VIROLOGY

INTRODUCTION
A. General characteristics of virus
 Obligate intracellular parasite
 Cannot multiply by binary fission
 Cannot generate ATP
 Lack ribosomal RNA
 Haploid (with only one copy of their gene) except for RETROVIRUS –diploid
 Pass through filter, size ranges from 20-250 nm / 0.01 – 0.3 um
 Not sensitive to antibiotic

B. Viral Structure
1. Components
1.1 Virion (Nucleocapsid) – whole viral particle
1.2 Capsid – protein coat, composed of capsomer (protein subunit)
1.3 Nucleic acid – DNA or RNA
1.4 Envelope - contains phospholipid bilayer with adhesion molecules (spikes)
1.4.1 Enveloped nucleocapsid: with envelope
1.4.2 Naked nucleocapsid: without envelope

2. Capsid morphology
2.1 Helical (rod-like)
2.2 Icosahedral (cubic)
2.3 Complex

C. Criteria for Virus Classification

1. Nucleic acid composition
1.1 DNA or RNA
1.2 Single or double stranded
2. Capsid morphology
2.1 Helical or icosahedral
3. Envelope
3.1 presence or absence
3.2 site of virion assembly /nucleus or cytoplasm – site of virion
replication
D. Taxonomy:
1. Type of genome
2. Strand of genome
3. Capsid morphology
4. Presence or absence of envelope
E. Viral Replication
1. Adsorption: attachment of the virus to the host cell receptor
2. Penetration:
a. naked virus – injection
b. enveloped – fusion and endocytosis
3. Un-coating: virus loses its capsid exposing the viral nucleic acid

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 4. Eclipse stage: replication and expression of genetic material
5. Assembly: genetic material combines with the protein coat/pack into capsid.
Site of virion assembly: Nucleus or cytoplasm
6. Release:
a. naked virus – lysis
b. enveloped – budding

Viral Replication:
 Temperature independent
 Requires viral attachment protein. ( glycoprotein spikes)
 Cellular receptors: (host cell)
o Acetylcholine – rabies virus
o Sialic acid – influenza virus
o CD4 – HIV
o Complement - EBV

Note: Viral tropism – means preference for a tissue site.

CYTOPATHIC EFFECTS: any cellular changes or cellular damages cause by virus.

Viral replication is detected by cellular changes or cellular damage called CYTOPATHIC EFFECTS.
 rounding
 Clumping
 Vacuolation
 Granulation
 Giant multinucleated cell formation
 Syncytial formation
 Cell destruction or lysis or immunofluorescence

LABORATORY DIAGNOSIS
A. Specimen Collection for Viral Diagnosis
 Specimen should be collected early in the acute phase of infection.
 Must be inoculated w/in 2-4 hrs after collection.
 Use of cotton swabs are not recommended bec they are toxic to viruses (use Dacron or calcium
alginate).
 Transport w/ viral transport media
 Aspirate (w/o transport media)
 Proper temperature:
o All specimen regardless of source should be transport and stored at ref temp (0-4 degC)
or -70⁰C if the delay is >5 days b4 processing)
 Urine should NOT be collected into containers with preservatives.
 Blood should be collected into Heparin or EDTA tubes.
 Stool specimen should be collected into a clean container.

B. Virus Transport media

1. Modified Stuart’s media or culturette
2. Modified Hank’s medium
3. Veil infusion broth
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 4. Leibovits – Emory medium
5. Hanks Balance salt solution
6. Amies medium

Components of viral transport media:

1. _________________________________
2. ________________________________
3. ________________________________
4. __________________________________

Sample sites and associated viral agents:

1. Respiratory System
2. Viral Meningitis
3. Encephalitis
4. Cutaneous Infections
5. Genital Infections (Urethritis, Cervicitis, etc.)
6. Gastroenteritis
7. Eye Infections
8. Neonatal Infections

