Cases (Non-enveloped Viruses)

Question 1

Non Enveloped DNA Viruses

Answer 1

Aden’s Papillon has Parvo
Adenovirus
Papillomavirus
Parvovirus

Question 2

Non-Enveloped RNA Viruses

Answer 2

Picornavirus (rhinovirus, poliovirus, coxsackievirus, Hepatitis A)

Let’s meet our hero, PICO (that’s short for Picorna). Notice he is riding his pet Rhino (Rhinovirus), while playing Polo (Polio). Did you notice his saddlebags… or Sacks (Coxsackie A/B). Oh yeah, Pico has some drinking problems (note the bottle), so throw Hep-A and Entervirus in this group.

HEPpy NORO wants to go to REO

Hepevirus (E)
Norovirus
Reovirus

Question 3

Adenovirus Structural Details

Answer 3

dsDNA
57 serotypes
Stable
Vector for vaccination approaches
Can be asx's 

Gene Expression in NUCLEUS, using HOST MACHINERY

E genes - regulatory
L genese - structural

Question 4

Pt present with unilateral red eye, fever + pharyngitis. What organism do you suspect?

Answer 4

Adenovirus serotypes 3,4,7,8,19,37

Question 5

Adenovirus 40-41 cause this type of infection?

Answer 5

Gastroenteritis

Question 6

Pt presents with Croup, suspect this serotype of adenovirus.

Answer 6

Adenovirus 1,2,5,6,14

Question 7

Teen present with painful urination, dysuria + hematauria. You suspect adenovirus, what serotype?

Answer 7

11 + 21

Question 8

HPV

Answer 8

dsDNA with >100 serotypes
Infects undifferentiated basal keratinocytes
Uses HOST DNA polymerase

Question 9

What HPV serotypes are the most common cause of genital warts (90%)?

Answer 9

6 + 11

Question 10

What type of HPV is most commonly associated with progression to CA? Why?

Answer 10

16 + 18
Drives cell cycle progression for activation of DNA polymerase for use by virus.
E6 early protein INHIBITS tumor suppressor gene
E7 early protein INHIBITS pRB tumor suppressor gene.

Gardasil - 6,11,16,18 - Recombinant vaccine (L1 capsid)

Question 11

Your pt brings in her 5 mo daughter Rosie. Rosie has been running a low grade fever. Her mother brought her in because she developed a rash that began on her face and then moved to her extremities. Mom says Rosie does not act itchy or irritated. This is at the top of your DDx

Answer 11

Fifth’s dx (erythema infectiosum) - Parvovirus B19

In older children the rash can be more itchy and arthritic symptoms may occur in hands, wrists, knees, ankles.

Transmitted via respiratory droplets.

Question 12

Parvovirus

Answer 12

ssDNA
Mostly affecting animals - not zoonotic
Replicates in NUCLEUS using HOST transcription, translation + replication.

Question 13

Picornaviruses - key features

Answer 13

ssRNA (pico = small)
icosahedral capsid with 4 proteins.
Replicates in CYTOPLASM
Protealytic cleavage.

Question 14

Your patient presents with all the signs of the common cold, including mm weakness and fatigue. You know from Dr Chew that this is a common, season causative organism…..

Answer 14

Rhinovirus

has greater than 100 serotypes.

Question 15

This virus causes CNS invasion and flaccid paralysis at various locations….

Answer 15

Poliovirus

1. Anterior Horn = asymmetrical facial paralysis (m/c) - SPINAL
2. Bulbar region of brainstem (V, A, Hypo N’s) = swallowing, breathing, lung + heart fx - BULBAR
3. Combo - RESPIRATORY polio - diaphragm + phrenic nerve affected. Need assisted ventilation.

Question 16

This virus typically present in children <5yo and may cause mild URT, GI + Flu-like symptoms. May also cause non-paralytic aseptic meningitis…..

Answer 16

Poliovirus

If causing these symptoms it is generally self resolving.

VACCINE avail
Jonas Salk - inactivated polio
Albert Sabin - oral, live attenuated 1952; low risk of vaccine induced polio. Admin in endemic areas where risk of dx outweighs risk of reversion.

Question 17

Post Polio Syndrome

Answer 17

NOT ASSX with Shedding/infection –> Molecular Latency?

MM weakness + extreme fatigue

Question 18

This organism causes an acute febrile illness with nx + vx. Assx with aseptic meningitis in kids + with mycarditis and pericarditis in some individuals…….

Answer 18

Coxsackievirus

Question 19

Pt presents with a faver, fatigue + rash. You notice the ulcerations on the hands + feet. On PE you see blisters in the mouth and throat as well as conjunctivitis. You suspect…..

Answer 19

Hand, foot + mouth Dx - Coxsackie A

Question 20

Pt presents with chest pain. You rule out MI and find out that the pt also has: fever, HA, abdominal pain…… you suspect….

Answer 20

Pleurodynia - Coxsacki B

Question 21

Jaxson comes by your office because upon return from visiting his family in Mexico he had abrupt onset of fever, malaise, anorexia and abdominal pain. He tells you that his sister is experiencing similar symptoms back in Mexico. What (+)ssRNA virus might this be indicative of?

Answer 21

Hepatitis A virus

polyprotein synthesis followed by protealitic cleavage.
Assx with contaminated food/water
Vaccine is available.

Worry about long term complication is rare - only 10% of ppl.
Prevention - heat food + water to >85C

Question 22

You need to worry about this -/+ ssRNA virus in pregnant women. What are key symptoms and why is this a problem in pregnancy.

Answer 22

Hepatitis E

Fever, malaise, nausea, anorexia + abd pain (SAME as Hep C)
ALSO: Jaundice, DARK urine. Joint pain.
Generally self limiting - but risk of Fulminant Hepatitis in pregnant women with high mortality in the 3rd trimester.

Question 23

While on a cruise over 60 ppl come down with severe diarrhea and vomiting. You know this is likely related to this virus of the Calicivirus Family….

Answer 23

Norovirus
-/+ssRNA virus with 5 genogroups

Infx is self limiting but lasts about 1-3 days

Question 24

This virus uses NSP4 virulence factor to cause Ca2+ into the gut lumen causing osmotic diarrhea. Also assx with fever + vomiting….

Answer 24

Rotavirus
Of the REOvirus family
-dsRNA virus
Live attneuated vaccine available - low risk of intussuception even

Question 25

Name the non-enveloped virus’ that have vaccine’s available

Answer 25

HPV strain’s 11,6, 16, 18
Polio
Hep A
Rotavirus