VIROLOGY 2.

Structure of capsomere
3. Presence/ absence of envelope
Virus: originate from Latin word “poison” 4. Host infected
5. Types of disease produced
Virion 6. Target cell

 Complete virus particle TYPES OF VIRUS

 Infective stage
1. (+) RNA/mRNA
GENERAL CHARACTERISTICS 2. (-) RNA
3. RNA of retrovirus
 Obligate intracellular parasite 4. DNA
 Cannot multiply by binary fussion
 Cannot generate ATP (requires host cell) VIRAL REPLICATION
 Consists of a protein coat that encloses the genetic material
material → capsid Attachment
 Possess either DNA or RNA
 20-300 nm Penetration

Parts Uncoating

Synthesis
(+) RNA/ of Replication/
Assenbly Release
mRNA structural Multiplication
protein

Conversion to (+)RNA by: Same

(+) RNA/
(-) RNA -> RNA dependent process with
mRNA (+) RNA
->RNA polymerase

Conversion to (+)RNA by: Same

(+) DNA (+) RNA/
-> RNA dependent process with
(-) DNA mRNA (+) RNA
A. CAPSID ->RNA polymerase

- Protein shell or coat that encloses the nucleic acid

genome
Same
Conversion to DNA by: (+)DNA process with
Morphology Retrovirus (+)DNA
Reverse transcriptase (-) DNA
(-) DNA
 Helical: rod shape
 Icosahedral: cube 1. Attachment
 Complex: irregular - Glycoprotein spikes are lost
- FUSION (enveloped): glycoprotein spikes attach to
B. CAPSOMERE receptor sites of host cell
- Morphological unit, represents cluster of polypeptides - ENDOCYTOSIS (naked): engulfment of foreign object
(protein subunit) 2. Penetration
C. NUCLEIC ACID/ GENOME - Enters the cell
- ss (single stranded) 3. Uncoating
- ds (double stranded - Capsid is lost with genome/nucleic acid still intact
4. Synthesis
**Nucleocapsid: genome+capsid
- Synthesis of genome
5. Replication/Multiplication
- Multiplication of virus
D. VIRAL ENVELOPE
6. Assembly
- Lipid bilayer
7. Release
 Enveloped
- BUDDING (enveloped): part of cytoplasmic membrane
 Non-enveloped/ naked
will be used as viral envelope
- LYSIS (naked): virus leaks out of the cell
E. GLYCOPROTEIN SPIKES
- Projections on the surface of the envelope **Oncogene- mutation of normal cells into cancer cells
- For attachment
MODES OF ENTRY
CLASSIFICATION OF VIRUS
 Inhalation: measles, SARS, Rhinovirus
1. Type of nucleic acid  Ingestion: Hepatitis A
  Sexually transmitted: HIV, HSV-II - Throat swab/ throat wash in VTM
 Direct contact: Chickenpox, HSV-I - NPA/nasal wash is better than NP swab as most virus
 Blood Transfusion: Hepatitis B, HIV replicate in columnar epithelial cells at the posterior
 Fecal Oral: Hepatitis A, Hepatitis E nasopharyngeal and lower repiratory tract
 Zoonotic: Rabies virus 3. Anticoagulant
- Heparin
SPECIMEN COLLECTION - EDTA
- ACD (Acid Citrate Dextrose)
1. Stool/feces 4. VTM
- Thumb size→ sterile container - Isotonic (prevents cell lysis)
- Fresh stool is preffered instead of rectal swab as the - Contains protein and antibodies
latter dehydrate easily - Non-toxic to culture, antigen detection and molecular
2. Urine assays
- First morning urine specimen 5. Temperature requirement
- 10-20 mL in sterile container - 40C (refrigerator temperature)
3. CSF  Ideal for storage, transport, viral culture and
- At least 1mL in sterile container antigen detection
4. Vesicular fluid  Virus are stable for 3-5 days
- Collected from fresh wound - -200C (freezer temperature)
- Aspirate with Gauge 26 needle/ use swab  Destroys or significantly reduces infectivity of
- Suspend in VTM (Viral Transport Medium) virus
5. Vesicular lesion - -700C (ultra low temperature)
- Scrape base with scalpel/ swab
 Longer storage of virus (more than 3-4 days)
- Place in VTM
 Specimen must be transported in laboratory on
- Smear for Immunofluoresence
dry ice
6. EDTA blood for culture
- 10 mL (EDTA tube) CRITERIA FOR REJECTION
- Room temperature
7. Blood for dengue  Improperly collected and transported
- 5mL plain tube  Inappropriate for the test requested/ suspected disease
- Allow to clot at 40C  Improper labelling/ unlabelled
- Separate serum to avoid hemolysis before transport  Grosly hemolyzed/ chylous
8. Blood for serology  Comtaminated (bacteria/fungi)
