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CAUSING
GASTROENTERITIS
Dr N. Narayan
VIRAL AGENTS CAUSING
GASTROENTERITIS
1. Rotavirus
2. Enteric adenoviruses
3. Calicivirus
4. Astrovirus
ROTAVIRUS
Family Reoviridae
Genus Rotavirus
ROTAVIRUS
First isolated in 1973 from children with
diarrhea
EM identification from duodenal
biopsies
Human and animal strains
Rotavirus
Rotavirus- EM Structure
ROTAVIRUS
60-80nm in size
Non-enveloped virus
Double capsid
EM appearance of a wheel with radiating
spokes
Icosahedral symmetry
double stranded (ds) RNA in 11 segments
STRUCTURE
Double capsid (outer and inner capsid)
Core with genome
7 Groups (A through G)
8 P protein serotypes
Classification (contd.)
Electropherotypes
600,000-850,000 deaths/year
Nosocomial infections
Outbreaks
Epidemiology (contd.)
Seasonality
Winter months (Nov. through May in US)
Gradual spread W to E
Year-round in the tropics
Prevention-
Handwashing and disinfection of
surfaces
Vaccine
Live tetravalent rhesus-human reassortant vaccine
(Rotashield)
Licensed for use in August 1998
Removed from the market in October 1999 due to
risk of intussusception
Cases were seen 3-20 days after vaccination
Approx. 15 cases/1.5 million doses
GASTROENTERITIS DUE
TO ENTERIC ADENOVIRUS
GASTROENTERITIS DUE TO
ADENOVIRUS
Types 40, 41
Belong to serogroup F
Typical morphology
32 cup-like depressions
EM appearance of Star of David
E.g.- Sapporo-like viruses
HUMAN CALICIVIRUSES - SLV
Morphology of HuCV-
atypical
Atypical morphology
Smooth surface
Small Round Structured viruses
E.g.- Norwalk-like viruses
SRSV- NORWALK VIRUS
CLINICAL FEATURES
Adults and Children
Usual incubation Period is <24 hours
(ranges from 12hrs. to 4 days)
Short duration of illness <3 days
Nausea, vomiting, fever, headache
Abdominal cramping
Watery diarrhea
Epidemiology-Noroviruses
Worldwide distribution
>23 million cases/year in the U.S.
Major cause of foodborne outbreaks of
GE
Most people have had infections by age
4 years (by seroprevalence studies)
Spread of Norwalk virus
A. Person-to-person Fecal-oral spread
(stool/vomitus)
B. Fecal contamination of food or water
C. Spread through fomites?
Epidemiology-Noroviruses
Asymptomatic infections- seroconversion but
asymptomatic shedding of virus
Low infective dose
Viral excretion during convalesence
(up to 2 weeks)
Ability to survive in water chlorination at
routine levels
Epidemiology of Outbreaks