Microbiology and Immunology
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What are viruses made up of?
Envelope, Spikes, Nucleic acid, Protein coat
infectious genetic material
protective to viruses
protein or carbohydrate-highly variable
Absorption, penetration and uncoating, nucleic acid and protein synthesis, assembly, release
how do we detect viral infections?
detect virus, detect immune response
Viral diagnosis: A) detection in clinical specimens
visualisations by electron microscopy, cell culture, detection of viral antigens (ELISA)
viral diagnosis: B) detection of patient's immune system
immunity test, diagnostic test
which influenza virus causes major epidemics?
which influenza virus is a milder disease?
What test produces haemagglutinin?
The following are examples of what? (to do with treatment of influenza viruses)-fever, variable respiratory symptoms-infants and elderly more susceptible
The following are examples of what? (to do with treatment of influenza viruses)- Throat washings, naso-pharyngeal aspirate inoculated into cell culture
The following are examples of what? (to do with treatment of influenza viruses)-paired sera (acute and convalescent stage)
The following are examples of what? (to do with treatment of influenza viruses)-annual vaccination especially for high risk groups.
The ____ Pandemic response and planning is a direct reflection of disease _________ and not of disease ________
WHO, SPREAD, SEVERITY
What is the most severe of infections?
Widespread human infection. Pandemic
What are some groups that have risk of complications during flu season?
pregnant women, asthma, diabetes, immune suppression, heart disease, kidney disease
At what ages are there greater disease burdens?
less than 25 years, more than 65 years.
In 2009, what were the 4 types of H1N1 segments?
classical swine (3), asian swine (2), avian (2), human (1)
The influenza genome has how many segments?
What does the 8 segment genome been termed?
adjuvanted vs. unadjuvanted vaccine:why adjuvant?
to reduce amount of vaccine protein per dose
adjuvanted vs. unadjuvanted vaccine:why new adjuvant?
existing adjuvants have never worked well for flu shots
why is the new adjuvanted vaccine controversial?
-little data on adjuvant in children and pregnant women-new adjuvant hasn't been used in other vaccines. (other than the H1N1 2009 vaccine)
The following are characteristics of what virus?-infants and young children-respiratory infection that could have serious complications-Croup (barking cough, high pitch sound on inhalation)-bronchiolitis, bronchopneumonia-no vaccine
What is an example of an antiviral medication for respiratory syncytial virus?
The following are characteristics of what type of virus?-major respiratory pathogen for children under 2 years-pneumonia and bronciolitis; occasionally fatal-epidemics-no vaccine
respiratory syncytial virus
What is another name for a common cold?
The following are characteristics of what type of virus?-common colds- over 100 serotypes; no cross-immunity-repeated infections
colds have a _____ onset, flu's have a ______ onset. (slow or sudden)
if your child's head feels achy, chances are they have a _____
The following are characteristics of what type of virus?-pharyngitis and conjuctivitis; pneumonia in young children-children most commonly infected-asymptomatic infection common-vaccines used in army
enterovirus= ______ _____?
enteric viruses infect _______/_______ cells
poliovirus, coxsackievirus, and echovirus are examples of what?
enteric viruses multiply in the GI tract but RARELY cause ____________
enteric viruses are ___% inapparent infection, ___-___% minor illness, and __% serious illness.
95, 4-5, 1
what type of virus:-multiplies in GI tract, but rarely causes gastroenteritis-infection via respiratory or GI tract-spread to other target organs in the body??
what type of virus:- enters via aerosol or ingestion- replication in pharynx and tonsils-virus in feces
for what type of virus are humans the ONLY natural host?
poliovirus causes _________:-a highly infectious, invades the host nervous system and can cause total paralysis in as little as a few hours.