- 5mL plain tube  Incomplete information on request form/ no request form
- 1mL serum  Aged specimen (delay submission)
9. Skin scrapings  Leaking/ damage container
- Collect and suspend in VTM  QNS
- Use rayon/Dacron tip
- Swab with plastic shaft LABORATORY TESTS
10. Aspirat/sputum/ bronchoalveolar lavage
- >5mL sample place directly in sterile container 1. Direct examination
- <0.5mL sample place into 2-3mL VTM to prevent a. Light microscopy
dehydration b. Electron microscopy
11. Nasopharyngeal aspirate  CIEM (Classical ImmunoElectron Microscopy)
- Collect into mucus trap using gentle suction o Sample was treated with specific anti-
- 1.5-2mL sera before viewing.
12. Nasal wash o Presence of virus will result to
- Aspirate 3mL saline into suction bulb and instil into agglutination
one nostril  SPIEM (Solid Phase ImmunoElectron Microscopy)
- Immediately aspirate back into sunction bulb o Grid is coated w/ specific anti-sera
13. Oropharyngeal swab o Virus particles present in the sample
- Scrape tonsillar crypts and other inflammatory areas of will be absorbed onto grid by the
the throat antibodies
14. Endocervical/urethral swab c. Viral isolation
- Swab pap smear for IF  Cell culture
o Primary cell culture
SPECIMEN CONSIDERATION → normal cells obtained from freshly
killed adult animals
1. Synthetic swabs → have the same karyotype &
- Dacron (rayon, cotton, plastic/aluminium shaft w/ chromosome number as the original
transport tube) tissue
- Calcium alginate or charcoal impregnated swabs with → best culture (supports the widest
wooden shaft → inactivate virus, inhibits PCR range)
2. Respiratory illness/virus
 → expensive, difficult to obtain viable  Western Blot Assay
supply
EFFECTS OF VIRUS
Examples:
HEK(Human Embryonic Kidney) a. Cell culture
RK (Rabbit Kidney) - CPE
PMK (Primary Monkey Kidney) - Hemabsortion
CMK (Cytomegalous Monkey Kidney) - IF (laboratory test to be performed)
AGMK (African Green Monkey Kidney) b. Egg
- Hemagglutination
o Diploid/ Semi-continuous cell culture - Inclusion bodies
 cells taken from embryonic tissue c. Animal
→ >75% w/ karyotype same as normal - Disease/ death
cells
CLINICALLY SIGNIFICANT VIRUS
Examples:
MRC5 (Human Embryonic Lung) DNA VIRUS
WI-38 (Human Diploid Fibroblast)
FS9 (Foreskin Fibroblast) Family Genus Common name Disease
Herpesviridae Simplex virus HSV-1 Cold sores
HSV-2 Genital
o Immortal/ Continuous cell culture VZV herpes
→ from malignant tissue Chikenpox
→ <75% w/ karyotype same as normal Adenoviridae Mastadenovirus Human adenovirus Colds
cells URI
Papovaviridae Papillomavirus Human Warts
Examples: papillomavirus
HeLa (Human Cervical Carcinoma) hapadnaviridae Hepadnavirus Hepatitis B virus Serum
Hepatitis
Hep2 (Carcinoma of the Human
Larynx)
KB (Nasophayngeal Carcinoma) RNA VIRUS
A-549 (Human Lung Carcinoma)
Vero (AGMK) Family Genus Common name Disease
BGM (Buffalo Green Monkey Kidney) Picornaviridae Enterovirus Poliovirus Poliomyelitis
RD (Human Rhabdomyosarcoma cells) Hepatovirus Hepatitis A virus Short term
Hepatitis
 CPE (Cytopathic Effect) Rhinovirus Human Rhinovirus Comon cold
o Normal→ malignant Togaviridae Alphavirus Rubella virus German
measles
a. Rounding
Flaviviridae Flavivirus Dengue fever virus Dengue fever
b. Clumping
Filoviridae Filovirus Ebola virus Ebola fever
c. Vacuolation Orthomyxoviridae Influenza virus Influenza virus Influenza
d. Granulation Paramyxoviridae Paramyxovirus Measles virus Measles
e. Giant multinucleated cells Rhabdoviridae Lyssa virus Rabies virus Rabies
f. Syncytia formation Retroviridae Lentivirus HIV AIDS
g. Cell destruction Coronaviridae Coronavirus SARS virus SARS
h. Cell lysis
d. Serologic test
- Diagnose past, prest or recent acute viral infection
HERPESVIRIDAE
- Detects IgM and IgG
e. Nucleic acid base method
 Icosahedral
 PCR (Polymerase Chain Reaction)  Enveloped
o In vitro amplification of nucleic acid  Ds DNA
sequences  Classification:
o Carried out in cycles, each cycle Alpha: HSV-1, HSV-2, VZV
doubling the amount of nucleic acid Beta: CMV
product Gamma: EBV

