Enteroviruses Flashcards

1
Q

What are the two main categories of enteroviruses?

A

Polioviruses

Non-polio enteroviruses (coxsackie, echoviruses)

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2
Q

What are characteristics of the enterovirus virions?

A

Small, icosahedral
non-enveloped, (+) ss RNA
Viral RNA translated into polyprotein that’s cleaved into structural proteins and enzymatic proteins

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3
Q

What is the transmission of enteroviruses?

A

Primarily Fecal-oral

Respiratory droplets

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4
Q

What is the seasonality of enteroviruses?

A

Summer/autumn

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5
Q

What is the pathogenesis of enterovirus?

A

Inhaled and virus replicates in oropharynx
Primary minor viremia disseminates to other tissues (muscle, fat, liver, spleen, bone marrow)
Most people contain infection at this stage, producing minor or no symptoms
Some people continue to secondary major viremia that leads to symptoms, depending on what target organ is infected

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6
Q

What is the cause of most of the enterovirus disease manifestations?

A

Cell destruction by virus (cytolysis)

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7
Q

What is the cause of enterovirus myocarditis and rash?

A

Host immune response

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8
Q

If enterovirus targets meninges, what disease can manifest?

A

Aseptic meningitis

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9
Q

If enterovirus targets brain, what disease can manifest?

A

Encephalitis

Paralytic disease

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10
Q

If enterovirus targets heart, what disease can manifest?

A

Myocarditis

Pericarditis

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11
Q

If enterovirus targets muscle, what disease can manifest?

A

Myositis

Pleurodynia

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12
Q

If enterovirus targets skin/mucosa, what disease can manifest?

A

Hand-foot-mouth disease

Rash, herpangina

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13
Q

What is the most common target of poliovirus?

A

Anterior horn of spinal cord

where innervation of skeletal muscle occurs

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14
Q

What is the major presentation of poliovirus?

A

Asymmetric flaccid paralysis without sensory loss

Preferentially affects proximal muscles of lower limbs

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15
Q

How is poliovirus diagnosed?

A

Clinical
MRI showing ventral horn defects
Cell culture is gold standard

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16
Q

Which polio vaccine is live and which is killed?

A

Salk - killed

Oral - live

17
Q

What is the major disadvantage to oral polio vaccine, the reason it’s not used in US

A

Can mutate and cause paralysis

18
Q

What are the non-polio enteroviruses?

A

Coxsackievirus
Echovirus
Numbered enteroviruses

19
Q

What is the different between Group A and B of the non-polio enteroviruses?

A

Group A - grow poorly in cell culture

Group B - grow well in cell culture

20
Q

What are clinical manifestations of exanthems and enanthems of non-polio enteroviruses?

A

Herpangina/stomatosis (painful vesicles of soft palate & posterior pharynx)

Hand-food-mouth disease (vesicles or papules on hands, feet, groin)

21
Q

What are clinical manifestations of CNS infections of non-polio enteroviruses?

A

Aseptic meningitis
Encephalitis
Poliomyelitis-like syndrome (some flaccid paralysis but less severe than poliovirus)
Other neurologic syndromes: Guillan Barre, acute transverse myelitis

22
Q

What are clinical manifestations of skeletal muscle infections of non-polio enteroviruses?

A

Pleurodynia (inflammation of chest wall and abdominal muscles)
Myositis (general muscle pain)
Myocarditis

23
Q

What are additional clinical manifestations of non-polio enteroviruses?

A

Acute hemorrhagic conjunctivitis
Severe neonatal infection
Chronic infection in immunodeficiency

24
Q

How are non-polio enteroviruses diagnosed?

A

Viral isolation from invasive site
Serologic testing
PCR