The Global Polio Eradication Initiative:-launched in ____ by WHO, goal was to _________ poliovirus in the same manner as smallpox was eliminated.-since 1988, number of cases has decreased almost 99% (from more than 350,000 cases in 1988 to 1997 cases in 2005)- currently, Polio is only found in parts of _______ and _____ _____ (Nigeria, India, Pakistan, Afghanistan)
1988, eliminate, Africa, South Asia
Poliovirus diagnosis:___________ from stool samples (up to 5-6 weeks after infection), CSF and pericardial fluid
Poliovirus diagnosis:__________: acute and convalescent phases
What are some vaccines to prevent Polio?
Salk vaccine (Jonas Salk), Sabin vaccine (most common; Albert Sabin)
-killed/inactivated vaccine; does not produce local immunity in GI of host (IgA); Virus can still colonize host GI tract and spread to the community-used for immunocompromised-used in polio prevention
-live attenuated; host will produce IgA and IgG, so is protected against intestinal colonization and virus can NOT replicate and spread-Oral administration-used in polio prevention
What Group (A or B) of Coxsackievirus is a minor respiratory illness?
What Group (A or B) of Coxsackievirus causes Aseptic Meningitis
Both A and B
What group (A or B) of Coxsackievirus causes Herpangina and hand-foot-and-mouth disease
What group (A or B) of Coxsackievirus causes Pleurodynia, pericarditis and myocarditis?
What virus is being described?:-Grops A and B-seasonal variation-Diagnosis by stool sample and paired sera (same as Polio)- NO VACCINE
What Virus is being described?:-Enteric cytopathogenic human orphan viruses
What virus is being described?:-several types-enteric cytopathogenic human orphan viruses-minor respiratory illness-aseptic meningitis-same diagnosis as coxsackie and poliovirus-NO VACCINE
Name the viruses of Diarrhea
rotavirus, norovirus, adenovirus, calicivirus, astrovirus
The following are characteristics of what virus?:-Epidemics in infants (6 months-2 years); mainly in winter-replication in small intestine-Acute gastroenteritis- vomiting, diarrhea, fever-highly infectious
The following helps to diagnose what virus?:-EM or immunological testing of virus from stool samples (within 3 days)
rash first appear
behind ears, forehead and nostrils then spread to whole body. Blotchy appearance. Lifelong immunity after
May cause as complications: secondary bacterial infections i.e bronchopneumonia.
Encephalitis, TB and leukemia..
Which viral infection?
Immunoglobulin can suppress disease if given within
5 days of contact with virus
Live attenuated vaccine: very effective, widely
used. Administer after 12 months of age. MMR.
50% chance of damage to the fetus if non-immune
mother is infected between 0-4 weeks. General: abortion, death of newborn
– Localized: cataracts (infection during 6th week). deafness (infection during 9th week). heart defects (infection during 5th-10th week). Other: low birth weight, cleft palate, mental deficiency.
Clinical: similar to measles
but milder; life-long immunity
Do NOT give vaccine to women who are already
childhood febrile illness
with characteristic rash
– Successive crops of fresh
vesicles appear within 3- 4 days of onset
– In non-immune adults,
occasional pneumonia, may be fatal
LIMITED rash, along trajectory of ONE nerve
– Late recurrence of latent VZV
(chicken pox) infection
Herpes Zoster (Shingles)
Become LATENT after initial infection;
lesions reappear periodically
High percentage of inapparent infections
Herpes Simplex (HSV)
“cold sores” oral and ocular lesions; transmitted
via oral and respiratory secretions
herpes genitalis” associated with genital tract;
infected females can transmit to the newborn
What are other clinical forms of herpes virus other than cold sores?
- Genital infections: recurrent in both sexes
- Herpetic encephalitis: RARE (see CNS viruses)
- Neonatal Herpes: acquired during birth from asymptomatic mother; difficult to prevent; can result in death or severe sequelae
- Herpetic Whitlow: affects fingers, occupational hazard
- of health care workers; nosocomial infections in neonates
- Corneal and Conjuntival Infection:
- can cause ulceration of cornea and blindness
Cause different types of warts
– Common warts on hands and feet
– Genital warts: sexual transmission, asymptomatic carriers
– Some types associated with cancer: cervix, vulva,
Vaccine for HPV?