C. METHOD OF DETECTION
Methods of Diagnostic Virology
 Direct detection
 Nucleic acid-based detection
 Virus isolation
 Serologic Assays

C.1 DIRECT EXAMINATION/Detection: for the presence of viral detection can be done by the
following:
 Cytopathic effects (CPE)
 Immunofluorescence
 Latex Agglutination
o Immunohistochemical staining: uses fixed or fresh specimens incubated with
chemically labeled (fluorescein) or enzymatically labeled (peroxidase), antibodies to
detect viral antigens.
Histology and Cytology
 Commonly used for HSV, VZV & CMV
 Cellular inclusions are diagnostic for many viruses.

o Electron Microscopy =helpful to detect viruses that do not grow readily in cell culture &
virus particle that are too small in numbers.
o i.e.
o Rabies virus - Negri bodies
o Yellow fever virus - Torres councilman bodies
o Fowl pox virus - Bollinger bodies
o Variola and varicella - Guarnieri-Paschen bodies
o Cytomegalovirus - owl’s eye inclusion

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  Tzanck test/smear: a stained smear of cells from the base of skin vesicle used to detect
inclusions. (Papanicolau and Giemsa); H and E.

C.2. Nucleic acid hybridization: involves the detection of viral DNA or RNA sequences in nucleic acid
extracted from specimens.
 PCR – POLYMERASE CHAIN REACTION: is a technique that allows the viral genes to be
amplified to enhance detection.
 Western Blot (dot blot): is a technique that employs single stranded, complementary
nucleic acid probes for detection of human immunodeficiency virus (HIV) in the blood of
seronegative individuals.

C.3. VIRAL ISOLATION

 Chicken Embryo - research
 Cell Culture - CPE
 Shell Vial Cell Culture – Early viral Ag’s

Tissue culture cells are derived into 3 categories:

 Primary Cell line
 Diploid/Log passage
 Continuous /Heteroploid

C.3.1. Primary Cultures: Cells derive directly from the donor (animal or human sources).
o Have the same karyotype and chromosome number as the original tissue

i.e.
a. Primary MONKEY/RABBIT KIDNEY: – are directly derived from the parent tissue, but they
can only be maintained for a short time in the laboratory. i.e. Primary monkey kidney, rabbit
kidney (for HSV – 1)

-“Spitting” or “passaging” – transferring cells from one container to another.

-Primary cell lines can only be a passage for a few times.
b. Primary Human Embryonic Kidney:
HEK : OR Baby hamster Kidney is a cell line with an added B-galactosidase gene used for
ENZYME-LINKED VIRUS INDUCIBLE SYSTEM for detection of HSV 1 and 2.

C.3.2. Established/Low passage/Diploid cell lines:

o At least 75% of cells have the same karyotype as the normal cells which referred
to as diploid.
o can be maintain longer than primary cell lines. Cells that have at least 75% of
normal chromosome which referred to as diploid.

i.e.
Human embryonic lung = WI-38,
MRC-5 = Derived from lung CA
Human diploid fibroblast (HDF) = Derived from lung CA

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 C.3.3. Continuous/Heteroploid cell lines:
o Can be use to grow HSV, VZV, adenovirus & rhinovirus
o <75% of cells have the same karyotype as the normal cells.
o The abnormal cells are referred to as heteroploidy.
o They have continuous or indefinite number of passages.

i.e
Human cervical CA = HeLa
Human laryngeal CA = Hep-2
Nasopharyngeal CA = KB
Human lung CA = A-549

HEp-2: derived from human laryngeal CA. Use to culture RSV & adeno
HeLa: derived from human cervical adenocarcinoma. Use to culture RSV,
rhino & adeno.
A549: derived from human lung carcinoma. Use to culture VZV & adenovirus.

Order of inoculation
 1st the diploid cell line
 2nd continuous cell line
 3rd primary cell line
o The inoculated monolayers are incubated at 35 to 37 deg C (33 deg C for
respiratory viruses) for 2 weeks (for HSV 5-7 days; for CMV 21 days).

