Viral Gastroenteritis - Diebel

Question 1

What kind of genome does the rotavirus have?

Does the structure have any important implications?

Answer 1

segmented, double-stranded

The segmented nature allows the virus to undergo reassortment, evades immune systems

Question 2

Why do you think that rotavirus is so stable in detergents, the air, etc?

Answer 2

Probably due to it’s double-shelled capsid

Even though it is UNENVELOPED!

Question 3

What part of the small intestine do rotaviruses infect?

Answer 3

The proximal 2/3 (the villous epithelium)

Question 4

What complication of gastroenteritis brings children into the hospital?

Answer 4

Dehydration

Question 5

Please explain viral NSP4:

Answer 5

• NSP4 is rotovirus enterotoxin
• Basically it disrupts the Calcium flux potential between the ER lumen and cytoplasm of the host cell by forming a pore
• It goes on to cause diarrhea

Question 6

What will you see microscopically 8 hours after rotavirus infection?

Answer 6

You will see cytoplasmic inclusions in intestinal cells

Question 7

What nutritional deficiency, especially in underdeveloped countries can increase the severity of rotavirus infection?

Answer 7

Vitamin A deciency

In these countries, giving a Vit A shot is common when malnourishment is suspected

Question 8

Any differences between Rotarix and Rotatez vaccines?

Answer 8

Both are live attentuated rotavirus vaccines

Rotarix is strictly human strain
Rotateq is a human-cow hybrid

Question 9

Describe the genome of norovirus:

Answer 9

SS+ nonsegmented

Non-enveloped

Question 10

How long will it take you to feel better after norovirus infection?
How long will you stay infectious?

Answer 10

You feel better 2-3 days later, but the virus will continue to be shed by the infected for 2 weeks or so, with no symptoms

Question 11

Norovirus accounts for what % of all gastroenteritis outbreaks?

Answer 11

50%

Question 12

Norovirus has recently been one of the big culprits behind cruise ship outbreaks. Let’s say you’re one of the unfortunate souls who gets sick on a cruise ship. You at least could go on that same cruise ship after you feel better and now be immune to the virus right?

Answer 12

Wrong.
Turns out norovirus immunity is very short-lived.
Why?
It has a very high mutation rate AND there are already many strains of the virus out there

Question 13

Treatment for norovirus infection?

Answer 13

Mostly just hydration and pepto bismol for symptomatic stuff

Prevention more effective - hand-washing and hygiene

Question 14

Is adenovirus enveloped? What kind of genome?

Answer 14

Non-enveloped

DS - DNA

Question 15

You are working at the University clinic and 82 students from the school marching band are in your waiting room at the student clinic you work at. They have just returned from the Rose Bowl parade which took place a little less than 2 days ago.
Most of their presenting symptoms include nausea/vomiting, diarrhea, abdominal pain, fever, headache, and myalgia. Some have a pretty low-grade fever. (highest is 101, but most are under 100).
What do they have doc?
What recommendations will help the director get his woodwinds section back on the field?
(the clarinets were hit hard)

Answer 15

Sounds like norovirus

Make sure they stay very hydrated, treat symptoms

Question 16

An 8 mo old previously well infant is brought into your clinic with 2 days of vomiting, watery diarrhea, and a fever of 102. Her pulses and repiratory rate are a little high, her blood pressure is 90/44 and her mucous membranes are dry. Labs reveal BUN and creatinine are elevated.

What is the likely diagnosis?
How do you treat it?

Answer 16

Rotavirus

Should tx with hydration therapy