What are the viruses causing glandular enlargement?
Mumps, Infectious Mononucleosis, Cytomegalovirus (CMV), Hepatitis viruses and Yellow fever virus.
Childhood disease; bilateral inflammation of parotid glands; many inapparent infections
Complications: meningitis, orchitis (can lead to sterility), ovaritis
Epidemiology: spread by salivary and respiratory secretions; incubation 18-21 days
What are the complications or Mumps?
meningitis, orchitis (can lead to sterility), ovaritis
How is Mumps spread?
By salivary and respiratory secretions.
how long is the incubation of mumps?
Epstein-Barr Virus (EBV). Belongs to Herpes virus family. Mild disease; children and young adults; can be prolonged and debilitating. Transmission by saliva (kissing disease)
What are the symptoms of Mono?
lymphadenopathy, fever, sore throat, atypical lymphocytes, enlargement of liver and spleen
Detects RBC agglutination. Presence of EBV antigens. Infectious Mononucleosis.
Herpes family, infection usually asymptomatic and latent BUT dangerous for
Pregnant women: neonatal infection with jaundice, enlarged liver and spleen, mental retardation and motor disorders
Transplant patients: disseminated infection can cause transplant rejection
AIDS and other immunocompromised patients: frequent infection, GI tract ulceration and retinitis
3 different diagnosis procedures for CMV
- 1. Isolation of virus from urine, blood, organ biopsies (slow process, but accurate)
- 2. CMV antigen detection, DNA hybridization and PCR in leucocytes much faster
- 3. Serology screening for donors and recipients before transplant
What does hepatitis mean?
Inflammation of the liver.
What are the common symptoms of hepatitis?
Malaise, fatigue, nausea, loss of appetite and jaundice
Haemorrhagic fever with hepatitis. Endemic in Africa, South America and Caribbean. Mortality rates as high as 50%. Transmitted by mosquito. Travellers to endemic countries receive live attenuated vaccine
Yellow fever virus
Which Hep? Mainly children and young adults. Sporadic cases and small epidemics. Transmission by fecal-oral route. Incubation 15-50 days. Stools infectious 2-3 weeks before onset. Mild or inapparent infection in children. No chronic hepatitis. Life-long immunity.
Sporadic cases; all ages. Contaminated blood/blood products; saliva, urine, semen. Avg. incubation 90
days. Infective serum 30-60 days before onset of symptoms Severe. Chronic hepatitis and chronic carrier-state. Vaccine available.
Which Hep? Blood and sexual transmission. Initially mild disease but can cause chronic hepatitis. No vaccine. Treat with recombinant interferon and ribavirin.
Which Hep? Blood and sexual transmission. “Viroid”-relies on HepB presence for replication in cells. Increases severity of HepB infection. Vaccination against Hep. B
Hepatitis Delta Agent.
Which Hep? Transmission via fecal-oral route. Incubation 15-50 days. Symptoms similar to HepA BUT 20% mortality in pregnant women. Endemic in India, Pakistan, Nepal, Burma, North Africa and Mexico
Blood and sexual transmission. Incubation 14-180 days. Initially mild and no jaundice, can cause chronic hepatitis.
List CNS viruses with a human reservoir.
Mumps, Enteroviruses, HSV.
Name the two CNS viruses with an Animal reservoir.
Arbovirus and Rabies virus.
Human are accidental or dead-end hosts.
Arbovirus and Rabies virus.
Over 200 different types. Tropical rainforest areas. Encephalitis
Fatal, acute encephalitis
. Infects mammals, transmitted via saliva
. Long incubation (30-60 days)
. Combined active and passive immunization
Prevention by vaccination of wildlife and pets
Manifestations: – Aseptic meningitis
Meningo-encephalitis – Poliomyelitis
– Slow progressive, persistant infections
Viruses affecting the CNS.
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