Viral adsorption: the moment when virus comes in contact with the tissue culture and cells.

a. Stationary adsorption: simply incubating the cells and virus for 3o to 60 mins at 35 ⁰ C.
b. Roller drum method: gentle rotation of the culture tubes to enhance adsorption.
c. Low – speed centrifugation method: requires that shell vials be centrifuged @ 750 to 1000 x g
for 30 to 40 mins @ 25 ⁰ C.

Viral detection for conventional culture: by observing characteristics of CPE.

Shell Vial Cell Culture

 A rapid modification of conventional cell culture.
 (+) result FLUORESCING INCLUSIONS
 Advantage:
o more quickly
o Early viral Ag develop w/in 1 to 2 days
o CPE develop 2-10 days
 Disadvantage:
o only 1 type of virus can be detected

Note: Some viruses (influenza, parainfluenza and mumps virus) produce little or no CPE, it can be
detected by Hemadsorption (an alternative method for cell monolayers that remain intact).

C.4. Viral Serologic Tests

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  2 Major clinical application:
o diagnosis of recent infection
o detection of immunity.
 Method of choice for viruses that requires complex isolation procedures.
 Fast and inexpensive.
 Use for Non – culturable agents
 Monitoring of transplant patients
 Epidemiologic studies

i.e. Complement fixation

Hemagglutination inhibition – influenza, rubella
Direct and Indirect fluorescent antibody
ELISA

CLINICALLY SIGNIFICANT VIRUS

DNA VIRUSES
General characteristics:
 All are dsDNA except Parvovirus.
 All are icosahedral except Poxviridae.
 All are enveloped except PAP: Parvoviridae, Papovaviridae and Adenoviridae.
 All replicate inside the nucleus except Poxviridae.
 Size: largest – Poxvirus
 smallest - Parvoviridae

A. The NAKED DNA viruses with an icosahedral symmetry are the: Parvoviridae, Papillomaviridae,
Adenoviridae
B. The ENVELOPED DNA virus with icosahedral symmetry: Hepadnaviridae, poxviridae, and
herpesviridae. Herpesviridae w/ 3 medically significant subfamilies: Alpha herpesviridae, Beta
herpesviridae, and Gamma herpesviridae. All have the ability to become latent.

Naked DNA viruses:

1. Virus Family: Parvoviridae

 Specific virus: Parvovirus B 19 virus
o Replicates in immature erythroid cells.
o Virus stop rbc production in the bone marrow lead to transient and Aplastic anemia.
o Disease:
 Aplastic crisis
 5th disease or Erythema infectiosum
 Characterized by slapped cheek rash.

2. Virus Family:Papillomaviridae/Papovavirida
 Specific virus: Human Papilloma Virus – HPV
o Also known as “wart viruses”
o MOT – sexually transmitted disease; EPC – site of latency.
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Virus Family: Polyomaviridae
 Also formerly part of the Papovaviridae family.
 Names originated from initials of patients from whom the virus was discovered.
 BK virus
o Associated with Nephropathy in transplant recipients.
 JC virus
o Causes PML – Progressive Multifocal Leukoencephalopathy
 Simian Vacuolating virus (SV40)
o Also infects humans and has been recovered from human tumors

3. Virus Family: Adenoviridae

 Specific virus: Adenovirus
o Hexon: the common Ag that is cross reactive in all human adenoviruses.
o Can replicate and produce dse in:
 Respiratory: CROUP
 Gastrointestinal: Gastroenteritis
 Urinary tract and
 Eyes: conjunctivitis

SEROTYPES OF ADENOVIRUSES:
 1,2,3,5 and 7 : Respiratory serotypes
 40 and 41 : Gastroenteritis types
 3, 4 and 7 : is common among military recruits
 11 : caused an outbreak in 1997
 3 and 7: caused of swimming pool conjunctivitis, commonly occurred in summer.
 34 and 35: found most often in bone marrow and renal transplant recipients.

