virology 2 Flashcards
describe the measles and mumps in terms of the structure of the virus and their nucleic acid content
paramyxovirusesRNAsingle strandednegative senseenvelopedhelical
do paramyxoviruses have to carry RNA polymerase?
yes
are measles and mumps capable of radical antigenic shifts?
no- paramyxoviruses only contain one strand of RNA
how does the type of infection dictate the incubation period and subsequent immunity for measles and mumps?
they travel through the blood as viremia and cause systemic infections. thus:1 incubation time is longer2 IgG provides life long immunity
how many serotypes of mumps are there?
1
how many other animals act as resevoirs for mumps?
just humans
what is the normal incubation period for mumps?
3 weeks
what are the symptoms of mumps?
after 3 weeks, prodromal symptoms will developfever, malaise, anorexiafollowed shortly by asymmetrical parotiditis and potentially orchitis post puberty. parotiditis is the presenting symptom.aspetic meningitis is also common
describe transmission of mumps
occurs usually via respiratory exposure to saliva droplets containing virionviremia spread from the parotids to the salivary glands, where virions produced there enter the mouth and spread via coughs and sneezes
describe antiviral therapy for mumps
none
describe the vaccine used for mumps
live-attenuatedparted of the MMR vaccine given twice
explain the occurrence of 3 year cycles of epidemics for measles
measles is the most contagious disease known. an outbreak would result in herd immunity, but as years go by and new people are born, the proportion of immune people decreases to a critical point where herd immunity is no longer effective, causing a new epidemic
describe measles transmissoin
transmitted through respiratory droplets (coughs/sneezes) and infects respiratory tract.it multiplies in the lymph and respiratory epithelium
describe measles symptoms
prodromal symptoms occur first:fever, cold-like symptoms, runny nose, red eyes, coughing, sneezing, photophobiafollowed by Koplik spots (bright red lesions w white central spot inside mouth)- predicts measles rashrash begins after 14 days. maculopapular erythematous rash generated at least partially by immune system
describe measles virus excretion
excreted from respiratory tract and in tears and urine in the days before and after rash
measles incubation period
14 days
measles complications
- pneumonia2. otitis media3. acute encephalitisdeath in 1/1000complications more common in kids under 5, people over 20, and immunocompromisedgiant cell pneumonia- sometimes pneumonia results w/o measles rash d/t suppression of cell mediated immunity
measles treatment
nonetreatment with vitamin A in developing countries has helped reduce mortality- death often occurs w/ measles and malnutrition
does mumps or measles cause syncitia
measles
describe what measles does to cell mediated immunity
suppresses it, causes anergy
how many serotypes of measles are there?
1
how many animals act as a resevoir for measles?
just humans
describe measles immunization
live attenuatedgiven twice in MMRlife long protection
“slow viruses”
- long incubation period (years)2. relentless course leading to death3. genetic predisposition4. re-emerge from latency b/c of immune suppressionexamples: HIV, JC, BK neuropathy
JC virus
papovaviruscauses progressive multifocal leukoencephalopathy (PML)PML is a progressive demyelinating disease of the brain (affects oligodendroglia) w/o inflammationoccurs w/ immunosuppressionprogression includes blindness, dementia, and death
SSPE
subacute sclerosing panencephalitisonset of intellectual deterioration, psychological disturbance, blindness and terminal paralysisassociated w/ measles- - high Ab to measles- CNS contains measle antigendistinct inclusion bodies. relation to measles unclear. does occur after vaccination (one in a million)
prion characteristics
1 long incubation period2. slow relentless course to death3 confined to CNS4 produce spongiform encephalopathy5. genetic predisposition
what are prions?
theorized to be infectious proteins w/o nucleic acid
what are the 5 spongiform encephalopathies caused by prions?
KURUCDJ Cretzfeld-Jacob diseasevariant CDJ mad cowGSS- gerstmann straussler scheinker syndromefatal familial insomnia
scarpie
chronic progressive CNS disorder in adult sheepgenetic predisposition indicatedincubation period of less than a yearprion disease- no nucleic acids
KURU
progressive degenerative disorder of the CNS, especially the cerebellumlimited to small tribe in new gunieano environmental factors- partially geneticcould be transmitted to apes by eating the human brains
CDJ
most common human prionmost are the result of a mutation, w/ obvious cause. risk increases w/ agesome reported cases were iatrogenic- caused by physicians using contaminated surgical equipmentsome variants are linked to families fCDJsome are sporadic sCDJ
mad cow
variant CDJcaused an epidemic in great britain as a result of using brains/bone marrow of cows to feed other cows, which became infected, and when consumed, infected other people
describe the structure of a herpes virus
DNA, double strand, enveloped, icos
describe the herpes life cycle
adsorption and fusion w/ hostnucleocapsid releases viral DNA into nucleusDNA becomes circularmRNA, viral protein synthesis inside nucleusprogeny nucleocapsids assemble in nucleus causing inclusion bodiesviral glycoproteins are inserted into membrane (can cause syncitia)progeny bud out from membrane**needs nucleus
describe how herpes is eliminated from the body
herpes is not eliminated from the body, even upon asymptomatic recovery. instead, herpes becomes latent. even in asymptomatic latency, pts may sporadically create infectious virions
describe the subclassifications of herpes virus and some examples
alphaherpesvirus- HSV1- wide host range, latency in neuronsbetaherpesvirus- CMV- narrow host range, latency in monocytesgammaherpesvirus- EBV- narrow host range, latency in B lymphocytes
latency
all herpes viruses can become latent:non destructivelifelongpersistence of viral genome in non infectious statepotential to be reactivated
is latency active or static?