A. ALPHA HERPES VIRUS

OTHER LABORATORY TESTS
 Herpes Simplex Virus
 Varicella Zoster Virus
 RIA (RadioImmuno Assay) Pathogenesis:
 ELISA (Enzyme Linked ImmunoSorbent Assay)  Acute infection is usually local
 HAI/HIT (Hemagglutination Inhibition Test)  Produces vesicles which are infectious and often ulcerate
 Neutralization
Latent infection:
 RIBA (Recombinant ImmunoBlot Assay)
 Virus travels up to neuron to ganglion
 PA/LA (Particle/Latex Agglutination)
Laboratory Diagnosis: Treatment:
 CPE – multinucleated giant cells (24-36)  Acyclovir
 Neutralization test  Famciclovir
 Valacyclovir
3 genes:
 Alpha (immediate)
 Beta (early) B. BETA HERPES VIRUS
 Gamma (late)
a. CYTOMEGALOVIRUS
a. HSV – 1 / HHV -1
 Upper or Oral Mode of Transmission
 Infection occurs in early childhood  Direct contact with the body fluids , transplacental , blood
 Infects skin and soft tissue “cold sore” transfusion , organ transplant

Manifestation:
 Encephalitis
 Keratoconjunctivitis
 Keratitis → visual impairment
 Acute herpetic gingivostomatitis
 Herpetic whitlow (fingers)
 Herpes labialis- most common
Pathogenesis:
 Primary infection is usually asymptomatic
 Frequently seen in organ transplant patients
Epidemiology :
 Most common agent of congenital infection
 Pregnant usually have subclinical infection

Day 1 : Prodrome (Tingle Stage) Manifestation :

