Virus

Epidermis

Respiratory
Syncytial
Virus
(RSV)

- Acute upper
and lower tract
respiratory
diseases.
- The most
important
respiratory
pathogen in
infants: leading
cause of
bronchiolitis
(moratlity every
year).
- Re-infections
occur
throughout life.
- Transmission:
+ Inhalation of
droplets.
+ Close
contact/Direct
inoculation into
the eyes &
nose.
- The virus is
very contagious
(kindergarden).
- Outbreaks
every year.
- Nosocomial
acquisition is

Pathogenesis

Clinical disease

Microbiological
diagnosis

Treatment
&
Prevention

(-) ss RNA - Paramyxoviridae (subfamily: Pneumovirinae)

- Direct viral
- Variable severity: - Antigen
Treatment:
effect: lower
+ Age < 1 year:
detection:
- NO treatment,
respiratory
Bronchiolitis.
most
only
tract (bronchi,
+ Underlying:
common,
symptomatic
bronchioles,
* Premature
rapid test.
treatment:
alveoli).
infants.
- Nucleic acid
+Ribavirin (not
- Cell
* Immunobased test.
routinely
inflammatory
compromised.
- Cell culture.
recommended):
infiltrates (mostly
* Heart-lung.
- Serology:
can used for
T-cytotoxic cells)
rarely.
RSV (children
- High severity.
- Bronchiolitis
with severe
- Viremia: rare.
Laryngotracheiti
disease) & HCV.
- Plugging the
s (Croup): see
airways.
below.
Prevention:
- Immunity (IgG
- NO vaccine.
& IgA): DONT
- Passive
prevent future
immunization:
infections.
+ In the past:
RSV-IVIG.
+ Current:
Palivizumab.

Note

IMPORTANT

also a major
problem.

Bronchiolitis
RSV
Cough (Dry)
Recession
Hyperinflation (air trapping)
Wheezing (expiration) similar to Asthma

Laryngotracheitis (Croup)
HPIV 1,3
Cough (Barking Cough)
Recession
Stridor (Inspiration)

Virus

Human
metapneu
movirus
(HMPV)

Epidermis

- Acute
respiratory
tract
infections.
- Almost all
children by the
age of 5 years.
- Transmission:
unknown.

Pathogenesis

Clinical disease

Microbiological
diagnosis

Treatment
&
Prevention

(-) ss RNA - Paramyxoviridae (subfamily: Pneumovirinae)

Treatment:
- Antigen
- Therapy is only
detection:
supportive.
most
- No antiviral
- Variable severity: common,
agents or
- Reinfection.
rapid test.
antibody
- Very severe in IS - Nucleic acid
preparations are
patients.
based test.
available for
- Cell culture.
HMPV.
- Serology:
rarely.
Prevention:
- NO vaccine.

Note

- Similar to
RSV but
uncommon.

Virus

Rubella
virus

Epidermis

Pathogenesis

Clinical disease

Microbiologica
l diagnosis

Treatment
&
Prevention

(+) ss RNA Togaviridae (2 genera) Eveloped Capsid.

*
- Genus Alphavirus Transmitted by arthropods (Chikungunya virus, Onyong-nyong virus).
- Genus Rubivirus Not transmitted by arthropods (Rubella virus).
- Rubella is one
of the 6 classic
childhood
exanthems.
- Post-natal rubella:
- Human are
+ Similar to Measles
the only host.
- Post-natal rubella: (but: milder, shorter).
- Less
+ Entry ->
+ Forschheimer's
contagious
Nasopharynx ->
spots (red spots in
Treatment:
than measles.
Local lymph nodes
mouth)
- NO Treatment.
- Benign
(lymphadenopathy)
+ Lymphadenopathy
- Serology
disease.
-> Viremia -> Spread (most feature).
(mainly for
Prevention:
- Teratogenic
to other tissues and
+ Arthralgia, arthritis
post-natal).
- Pre-exposure:
-> infect in
rash.
(adults)
- PCR (mainly
MMR vaccine.
baby.
+ Immunity: Forever. - Congenital rubella:
for
- Post-exposure
-The most
+ Cellular immune
very severe.
congenital).
prophylaxis:
important
responses and
+ Complications:
- Cell cuture:
Immunoglobulin
clinical
circulating immune
(1) Fetal death.
not common.
doesnt prevent
consequence
complexes.
(2) Premature delivery.
rubella infection.
of rubella is
- Congenital
(3) Congenital rubella
congenital
rubella: not well
syndrome (CRS):
rubella
unknown.
*Permanent
syndrome
(deafness, cataract,)
(CRS).
*Transient.
- Transmission:
Inhalation by
droplets.

Note