(+) Stranded RNA Viruses I
•Polio
•The Common Cold
• Norwalk Virus
Totally Paralyzed Poliomyelitis Patients in Mechanical
Respirators
• Last US epidemic before universal immunization (1955).
Picornaviridae family
1. Enterovirus
a) Polioviruses types 1, 2 and 3
b) Coxsackieviruses A1-A24 (no A23), B1-B6
c) Echoviruses 1–34 (no 10 or 28)
d) Enteroviruses 68 -71
2. Rhinovirus
a) Rhinoviruses 1 -100+
3. Hepatovirus
a) Hepatitis A virus
4. Cardiovirus
Caliciviridae family
1. Norwalk virus
2. Hepatitis E virus
Biologic properties
Heat and detergent stable
Acid stability (ability to survive gastric acids
following ingestion)
a. Enterovirus, Hepatovirus , and
Calicivirus are acid-stable (pH >3)
b. Rhinovirus is acid-labile (pH <5)
Virion structure
1. Picornaviridae: non-enveloped icosahedral
capsid, 30 nm in diameter, 60 protomers
2. Caliciviridae: nonenveloped icosahedral
capsid, 30 – 38 nm, 90 capsomers; named for
the 32 characteristic cup-shaped depressions on
the virion surface
Genome structure
1. Linear, plus sense ssRNA, 7 – 8 kb
2. Protein primer at 5’ end, polyadenylated
at 3’ end
3. Genome RNA is infectious
Virus Structure and Adsorption
Fig. 57-2 From Murray et. al., Medical Microbiology 5th edition, 2005, Chapter 57, published by Mosby Philadelphia,
Replication
1. Attachment to receptor- canyon
2. Virion RNA acts as mRNA and is translated into a
polyprotein which auto-cleaves to yield non-structural
and structural proteins- RNA dependent RNA
polymerase
3. Cytoplasmic site of replication
4. Virus inhibits cellular transcription, DNA
replication & protein synthesis.
Cytocidal.
5. Assembly of genome into capsids
Poliovirus RNA and Posttranslational Processing of the
Poliovirus Polyprotein
Fig. 57-4 Pathogenesis of Enterovirus Infection
From Murray et. al., Medical Microbiology 5th edition, 2005, Chapter 57, published by Mosby Philadelphia,,
Neurologic
1. Meningitis (“aseptic meningitis”)
a) many enteroviruses (are most common cause
of meningitis)
b) differential diagnosis with bacterial meningitis
is very important
2. Paralysis
a) Polioviruses 1, 2, 3
b) Echoviruses
c) Coxsackieviruses A and B
3. Chronic meningoencephalitis/ dermatomyositis
a) Echoviruses
Idealized Scheme of the Course of Infection with Poliovirus
Post-polio
Syndrome
90% ~5% 1-2%
Cardiac and Muscular
1. Myocarditis
a) Coxsackievirus B
b) some coxsackievirus A and
echoviruses
2. Pleurodynia
a) Coxsackievirus B
Skin and Mucosae
1. Herpangina
a) Coxsackievirus A
2. Hand-foot-and-mouth disease
a) Coxsackievirus A16
Respiratory
1. Colds
a) Rhinoviruses
b) Coxsackieviruses A
c) Echoviruses
d) Coxsackievirus B
Ocular
1. Acute hemorrhagic conjunctivitis
a) Enterovirus 70
b) Coxsackievirus A24
Hepatitis
1. Hepatitis A virus
2. Hepatitis E virus
Gastroenteritis
1. Caliciviruses (Norwalk agent)
2. various enteroviruses
Treatment/Vaccines
The polio vaccine represents an important milestone
in vaccine technology
1. Salk vaccine – killed, inactivated (IPV and EIPV)
Since 2000 used exclusively in US
2. Sabin vaccine – live attenuated (oral -OPV)
No longer used in US
3. World-wide eradication effort- OPV
TABLE 57-2
From Murray et. al., Medical Microbiology 5th edition, 2005, Chapter 57, published by Mosby Philadelphia,,
Caliciviridae
family includes several viruses that cause
gastroenteritis
Norwalk virus
Negatively Stained Electron Micrographs of Noroviruses
Calciviridae Astroviridae
Enteroviruses
• Structure
– Positive sense ssRNA genome, protein coat
• Pathogenesis
– Fecal oral transmission
– replication in cytoplasm
– Viremia to diverse target tissues, viruses very cytopathic
killing cells they infect
– Infections often asymptomatic; polio causes paralytic
poliomyelitis; rhinoviruses restricted to upper respiratory
tract, common cold; calici viruses diarrhea
• Diagnosis
– Serology and nucleic acid
• Treatment/prevention
– Only polio vaccines, Salk and Sabin