Day 2-3 : Blister Stage  Children : Hepatitis , interstitial pneumonitis
Day 4 : Ulcer / weeping stage  Acquired Hemolytic Anemia
Day 5-8 : Crusting Stage (drying of blister)
Day 9-12 : Healing Stage ( scabbing / flakes ) Cytomegalic Inclusion Disease
( Congential CMV infection)
Mental Retardation
b. HSV – 2 / HHV – 2 Large Intranuclear Inclusion
 Genital Herpes  Salivary Gland , pancreas , Kidney , Endocrine glands , Brain
 Infectious Mononucleosis (10% cases)
Manifestation:
 Genital Herpes – most common manifestation Immunocompromised:
 Neonatal Herpes CMV, pneumonitis , generalized disease
 Meningitis
 Herpetic Whitlow Infection of finger in healthcare personnel / Site of infection :
child who sucks their thumb.  WBC , endothelial cells in variety of organs

Mode of Transmission Laboratory Diagnosis:

 Direct Contact with vesicle fluid and infected secretions  Cytopathic effect: “Large nucleus”/ Owl’s eye

Treatment: Treatment :
 Idoxorudine  Ganciclovir – inhibits DNA polymerase
 Ara A ( AdenineArabinoside) - Keratitis and Encephalitis
 Acyclovir : Blocks viral DNA, most commonly used Morphology:
 Glycoprotein spikes: glycoprotein I & III
Prevention:
 Avoid contact with vesicle fluid and secretions C. GAMMA HERPES VIRUS

c. Varicella Zoster Virus / HSV – 3 / HHV – 3 a. Epstein Barr Virus/EBV/HHV-4

Mode of Transmission Pathogenesis

 Inhalation , direct contact with vesicle fluid
 Infects B-cell – CR2 receptors
Pathogenesis:  Infected cell contain multiple virions and express viral antigen
 latent infection : dorsal root ganglion
Viral antigens:
Manifestation:
 Chicken pox (Varicella)  Lymphocyte-detected membrane antigen
 Shingles (Zoster): reoccurrence of chicken pox; concentrated at  EBV Specific Nuclear Antigen
one location but more severe Burkitt’s lymphoma – B cell transformation

Laboratory Test: Laboratory diagnosis

 DFA
 CFT  Monospot test (antibodies against sheep RBC)
 IF  Hemagglutination (+)
 RIA
 ELISA Manifestation

 Infectious Mononucleosis (10%)

Prevention:
 Heterophil Antibody – Infected B cell
 VZV – Ig
 Atypical Lymphocyte – Activated T cell
  Burkitt’s lymphoma – malignant tumor of jaw and face Vaccine: HBsAg vaccine (for titer)
 Nasopharyngeal Carcinoma
MARKERS INDICATION
Manifestation for the Immunocompromised HBsAg Acute HBV infection

 Invasive lymphoma Anti-HBs Immunity to HBV

 Oral hairy leukoplakia (resembles hair) Previous vaccination

HBcAg Acute HBV infection

Anti-HBc Acute or chronic HBV infection

PAPOVAVIRIDAE
HBeAg Acute infection
 ds DNA, naked
 HPV or Human Papilloma Virus
Anti-HBe Acute or chronic infection
 Papilloma, Polyoma, Vacuolating
Other hepatitis under RNA
Replication

 Early proteins (E1-E8) synthesize before DNA replication

Hepatitis A Virus/ HAV
 Late proteins (L1-L2) synthesize after DNA replication
 Enterovirus, Picornaviridae
Pathogenesis
 Icosahedral, naked
 Virus is specie-specific and tissue specific to epithelial cell  MOT: fecal-oral

Manifestation Hepatitis C Virus/ HCV

Common warts HPV 2, 4
(skin, neck, face)  Liver cirrhosis/carcinoma→May lead to chronic hepatitis
Deep plantar warts HPV 1, 2  Flavivirus
(sole of feet)  Icosahedral, Enveloped
Genital warts HPV 1, 2, 6, 11, 16, 18  MOT: parenteral
Condylomata acumulata  Lab: ELISA (screening) RIBA (Confirmatory test)
Cervical carcinoma HPV 16, 18
Hepatitis D (Delta agent)
Treatment
 Requires Hep B infection/coinfection with HBV
 Podophyllin, Salicylic acid with glutaraldehyde
Hepatitis E Virus/ HEV
 Alpha interferon (for severe genital warts)
 For cervical Carcinoma: Chemotherapy, hysterectomy  Calicivirus
 Acute infection similar to HAV
Prevention
 MOT: fecal-oral, contaminated water
 Through vaccination (age for vaccination: menstruation stage)  Manifestation:
 Trivalent (3 serotypes) and quadrivalent (4 serotypes) o Jaundice or yellowish eye and skin
o Cirrhosis
o Liver cancer