active-creating gene products that prevent apoptosis, but opens the virus to immune recognitionalso have asymptomatic shedding
why could herpes be good for you?
chronic stimulation of immunity by non-lethal pathogens could be beneficial
HSV1- primary and recurrent infection mechanisms
“cold sores”primary infection often subclinical and most commonly causes stomatitis virions produced at the site of initial infection travel up sensory neurons to nearest ganglion (often trigeminal ganglia) and establish latent infectionrecurrent infection occurs when viral multiplication resumes and virions are tranported down axons to cutaneous site of primary infection- results in cold sores
what % of the population has HSV1?
> 80%
what is the incubation period for HSV 1
1-2 weeks
what factors can aggravate latency, causing a recurrent infection?
UV lightfeveremotion
HSV1 vaccine
none
HSV2
“genital herpes”primary infection of genital mucosa, virus follows sensory neurons back to ganglia and establishes latency (sacral ganglia)
HSV2 incubation period
1-2 weeks
what % of the population has HSV2?
20%
describe the complications of HSV2 and perinatal infection
virions released by vaginal secretions can cause systemic disease in newborns ~6 days after birthdisease is often fatal, with destruction of liver and adrenalmost dangerous scenario is when mother has just gotten primary infection and has no AbHSV2 shedding before deliver is indication for C-section
HSV1 and 2 also cause what in addition to skin lesions
encephalitisocular disease
herpes simplex encephalitis
most common cause of sporadic encephalitis- usually HSV1causes high fever, confusion, lymphocytes in CSF, lesions on MRIoften death w/o early recognition
treatment for herpes simplex encephalitis
acyclovir
herpes simplex keratitis
herpes simplex infection of eyeunilateral red eyecan cause blindness if untreated
does herpes simplex cross placenta
no
how do you diagnose herpes simplex?
isolation and cultureELISADNA PCR of CSFserology (IgM in primary infection)
HSV2 vaccine
none
what are the treatments for herpes simplex
acyclovir- gold standardherpes thymidine kinase will phosphorylate ACV, which can then be subsequently be phosphorylated by host and incorporated into DNA, which halts synthesis and causes death in infected cells
varicella zoster virus
chickenpox/shinglesprimary infection causes chickenpox- infection through respiratory tract- causes viremia. then spreads to the skin andcauses small itchy vesicles (rash) and fever. then travels retrograde to sensory neuronsoften fatal to immunosuppressed
varicella zoster virus transmission
aerosolspread from mucosa in skin lesions to the respiratory tract. vesicles in respiratory tract may also rupture and spread disease
treatment for varicella zoster virus
can get IgG- VZIG or acyclovir
congenital varicella syndrome
fetal infection from a pregnant mothercauses limb atrophy and scarring of the skin
zoster
shingles- more common w/ agereactivation in a sensory ganglia that results in pain distributed along a specific dermatome, followed by lesionscan be followed by post-herpetic neuralgia- residual painmore
zoster treatment
acyclovir
vaccinations to varicella zoster virus
vaccines to both varicella (live attenuated, requires boosting) and zoster
CMV
causes enlarged cells w/ “owl eye” inclusion bodiescauses retinits, colitis, heterophile negative monoleading cause of congenital abnormalities- from infection in 1st trimester- can go through placenta
CMV immune evasion
has 6 genes to evade T cell activation via disrupting antigen presentation
CMV transmission
blood/ bodily secretions (urine)
CMV infects what
epithelia- moves to ganglia- infects monocytes
easiest way to test for CMV in neonates
CMV in urine
CMV vaccine
none
CMV treatment
ganciclovir or foscarnet
CMV findings in newborns
retinal inflammationjaundicelarge spleen and liverlow weightmineral deposits in brainrashseizuressmall headretardationdeafness
EBV
causes heterophile positive mono and cancersubclinical infections in kids, but more prevalent post puberty1st symptom is sore throatalso: fever, sore throat, lethargy
EBV transmission
salvia or oral contactseen in college aged peopleinfects mucosal epithelia before spreading to B lymphocytes. can become latent w/ these b lymphocytesseen in people post puberty
EBV vaccine
none