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Oral Microbiology > Oral Viruses- Herpes Lecture 6 (Test 1) > Flashcards

Oral Viruses- Herpes Lecture 6 (Test 1) Flashcards

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1
Q

What are Human Herpesvirus (HHV) 1-8 ?

A

A large group of fragile enveloped viruses which remain LATENT in the individual throughout life and cause oral diseases.

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2
Q

How are Human Herpesvirus (HHV) 1-8 spread?

exception?

A

Spread thru mucosal-mucosal contact → viremina. Exception: VZV: spread thru resp. droplets

Exception: Varicella/Zoster is spread via resp. droplet to lung muscosa

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3
Q

The latent period in the HHV can be interrupted and cause what?

A

Interrupted form variable periods of replication of transmissible virus & accompanying host tissue damage.

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4
Q

Herpes viruses infections are extremely _______?

A

-Common

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5
Q

Where does the HHV virus remain latent?

A

Remain latent in neurons, macrophages, lymphocytes

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6
Q

Who does HHV affect?

A

Viruses usually cause benign diseases in children, but can also cause morbidity and mortality, especially in immunosuppressed individuals.

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7
Q

What can lessen the viral shedding and recurrence of HHV symptoms?

A

The large herpesvirus genomes encode multiple targets for ANTIVIRAL THERAPY but cant cure latent infection

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8
Q

What are some characteristics of HHV ?

  • genome?
  • where do they replicate?
  • infect what?
  • Tx?
A

1) Enveloped (fragile)
2) Large dsDNA genome
3) Replicate & assemble in nucleus
4) initial mucsoal epi infection
5) All infections LIFE LONG (LATENCY)
6) Multiple relapses common
7) Treated with ACYCLOVIR (Antivirals)

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9
Q

What the common name for HHV-5?
-Where is it latent?
-important Disease?
% infected?

A

Cytomegalovirus (CMV)
Latent in Lymph/Mono
Important disease: Congenital infections
50%

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10
Q

Which HHV (s) do we all have present in our saliva?

common name ?
latent in?
important disease?
% infected?

A

HHV 6 (no common name)
-Latent in Mono/Macrophages
Disease: Roseola Infantum
-100%

& HHV 7 (no common name )
-Latent in T cells
Disease: Roseola Infantum
-100%

Note: 25% of ER visits due to HIGH FEVER
(4-6 months of age)

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11
Q 
HHV 1 ?
common name ?
latent in?
important disease?
% infected?
A
  • Herpes simplex Virus 1
  • Latent in Neuron
  • Disease: Cold sore, oral ulcers
  • 67%
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12
Q 
HHV 2 ?
common name ?
latent in?
important disease?
% infected?
A
  • Herpes simplex Virus 2
  • Latent in Neuron
  • Disease: Genital herpes
  • 15%
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13
Q 
HHV 3 ?
common name ?
latent in?
important disease?
% infected?
A
  • Varicella-Zoster Virus
  • Latent in Neuron
  • Disease: Chickenpox, Shingles
  • 100%
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14
Q 
HHV 4 ?
common name ?
latent in?
important disease?
% infected?
A 
Epstein-Barr Virus 
-Latent in B-cells 
Disease: Infectious mono &
 Burkitt's lymphoma (Sub. Sahara Africa) 
-75%
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15
Q 
HHV 8 ?
common name ?
latent in?
important disease?
% infected?
A
  • Kaposi Sarcoma Virus
  • Latent in Lymphocytes
  • Disease: Kaposi sarcoma
  • 10%
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16
Q

Viruses can infect many cell types but the initial cell infected is?

A
  • The Mucosal epithelium
  • It results in the release of many viral particles that SPREAD VIA the BLOOD (VIREMIA) to other cells and organs.

Note: If pregnant viremia can be dangerous

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17
Q

Once the virus is in the blood what happens?