HEPADNAVIRIDAE
Hepatitis B Virus/HBV ORTHOMYXOVIRIDAE

 The only ds DNA hepatitis virus, enveloped  Influenza or Flu (has antigenic drift)
 Serum sickness  ss (-) RNA
 Helical, Enveloped
Structure
Glycoproteins:
 Dane particle (virion or the infectious stage)
 HBV surface and/HBsAg  Hemagglutinin (HA) for attachment – 15 subtype
 H1, H2, H3
Mode of Transmission  Neuraminidase (NA) virus exit – 9 subtype
 N1, N2
 Sexual
 fecal oral Replication:
 exposure to blood
 needle (parenteral)  CAP snatching transcription

Manifestation Antigenic variation:

 Acute infection – hepatitis  Antigenic shift – reassortment of viral genome

 Chronic infection – primary hepatocellular carcinoma/ liver  Antigenic drift – due to mutation of virus
cirrhosis

Treatment: Influenza A

 IFN  Distribution: humans, aquatic birds, swine, horse, whales, seals

 Lamivudine  Epidemiology: Flu epidemics, highly contagious
  MOT: inhalation of respiratory droplets
 Manifestation:
o Sore throat, fever, chills, myalgia, headache
o Incubation period: 1-4 days
o Self-limiting infection: 3-7 days, cough(1-2 weeks)
Influenza B
 Distribution: humans (children, adolescence)
 Epidemiology: less serious than type A, does not undergo
antigenic shift
B. Measles Virus
Pathogenesis: generalized infection (1-3 weeks)
Manifestation
 Early symptoms: 3C (cough, coryza, conjunctivitis)
 Late symptoms: Maculopapular rash
 Severe symptoms: Otitis media, viral pneumonia
o Post infectious encephalomyelitis 1:1, 000
o SSPE/ Subacute Sclerosing Panecephalitis 1: 1, 000, 000

Influenza C Diagnosis: Koplik’s spot

 Distribution: humans, swine Treatment: Vitamin D (for children)

 Epidemiology: rarely causes diseases, ubiquitous (everywhere)
 Vaccine: Vaccine: MMR
o Usually administered during the fall (winter)
o Keeping the track of the antigenic types of the latest
strains
RETROVIRIDAE
o Used inactivated whole virus
Human Immunodeficiency Virus (HIV)
o Trivalent subunit vaccine
 Purified Hemagglutination (HA) antigen
 Genus: lentivirus
 (1) type A H1N1, H3N2
 ss (+) RNA, enveloped
 Type B antigen
Retroviral genes:
 Gag: encodes precursor proteins (p55, p24)
PARAMYXOVIRIDAE  Pol: encodes reverse transcriptase
 Env: encodes glycoproteins (gp160, gp120, gp41)
 ss(-)RNA, enveloped
 HN (hemagglutinin-neuraminidase) Virus Tropism (gp41)
 Fusion protein – responsible for forming syncytia (multinucleated  L-trophic (infects lymphocytes)
cells)  M-trophic (infects macrophage)
 Measles and Mumps
Replication:
Replication:  Cytoplasmic Stage
RNA genome utilizes reverse transcriptase to make ds DNA
 Entirely cytoplasmic  Nuclear Stage
 Syncytia (via F protein) allows cell to cell infection cytoplasm Gag, pol, env proteins are translated
infecting neighbouring cells
Manifestation:
Pathogenesis  Primary Infection:
o Mononucleosis-like infection
 Infection by respiratory tract o Pharyngitis
o Lymphadenopathy
Mode of Transmission
 Asymptomatic Phase (1-15 years)
 respiratory droplets o Virus continues to replicate
o Affects 5% of CD4+ (<500)
A. Mumps Virus Normal Value of CD4+ → 500-1, 000
 AIDS (Acquired ImmunoDeficiency Syndrome)
Structure:
o CD4+→ <500 or <200
 Only one major serotype
o Antigenic stimulation of CD4+ (apoptosis)
o Prone to opportunistic infection (fungi, mycobacterial,
Mode of Transmission
parasitic, viral)
 Inhalation of respiratory droplets
Complications:
Manifestation
 Generalized infection  HIV Neurological Disease→ microglial cell
 Parotitis (inflammation of the parotid glands; can be  HIV associated Nephropathy→ renal failure
unilateral/bilateral)
 Orchitis (inflammation of the testicles), inflammation of ovaries   HIV interstitial Pneumonia→ alveolar macrophage
infertility
Complications: Malignancies:
 Viral meningitis  Kaposi Syndrome
 Pancreatitis  B-cell lymphoma
 Encephalitis  Invasive cervical carcinoma

