Rotavirus, Coxsackie, Norovirus

Question 1

RNA viruses:

Answer 1

Rotavirus, norovirus, enteroviruses

Question 2

Antigenic drift and shift

Answer 2

Rotavirus (segmented RNA genome)

Question 3

Predominately a subclinical infection

Answer 3

Enteroviruses

Question 4

First step in management of rotovirus or norovirus infection

Answer 4

Fluid replacement

(They cause severe dehydration)

Question 5

What allowed for the development of a rotavirus vaccine?

Answer 5

Only four G-P capsid protein combinations cause ~90% of human disease

Question 6

Rotavirus is a major cause of ___, while norovirus is a major cause of ___

Answer 6

Diarrheal illness in infants and young children

Food-borne diarrhea in older children and adults

Question 7

Describe the replication of rotavirus

Answer 7

1. Processing (proteolysis) of capsid as it travels through the gut or once its inside enterocyte late endosome or lysosome 2. Synthesis of (+) strand mRNAs 3. Use of capped (+) strand mRNAs as templates for complementary (-) strand mRNAs 4. Assembly in cytoplasm 5. Release/cell lysis

Question 8

What makes rotavirus so stable?

Answer 8

1-2 outer shells + inner RNA core

Question 9

Which viruses cause dysentery?

Answer 9

None, dumbass!

(Viruses wouldn’t cause pus in feces…)

Question 10

How are both rotavirus and norovirus transmitted?

Answer 10

Fecal-oral route

Question 11

Asymmetric replication

Answer 11

Rotavirus (+ strand first that serves as template for - strand)

Question 12

Incubation period for enterovirus

Answer 12

7-14 days

Question 13

“Winter vomiting disease”

Answer 13

Norovirus

Question 14

What causes hand, foot, mouth disease? How does it present?

Answer 14

Coxsackie A

Initially enenthema (oral mucosal vesicles) then exanthema (hand and foot vesicles)

Question 15

Enteroviruses causing meningitis

Answer 15

Polio

Coxsackie (all)

Echovirus

Question 16

Never enters nucleus

Answer 16

Rotavirus

Question 17

Describe the pathogenesis of watery diarrhea caused by rotovirus and norovirus

Answer 17

Both initially infect villous epithelial cells of intestine –> cell lysis of small intestine and colonic cells –> functional alterations in small intestinal epithelial cells due to impaired glucose-sodium transport = less water absorption and loss of electrolytes

Question 18

Cytoplasmic inclusion bodies

Answer 18

Rotavirus

(Called viroplasms; where assembly occurs)

Question 19

List the picorna viruses relevant to GI/liver pathology

Answer 19

Hep A

Echovirus

Coxsackie

Enterovirus

Question 20

Both rhinovirus and enteroviruses are picorna viruses (small, + ssRNA viruses) that initially replicate in the upper GI tract. How can they be differentiated?

Answer 20

Enteroviruses are acid stable and can replicate at 37 degrees

Question 21

Which serotypes are covered by RotaTeq?

Answer 21

G1-G4 and P8

Question 22

List some sources of norovirus

Answer 22

Raw seafood, cake frosting, salads

Water = Cruise-ship outbreaks

Question 23

Reservoir of enteroviruses? Transmission?

Answer 23

Humans

Fecal-oral

Question 24

Which microbe’s pathogenesis is similar to Vibrio cholera?

Answer 24

ETEC

(Norovirus and rotovirus are NOT because they do NOT stimulate cAMP/AC)

Question 25

Viroplasms

Answer 25

Rotavirus

(Cytoplasmic inclusion bodies where assembly occurs)

Question 26

RotaTeq vs. rotarix

Answer 26

RotaTeq is pentavalent; given in 3 doses

Rotarix is monovalent; given in two doses

Question 27

Where do enteroviruses replicate? Rotavirus and norovirus?

Answer 27

Enteroviruses - lymphoid tissue of gut and URT

Rotavirus/norovirus - villous epithelial cells on small intestine

Question 28

Norovirus:

Enveloped, non-enveloped

Segmented, non-segmented

RNA, DNA

Answer 28

Non-enveloped

Non-segmented

RNA (+ strand)

Question 29

What is pleurodynia? What is the causative agent?

Answer 29

Epidemic myalgia = sudden onset of fever and spasmodic chest pain or abdominal pain lasting 2 days-2 weeks then self-resolving

Coxsackie B virus

Question 30

+ ssRNA viruses

Answer 30

Norovirus

Enteroviruses (polio, coxsackie, echovirus, enterovirus)

Question 31

Segmented genome

Answer 31

Rotavirus

(Allows antigenic shift and drift)

Question 32

Only enterovirus with a vaccine? Why?

Answer 32

Polio

Mant different serotypes and frequent subclinical infections of the other enteroviruses

Question 33

Rotavirus or norovirus:

Gradual development of antibodies

Answer 33

Norovirus

Question 34

Rotavirus or norovirus:

High antibody titer in young children

Answer 34

Rotavirus

Question 35

Rotavirus or norovirus:

dsRNA

Answer 35

Rotavirus

(Norovirus is + stand RNA)

Question 36

Rotavirus or norovirus:

Antigenic drift

Answer 36

Both

Question 37

Rotavirus or norovirus:

Antigenic shift

Answer 37

Rotavirus

(It’s segmented while norovirus is not)

Question 38

Rotavirus or norovirus:

N/V, watery diarrhea, fever, dehydration

Answer 38

Both

Question 39

Humans are the only reservoir

Answer 39

Norovirus, EIEC, Shigella

Question 40

Major cause of death due to rotavirus or norovirus infection

Answer 40

Dehydration

Question 41

Cruise ship outbreaks

Answer 41

Norovirus

(Contaminated water)

Question 42

List some illnesses caused by coxsackie

Answer 42

Diarrhea

Meningoencephalitis

Myocarditis

Pericarditis

Muscle pain

Question 43

When do antibodies to enterovirus develop? Disappear?

Answer 43

After 2 weeks

Can last many years

Question 44

Serum culture of a patient with enterovirus infection on day 9 would reveal:

Answer 44

No virus

(Disappears from blood after 8 days)

Question 45

For how long can enterovirus be isolated from stool?

Answer 45

Up to 2 months

Question 46

Describe the development of symptoms of enterovirus meningitis

Answer 46

Fever, malaise, headache, nausea, abdominal pain

Followed 1-2 days later by meningeal irritation and vomiting

Question 47

Myocarditis and pericarditis

Answer 47

Coxsackie B