A

1) The entire immune system is altered with Th, Tc and B cells all specifically cloning.
2) T cells & NK cells will kill infected cells (viral factories)
3) B cells will produce Ab to neutralize any free viral particles (stops spread)
4) Viruses can become latent (as plasmid or integrated into the host DNA) in neurons or lymphocytes
5) Viruses will “hide” from immune system and become reactivated and continue to infect nearby cells
6) Memory T & B cells will respond to keep from spreading but local pathology (e.g, cold sore) is caused by the viral damage and Tc cells damage.

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18
Q

What is a unique characteristic for Herpesviruses?

A

The nucleocapsid “docks” w/ the nuclear membrane & delivers the genome into the nucleus, where the genome is transcribed and replicated. Viruses are ASSEMBLED in the NUCLEUS, **ACQUIRE their envelope (and SPIKES) BEFORE they reach the CYTOPLASMIC OUTER MEMBRANE

19
Q

In both HSV-1 & VSV the primary infection usually occurs when?

A
  • In childhood or adolescence, followed by establishment of life-long latent infection in CEREBRAL or SPINAL GANGLIA
  • Later reactivation causes recurrent herpes simplex (cold sore) or zoster (shingles)
20
Q

Recurrences are common for _______ but less common for this herpesvirus.

A

Common for HSV-1 less common for VZV

Note: Immune suppression allows these recurrences to become more frequent and severe

21
Q

HSV-1

  • frequency?
  • disease acquired?
  • transmission?
  • latency?
A
  • 60-80% in US infected w/ HSV-1 before adulthood
    -Most common cause of viral encephalis in USA
  • HSV-1 keratitis is the leading infectious cause of blindness in USA
  • MOST often occurs via Oral-oral contact AS A CHILD
    -Can be spread or any combo of oral and/or genital contact at ANY AGE
  • Remain latent in “trigeminal ganglia”
    -VACCINES NEEDED
    -First 5 yrs of life primary lip lesion -85% asymptomatic
    (if present lesion persists 2-3 wks w/ viremia)
    -Primary & Secondary lesions–> Gingivostomatis & Herpes labialis MOST COMMON
    -T-cell immunity destorys infected epi cells & lesion heals
22
Q

HSV-2?

  • frequency?
  • disease acquired?
  • transmission?
A
  • 20- 25% in US infected w/ HSV-2 before adulthood
    -Herpes genitalis is a sexually transmitted infection caused by HSV-2
    -Sexually spread or any combo of oral and/or genital contact at ANY AGE
  • Remain latent in “SACRAL ganglia”
    Note: Herpes genitalis infection INCREASES the risk of acquiring HIV during intercourse by 2-4 fold.
    -VACCINES NEEDED
23
Q

VZV ?

  • Primary and Secondary infections?
  • Transmission?
A
  • Causes Chickenpox in primary infection (as a child) and Shingles in the secondary reactivation infections (adult)
  • Only HHV spread via resp. droplets, DOES NOT REQUIRE intimate mucosal to mucosal contact
  • VACCINE AVAILABLE :)
24
Q

What does the VZV infect?

A

1) The lung mucosal epi followed by the lymph nodes

2) Enters the blood where it infects the skin epi cells

25
Q

What are the most visible symptoms of VZV?

A
  • The rash & papules (the pox= varicella)
  • resolves ~ 2 wks w/ only a few deaths in immunosuppressed.
  • Can reemerge in adults as shingles (zoster)
  • Rash of shingles is painful and restricted to a single nerve root where virus is dormant
26
Q

The vesicles of shingles shed virus can infect and cause what?

A

A primary VZV infection (chickpox) in children

27
Q

Shingles can occur _____ times?

A
  • Multiple times causing eye damage and neuralgia

- Reactivation NOT reinfection

28
Q

What is the most common disease caused by EBV?

-What are the symptoms?

A

Mononucleosis “kissing disease” (worldwide)
-30-50% develop it

Symptoms:

  • Fever, sore throat, swollen lymph nodes (lymphadenopathy)
  • increase in infected B cells & attacker Tc cells both proliferating and fatigue
  • Individuals will shed virus in saliva over lifetime
  • 95% shos evidence of previous infection w/ EBV
29
Q

How is EBV spread?