Laboratory diagnosis: Health Measure: Reverse Isolation (prevents patient from contamination by
 CPE: multinucleated cells healthy individuals)

Prevention Laboratory Test:

 MMR (live attenuated vaccine administered at 12-15th month of  ELISA (screening; detects antibody to p24)
life against Mumps, Measles Rubella)  Western blot (confirmatory)
  IF and Flow cytometry (detects antibody to p24)
Symptoms
Treatment:  Fatal encephalitis
 AZT (Azidothymidine)  Hypertonic muscle contraction
 ddl (Dideoxyinosine)  Convulsion
 ddc (Dideoxycytidine)  Coma
 Protease inhibitors  Death
 Hydrophobia (as swallowing causes painful throat muscle spasms)

PICORNAVIRIDAE Treatment
 HRIG (Human Rabies Immune Globulin)
 Smallest RNA virus  HDCV (Human Diploid Cell Vaccine)→ 6 doses
 ss (+) RNA, naked
 Enterovirus: poliovirus, coxsackievirus A/B
 ECHO virus (Enteric Cytopathic Human Orphan)
REOVIRIDAE
Respiratory Enteric Orphan Viruses
A. POLIOVIRUS
 ds (-) RNA, naked
 ss (+) RNA
 concentric inner & outer capsid
 Icosahedral, naked
 Types  Viral Glycoprotein→ VP4, VP7
o Asymptomatic/ Brunheldi  MOT: Fecal-Oral
o Abortional/ Lansing  Replication
o Poliomyelitis/ Leon o Inner capsid is always intact
 MOT: fecal-oral o Outer capsid is removed upon entry of virus
 Vaccine
A. ROTAVIRUS
o Sabin (live attenuated PV) →Oral
 Icosahedral, naked
o Salk (formalin killed PV) → Parenteral  4 serotyped (based on VP7 antigen)
 Manifestations:
B. COXSACKIE A VIRUS o Gastroenteritis (most common cause for infants&
 26 serotypes young children)
 Manifestation: o Infant diarrhea
o Mild respiratory disease o Adult diarrhea rotavirus/ ADRV
o Aseptic meningitis (60-90% viral meningitis) o Rare sporadic diarrhea in children
o Hepangina “mouth blisters”  Target Cells → epithelial cells of small intestine (causing watery
Accompanied by severe febrile, vesicular pharyngitis
diarrhea)
o Acute hemorrhagic conjunctivitis (Coxsackie A24)
 Treatment: REHYDRATION
o Hand, Foot & Mouth Disease (Coxsackie A9, A16)
o IV fluid rehydration
o HUS (hemolytic uremic syndrome)
o Oral rehydration theraphy
 Vaccine: Rotashield (VP4/ VP7)
C. COXSACKIE B VIRUS  Laboratory Diagnosis
 6 serotypes
 Manifestation o EM→ wheel shaped virus
o Leading viral cause of myocarditis and pericarditis o Latex Agglutination
o Aseptic meningitis o RT-PCR
o Pleurodynia (sharp muscle pain) o PAGE (Polyacrylamide gel electrophoresis)
o Newborn disease (can be fatal) o ELISA (stool sample)
Accompanied by myocarditis, encephalitis,
hemorrhagic hepatitis
FLAVIVIRIDAE
Flavivirus
RHABDOVIRIDAE  ss (+) RNA
