Adenovirus Flashcards
Adenovirus Family
Adenoviridae
Adenovirus Genome
Double-stranded DNA,
non-enveloped virus
Adenovirus has ____ serotypes and is classified into ___ species
60 serotypes, 7 species
Which types are more commonly associated with respiratory infections?
types 3, 4, 7, 14
Adenovirus Structure
Icosahedral capsid,
with fiber proteins that mediate
cell attachment
Adenovirus Transmission
Respiratory droplets, fecal-oral route, and direct contact
TRUE OR FALSE: Can survive on surfaces for short periods
FALSE, long periods
There are higher rates for the virus in ______, military recruits, ___ and ______
children, military recruits, and immunocompromised individuals
Seasonality of Adenovirus
Occurs year-round but can have peaks in late winter to early summer.
TRUE OR FALSE: Outbreaks are common in close quarters
TRUE
Adenovirus is composed of ____ subunits, _____ hexons, and 12 ____ and _____
252 subunits, 240 hexons, 12 pentons and fibers
What
contain most of the
neutralizing antibodies’
epitopes?
Hexon and the fiber
TRUE OR FALSE: Adenovirus is relatively susceptible and less stable than other enveloped respiratory viruses
FALSE. resistant and more stable than others
Function of penton base
Penetration, toxin like activity that causes
rapid appearance of cytopathic effect
What proteins serve as virulence factors?
Fiber, E1A/E1B Proteins
The ____ protein mediates attachment to epithelial cells
Fiber
E1A/E1B proteins interfere with _______, preventing _____
host cell
cycle control, preventing
apoptosis
Adenovirus blocks _____ and ___ Expression
interferon and MHC 1 expression
Virus attaches to host cells via what receptor?
coxsackie-adenovirus receptor (CAR)
TRUE OR FALSE: Entry of virus happens through cell-mediated endocytosis
FALSE, receptor-mediated
What epithelial cells does adenovirus target?
Respiratory, gastrointestinal, and ocular
Replication in host nucleus leads to ___
cell lysis
Immunity to adenoviruses after infection
is ______-specific and usually ______
serotype-specific, long lasting
What is the body’s response to infection?
group-specific complement-fixing
antibodies
TRUE OR FALSE: Group-specific complement-fixing antibodies are useful indicators of infection, and is used specify the infecting serotype
FALSE, useful indicators of infection, but do
not specify the infecting serotype
What respiratory symptoms appear with infection?
Fever, cough, sore throat, and rhinorrhea
Croup, bronchiolitis and pneumonia are seen in ________
severe cases, infants and the immunocompromised
What combination of symptoms usually consist of the classical manifestations of adenovirus?
Conjunctivitis + sore throat (Pharyngoconjunctival fever)
_______ is common in young children
Gastroenteritis
What symptom is common among industrial workers?
Keratoconjunctivitis: Eye infection
These symptoms are rare but serious complications
Myocarditis and hepatitis
Among the following serotypes, which are NOT associated with outbreaks for childhood febrile illness?
2, 3, 4, 7a, 7b, 21
2, 4, 7b, 21
Which serotypes are associated with outbreaks for pneumonia and other acute respiratory illnesses?
3, 7a, 7b, 14a
Serotypes 3 and 19 are associated with outbreaks in which syndromes?
Pertussis and keratoconjunctivitis
Acute Respiratory Disease (ARD) is caused by which adenovirus serotypes?
Serotypes 1, 2, 5, and 7
ARD Symptoms
Fever, cough, sore throat, nasal congestion, and conjunctivitis. May lead to pneumonia in severe cases
TRUE OR FALSE: Pharyngoconjunctival Fever is associated with adenovirus serotype 4
False, serotype 3
Pharyngoconjunctival Fever Symptoms
Combination of pharyngitis, conjunctivitis (red eyes), fever, and sometimes
respiratory symptoms
Epidemic Keratoconjunctivitis is caused by which serotypes?
8, 19, and 37
Epidemic Keratoconjunctivitis symptoms
Redness, tearing, photophobia, and foreign body sensation in the eye. It is highly contagious and can cause
significant discomfort
Jessica was found to have redness in her eyes as well as tearing. She would prefer to have the lights in her room off. Upon going to the doctor, she would complain of a ‘foreign object sensation’ in here eye. After several diagnosis tests, the doctor confirms that it is adenovirus. What possible serotypes may have caused her symptoms?
Epidemic Keratoconjunctivitis: 8, 19, and 37
Assuming the causative agent is indeed adenovirus, a person who suffers from bloody urine and painful urination would test positive for which adenovirus serotype?
11
Most cases positive for adenovirus serotypes 40 and 41, who suffer from gastroenteritis, would come from which age group?
Children
TRUE OR FALSE: ELISA is gold standard for respiratory samples (throat swabs)
FALSE, PCR
Which comes first, clinical or laboratory diagnosis?
Clinical
Antigen detection is (less/more) sensitive, and is used in ________
Less sensitive, used in rapid diagnostics
Which laboratory diagnosis is useful for epidemiological studies but less helpful in acute infection?
Serology
TRUE OR FALSE: Viral Culture is definitive, but rarely used
TRUE
Common specimens for culture
Nasopharyngeal swabs, throat swabs, sputum, BAL, conjunctival swabs, stool, urine, blood, CSF, tissue samples
Adenovirus can be ____ in routine viral transport medium
stable
Challenges for adenovirus culture
- Not practical for routine use in hospitals.
- Some serotypes (e.g., types 40, 41) are non
cultivatable. - Expensive primary human embryonic kidney
cells may be required for fastidious serotypes.
Serology requires how many samples and why?
2 samples, acute and convalescent, to
demonstrate a 4-fold rise in titers
Most children are ____ by age __.
seropositive, 4
What are the types of antigen tests?
a. ELISA and PCR
b. DFA and EIA
c. HIA and HA
d. LAMP and PCR
Direct fluorescent antigen (DFA) and enzyme
immunoassay (EIA)
_______ are used to diagnose patients with keratoconjunctivitis, respiratory disease, and
enteritis.
Antigen Tests
Antigen tests are best for detecting ______ in stool
non-cultivatable types (e.g.,
types 40, 41) in stool
PCR has ________ for respiratory, tissue, urine, and blood samples
High specificity
When an immunocompromised patient is confined in the hospital for adenovirus, the doctor will request which laboratory diagnosis?
a. Serology
b. Antigen Tests
c. Culture
d. PCR
d. PCR
Quantitative PCR is vital for monitoring viremia in immunocompromised patients.
What must be considered for the interpretation in PCR testing?
Interpretation must consider virus shedding versus active infection
There has been several outbreaks of adenovirus in the Philippines. The DOH is tasked to map the virus in terms of serotypes. Which laboratory diagnosis is most useful in this scenario?
Serotyping
What type of testing is used for ARD?
Syndrome-specific testing
______ for culture of respiratory viruses
(eg, influenza virus, adenovirus, respiratory syncytial virus, rhinovirus) is suggested.
Nasopharyngeal swab
What type of assay should be considered for Epstein-Barr virus?
Monospot assay
Which antiviral drug is considered in severe or immunocompromised patients but is not routinely used due to toxicity?
a. Brincidofovir
b. Cidofovir
c. Doxycycline
b. Cidofovir
Live oral vaccines for _____ are available for
military recruits in some countries
types 4 and 7