A

Thru saliva (takes tons of saliva exchange to be infected b/c virus is few virus particles in saliva)

30
Q

EBV was recognized as the first what?

A
  • First virus related to a malignancy
  • Associated w/ Malaria (The immunosuppression caused by malaria allows some of the hyperplastic, infected B cells to escape destruction by Tc cells & become malignant)
31
Q

EBV infections in immunosuppressed patient in the US and the rest of the world are often associated with?

A

HAIRY LEUKOPLAKIA and (sometimes nasopharyngeal cancers)

EBV–> Epi cells = hairy leukplakia (adherence proteins) and nasopharyngeal cancer

32
Q

What are some of the Viruses that are linked with cancer?

A

1) EBV w/ Burkitt’s and Nasopharyngeal Carcinoma
2) Kaposi sarcoma virus w/ Kaposi sarcoma
3) Hep B & C with Liver cancer
4) HTLV-1 a retrovirus w/ T cell leukemia
5) HPV with cervical and oral cancers

33
Q

CMV is the MOST COMMON cause of ?

A
  • Intrauterine infections and of congenital abnormalities in the US.
  • *Huge threat to the immunosuppressed.
34
Q

CMV commonly affect who?

-How can it be spread?

A

Young children

-Spread by all body fluids, including saliva and semen (HIGHEST viral load)

35
Q

What are the symptoms of CMV?

A

-Asymptomatic w/ periodic recurrent infections thru life.

Note: If a primary infection occurs in a PREGNANT woman fetus is at HIGH RISK (no anti-CMV ab established)

36
Q

Either primary or reactivation of latent CMV is also a problem for ?

A

Immunosuppressed individuals

AIDS and transplant recipients suffer serious infections that may cause death

37
Q

Coxsackie Virus?

A
  • ssRNA
  • non-enveloped (hardy)
  • Picornaviridae family
  • CAUSES serveral very common but usually MILD DISEASES, primarily in young children
38
Q

What are the mild dieases caused by the Coxsackie virus?

A

1) Herpangia- non-specific flu like symptoms for days duration. These symptoms accompanied by herpes-like oropharyngitis of the throat.

2) Hand, Foot, and Mouth Disease-
Easily diagnosed by its classic distribution to the pathology of hands, feet, and mouth of young children

39
Q

Measles (Rubeola) Virus?

  • Iceberg effect?
  • cause by?
  • Genome?
  • Transmission?
  • How does it affect immune system?
A
  • MOST COMMUNICABLE human disease
  • (100%) of non-immune individuals become infected and show disease (NO ICEBERG EFFECT)
  • Caused by Paramyxovirus
  • Enveloped ssRNA genome
  • Highly contagious
  • Transmitted from person to person via resp. droplets
  • Spreads via viremia thru body
  • CAUSES a TEMPORARY GENERALIZED IMMUNE SUPPRESSION
  • Vaccine present but 1 million children die per yr.
40
Q

What causes the characteristic rash of Measles?

A

Tc cells targeting measles-infected enothelial cells of capillaries cause the characteristic MEASLES RASH

41
Q

What does measles induced immunosuppression synergizes with?

A

***The measles induced immunosuppression synergizes w/ POVERTY-induced immunosupression to cuase EXCESS mortality in developing countries

42
Q

Mumps Virus?

  • Iceberg effect?
  • cause by?
  • Genome?
  • Characterized by?
A
  • Enveloped virus
  • Iceberg effect (unlike measles a significant # infected show no symptoms)
  • Characterized by swollen salivary glands, esp. parotid gland
    -Affects salivary ducts and inflammation blocks the drainage of salivary fluids
    (also affects testicular ducts)
43
Q

HPV?

A
  • ds DNA, Non-enveloped
  • Cause warts (hyperplastic epi lesions )
  • Infect only surface of epithelia of skin and mucosa
  • Cause cancers (cervical cancer, oral, throat cancers)
  • Several HPVs VERY COMMON STIs
  • Can also cause anal and penile cancers

Oral Microbiology (11 decks)

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