 Icosahedral, enveloped
 Rabies virus  Bud into internal membrane structure (golgi apparatus)
 ss (-) RNA, helical, enveloped
 “bullet shaped” Examples:
 St. Louis Encephalitis
Replication: o Major cause of arboviral borne encephalitis
 Cytoplasmic o MOT
Epidemiology  bird-man-bird (natural cycle)
 man-mosquito-man
 Raccoons → most common animal carrier
 Japanese Encephalitis Virus
 Unvaccinated domestic animals → DOGS  Yellow Fever Virus
 Skunks, wild animals, bats (US) o MOT: monkey-insect-monkey
o Occasionally transmitted to man
Diagnosis  Hepatitis C virus
 Negri bodies (found in animal tissue particularly in the BRAIN)  Dengue Fever Virus
o MOT: human-mosquito
Manifestation o 4 serotypes
 Virus replicates in striated muscles of the site of bite o Vector:
 Travels to nerve endings→ spinal cord→ brain  Aedes aegypti
 Aedes albopictus
 Virus hooks to acetylcholine receptor (neuromuscular junction)
  EM
DENGUE  Culture is not recommended
 Break bone fever, hemorrhagic fever→ 390C – 410C
**Viral replication occurs after the fever
 Bleeding (↓platelet) TOGAVIRIDAE
 Fever arthralgia rash
o Common symptom of viremia  Family: Alphavirus
o Characterized by:  Genus: Rubella virus
 Fever
 Chills RUBELLA
 Headache  Causative agent of german measles (less severity compared with
 Myalgia red measles)
 Rash  ss (+) RNA, enveloped
 Nausea
 Vomiting Pathogenesis
 Dengue Shock Syndrome  Incubation Period: 2-3 weeks
o Form of hemorrhagic fever
o Hypersensitivity reaction with reinfection of 2nd Manifestation
subtype of dengue virus  Lymphadenopathy
o More severe  Mild conjunctivitis
 Maculopapular rash “rubelliform”
Grading of Dengue Fever o 3-5 days (“3-day measles”)
o Small, discrete blotches
Fever , constitutional symptoms  Congenital rubella syndrome→ mental retardation
Grade I
(+) tourniquet test
Grade I + spontaneous bleeding of Laboratory Test
Grade II
skin, gums, gastrointestinal tract  ELISA
Grade II + circulatory failure &  HI
Grade III
agitation  EIA
Grade IV Profound shock  RIA
 Cell culturs

Prevention: MMR vaccine

FILOVIRIDAE

 ss (-) RNA
 filamentous/ long “filum”, enveloped
 Example: Marburg and Ebola Virus
 Endemic to monkeys & wild animals

Mode of Transmission
 Direct contact with body fluids

Strain
 E. zaire
 E. sudan
 E. ivory coast
 E. reston

Manifestation
 Hemorrhagic fever
 Liver necrosis

Laboratory Tests
 EM
 PCR
 ELISA
 Viral Culture

CORONAVIRIDAE

 ss (+) RNA “crown like”

 SARS (Severe Acute Respiratory Syndrome)

Mode of transmission
 Inhalation of respiratory droplets

Manifestation
 Common cold

Diagnosis