Viral Agents of Bioterrorism

Question 1

Hemorrhagic fever

Answer 1

Acute febrile illness: malaise, myalgia, abnormalities in vascular permeability, bleeding manifestations…
But not volume loss is not the problem, more like widespread vascular damage.

Question 2

Characteristics of viruses that cause viral hemorrhagic fever (VHF)

Answer 2

all are enveloped RNA viruses
animal or insect host
geographically restricted
unpredictable outbreaks
no real treatment

Question 3

off label treatment for VHF

Answer 3

ribavirin is the first choice when faced with an unknown virus causing VHF.
(It is approved for Hep C)

Question 4

What type of viruses are Ebola and Marburg?

Answer 4

Filoviruses (category A)

Question 5

Characteristics of Filoviruses: Ebola and Marburg

Answer 5

enveloped, single-stranded, negative-sense RNA

branched or filamentous coiling around

Question 6

5 subtypes of Ebola

Answer 6

cause disease in humans: Zaire, Sudan, Ivory Coast, Bundibugyo

cause disease in monkeys: Reston

Question 7

Reservoir of Ebola

Answer 7

bats

Question 8

Transmission of ebola

Answer 8

direct contact with blood/secretions of infected persons

infections are acute, no carrier state

Question 9

Crimean-Congo Hemorrhagic fever (CCHF) is caused by what type of virus?

Answer 9

bunyavirus (category C)

Question 10

Transmission of CCHF

Answer 10

transmission by ticks

Question 11

genome of bunyavirus

Answer 11

genome is circular, ambisense RNA in three parts

Question 12

What type of virus causes Lassa Fever and S. American hemorrhagic fevers?

Answer 12

Arenaviruses (category A)

Question 13

characteristics of arenaviruses

Answer 13

genome has 2 strands of ambisense RNA

enveloped, grainy appearance (ribosomes of host)

Question 14

What is the arenavirus reservoir?

Answer 14

rodent-borne disease

Question 15

Symptoms of Lassa Fever

Answer 15

fever, retrosternal pain, sore throat, back pain, cough, abdominal pain, vomiting,, diarrhea, conjuncctivits, facial swelling, proteinuria, mucosal bleeding.
Hearing loss in 1/3 of cases, tremors, encephalitis

Question 16

Where is Lassa Fever found

Answer 16

found in W. Africa because that’s where the multimammate rat is found

Question 17

Lassa Fever is especially scary for

Answer 17

pregnant women - high risk of mortality and abortion.

transmits person to person really easily - everybody is dieing.

Question 18

Lassa Fever Treatment

Answer 18

Ribavirin

Question 19

Hendra and Nipah viruses are what type

Answer 19

henipaviruses (category C)

Question 20

Henipavirus characteristics

Answer 20

enveloped virus with glycoprotein spikes

Question 21

Hendra and Nipah virus clinical manifestations

Answer 21

severe respiratory disease (pneumonitis/multi-organ failure)

Acute Encephalitis

Question 22

SMALLPOX virus characteristics

Answer 22

Large (seen by light microscope), brick-shaped particle.
Enveloped, dumbbell shaped core
Large, double-stranded DN

FUN FACT—only DNA virus that replicates in the cytoplasm

Question 23

Smallpox disease manifestations: lesions and spread

Answer 23

all lesions develop at the same time (each lesion is same “age”), unlike chickenpox were the vesicles are at different stages.
spread by secretions from mouth/nose or from lesions

Question 24

Smallpox diagnosis

Answer 24

stain smear with gentian violet, look for Guarnieri bodies
electron microscopy
egg inoculation - pock morphology on chorioallantoic membranes