlet fever
 Genus: Erythrovirus  Treatment and Vaccine: NO 4. Roseola
 Species: B19 virus TREATMENT AND VACCINE AVAILABLE 5. Parvo B19 virus
 Order: unassigned
 Structure: Naked, Icosahedral with SS,  Family: Papoviridae/Polyomaviridae
Linear DNA, 22 nm  Genus: Polyomavirus JC VIRUS

 Transmission  Structure: Naked, Icosahedral, with  Togaviridae

- Respiratory route DS, Circular, DNA, 45 nm - Eastern equine encephalitis
- Transplacental virus
- Blood transfusion  Transmission: No clear established - Western equine encephalitis
transmission but possible of fecal oral virus
 Host: Human route - Chikungunya virus

 Disease:  Disease: PML (Progressive MultiFocal  Flaviviridae

o Slapped Cheek Syndrome Leukoencephalopathy – most - St. Louis encephalitis virus
o 5th disease common in immune compromised - Yellow fever virus
o Erythema infectiosum patients - Dengue virus
o Aplastic anemia - West Nile fever virus

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 Bunyaviridae
- Califonia encephalitis virus

 Transmission:
- Insect bite
- Also transmit Transovarian

 Clinical Findings:
o Myalgia
o Viremia
o Non- hemorrhagic rash
o Petechiae
o Fever
o Headache
o Can lead to encephalitis and
hemorrhagic fever

 Arthropod vectors
o Mosquitoes
- Japanese
encephalitis,
Dengue, Yellow
fever, St. Louis
encephalitis, EEE,
WEE

o Ticks
- Crimean – Congo
Hemorrhagic Fever

o Sandflies
- Sicilian sandfly fever,
Rift Valley Fever

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