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GI Micro > Rotavirus, Norovirus, and Enteroviruses > Flashcards

Rotavirus, Norovirus, and Enteroviruses Flashcards

1
Q

Rotavirus is the single most important etiologic agent of severe diarrheal illness in what age group, worldwide?

A

Infants and young children

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2
Q

Rotavirus is a Reoviridae, what does Reo mean?

A

Resipiratory, enteric, orphan

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3
Q

Describe the structure of Rotavirus.

A

Non-enveloped (2-3 concentric icosahedral capsids), segmented, dsRNA genome with high antigenic diversity

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4
Q

Describe the antigenic diversity of rotavirus and why it is important.

A

It is divided into 11G (VP7) and 12P (VP4) serotypes; However only 4 G-P combinations cause about 90% of disease in humans = the reason we can have a vaccine!

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5
Q

The rotavirus is taken in by endocytosis and delivered to late endosomes or lysosomes, what happens here?

A

Capsid proteins are proteolytically processed –> generates infectious sub viral particle (this can occur outside cells or following endocytosis in late endosomes/lysosomes

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6
Q

After rotavirus penetrates, what happens?

A

Enzymes within the core begin synthesizing mRNA’s; transcription is asymmetric so only individual + strands mRNAs are made

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7
Q

After + strands of mRNA are made what happens?

A

Some of the capped mRNAs are assembled into assortment complexes, the capped + strands also serve as templates for synthesis of the complementary - strands –> produces dsRNA

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8
Q

Assembly of the rotavirus occurs where?

A

Within the cytoplasm; released by lysis of the cell

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9
Q

Noroviruses (Calciviridae) cause what?

A

Major cause of food borne epidemic acute gastroenteritis in older children and adults

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10
Q

What is the replication scheme for Noroviruses hypothesized to be similar to? What is their structure?

A

Picornavirus; Nonenveloped, non segmented, + strand RNA

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11
Q

True or False: Rotavirus causes diarrhea primarily in the elderly and is responsible for 35-50% of diarrheal hospitalization during the last two years of life.

A

False; in the young and first two years of life

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12
Q

True or False: Norovirus are responsible for 50% of community-based outbreaks of nonbacterial gastroenteritis in school aged children and adults.

A

True - known as “winter vomiting disease”

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13
Q

How are rotavirus and norovirus transmitted?

A

Fecal-Oral route

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14
Q

Why are rota and noro stable in the environment?

A

No envelopes!

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15
Q

Norovirus outbreaks are often linked to what?

A

A single source; contaminated food or water (think raw or steamed shellfish, cake frosting, and salads or cruise ship outbreaks)

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16
Q

What do the clinical symptoms for rota and noro consist of?

A

N/V, diarrhea, fever, dehydration

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17
Q

What do both rota and noro initially infect? How do they differ from V. Cholera?

A

Initially infect villous epithelium of SI which leads to functional alteration in the SI. Glucose-coupled sodium transept is impaired but adenylate cyclase and cAMP are NOT stimulated

18
Q

Why are deaths from rota and noro so rare in the US?

A

Availability of effective fluid and electrolyte replacements

19
Q

What is most important for protection of reinfection by rota and noro?

A

Local (intestinal) immunity

20
Q

Describe how antibodies to rota and noro are formed.

A

Ab to rota are obtained relatively early in life; ab to noro are acquired gradually and increase steadily over a person’s lifetime

21
Q

Why is there a vaccine for rota and not for noro?

A

There are only 4 major serotypes of rota that cause the disease which makes a disease practical even in the face of antigenic shift and drift; noro immunity is not long lasting and diversity is generated via antigenic drift like other ssRNA viruses

22
Q

What is Rotateq?

A

A pentavalent bovine-human reassortant virus covering G1-G4 and P8 (live attenuated and orally in 3 doses at 2, 4, 6 mo.)

23
Q

What is Rotarix?

A

Human derived monovalent (G1, P8) live attenuated vaccine (given orally in 2 doses starting at 6 weeks)

24
Q

How do you prevent norovirus?

A

Careful hand washing, effective disinfection of contaminated surfaces, proper food prep

25
Q

What are the general characteristics of Enteroviruses?

A

Small, non enveloped, + strand RNA

26
Q

What does Picorna mean and what should it help you remember?

A

pica + RNA (Small RNA); picor = polio, insensitive to ether (non enveloped), coxsackie, orphan virus, rhinovirus

27
Q

What does poliovirus cause?

A

flaccid paralysis

28
Q

What does Coxsackie cause?

A

various illnesses including meningoencephalitis, diarrhea, muscle pain, inflammation of myocardium and pericardium

29
Q

What do echoviruses and other viruses cause?

A

Mild gastroenteritis (echo = enteric cytopathic human orphan)

30
Q

What is hepatitis A?

A

An enterovirus-like picornavirus

31
Q

How are enteroviruses distinguished from rhinovirus?

A

Acid stable and replicate at 37 C

32
Q

How are enteroviruses spread?

A

Fecal oral route

33
Q

Where to enteroviruses replicate?

A

Incubate for 7-14 days and replicate in lymphoid tissue of the URT and gut

34
Q

Is asymptomatic infection common with enteroviruses?

A

Yes

35
Q

What is meningitis caused by? What are the symptoms of it?

A

Poliovirus, coxsackie, and echo; fever, malaise, headache, nausea, and abdominal pain –> 1-2 days later w/ meningeal irritation and vomiting.

36
Q

What is pleurodynia (epidemic myalgia) caused by? What are the symptoms?

A

group B coxsackie; abrupt fever and chest/abdominal pain; chest pain can be on either side or substernal and is spasmodic; lasts 2 days to 2 weeks, self limiting

37
Q

What is hand, foot, and mouth disease caused by? symptoms?

A

Coxsackie A16; universal symptom is enanthema (ulcers in the mouth) followed by lesions on hand and feet

38
Q

What is myocarditis associated with?

A

Group b Coxsackie

39
Q

What are eye diseases associated with?

A

Coxsackie and echo

40
Q

Can enteroviruses cause GI and skin disease?

A

Yes, a lot of them do

41
Q

Is there a vaccine for enteroviruses?

A

Besides polio there are no vaccines; large number of serotypes and many are asymptomatic so it is impractical for all of them

GI Micro (7 decks)

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