Prevention and Control:

 Careful hand washing.
 Disinfect environmental surface with sodium hypochlorite.
 Chlorination of swimming pools and waste water.
 Vaccines?

TX: No specific tx for adenovirus infection.

4. Virus Family: Herpesviridae

 All herpesvirus produce latent infections– site of latency: the ganglial (alpha HV), secretory
glands and kidneys (beta HV), and lymphoblastoid cells (gamma HV).
 Highly cytolytic.
 Specific viruses:
o Varicella-Zoster Virus (VZV) – (chickenpox and shingles)
o Herpes Simplex Virus 1 & 2 - (oral & genital)
o Cytomegalovirus/SGV
o Epstein-Barr Virus – (IM)
o Human Herpes Virus 6,& 7 – Lymphotropic
o HHV 8/KSHV – associated w/ Kaposi’s sarcoma

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Virus Family: Herpesviridae
Specific virus:

1. Herpes Simplex Virus – 1

 MOT: respiratory secretion, saliva.
 Causes herpes labialis, cold sore, fever blisters, acute gingivostomatitis, keratoconjunctivitis and
herpes encephalitis.
2. Herpes Simplex Virus – 2
 MOT: sexually transmitted
 Causes lesions below the waist; genital & neonatal herpes; aseptic meningitis.
3. Human Herpes Virus 6
 Known to infect T- lymphocyte; MOT: respiratory secretions.
 Causes 6th disease or Exanthem subitum also known as Roseola.
4. Human Herpes Virus 8/KSHV
 MOT-oral secretion
 Causes Kaposi’s Sarcoma – a vascular tumor; A malignancy in AIDS px
5. Cytomegalovirus (Salivary Gland Virus)
 MOT: contact w/ saliva or blood, from mother’s milk.
 infect endothelial cells, lympho & other organs , i.e. kidney.
 Reveal Owl’s eye inclusion bodies in infected cells.
 Causes Heterophile Negative Mononucleosis
 Congenital infections are severe & mental retardation.
6. Epstein-Barr Virus
 MOT: saliva
 Infect epc of the oropharynx and parotid gland.
 Establish latent infections in lymphoid cell – the B cells.
o causing formation of reactive lymphocytes; (+) in heterophile Ab test; (+) Monospot
test; EBV specific Ab test
 Causes Infectious mononucleosis, Burkitt’s lymphoma, Hodgkin’s dse., Heterophile Positive
Mononucleosis, NPC
7. Varicella-Zoster Virus (VZV)
 MOT: inhalation (infection mucosal cells in nose and throat), and skin contact
 Highly communicable, common epidemic dse of childhood
 causes, successive crops of skin lesions, later evolve into blisters and crusts.
 Site of latency – nerve cells causing herpes zoster
 Lab dx:
o Cytologic stain (Giemsa)
o Virus Isolation
o PCR
o Serology

ENVELOPED DNA VIRUS:

Virus Family: Poxviridae

 w/ brick shaped or ovoid virion; the only complex virus, the largest virus; only virus replicates in
the cytoplasm.
 Has a DNA dependent RNA polymerase
 Infections tend to produce skin lesions
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  Specific viruses:
o Variola virus: Agent of smallpox.

o Vaccinia virus: A virulent form of Poxviridae use in smallpox vaccine.

o Molluscum contagiosum: Causes small, pink, wart like benign tumors of the skin.

HEPATITIS VIRUS:
Viruses Family/Genus Genome MOT Disease & other
Incubation period comments:

HEPA. A Picornaviridae/ RNA Fecal/oral route, Not assctd. w/

(Infectious Hepatovirus gen. due to poor chronic liver dse.
hepa) (15-40 days inc.) sanitation & Vaccine available
hygiene.

HEPA. B Hepadnaviridae/ DNA Bld. transfusion, 5-10% associated w/

(Serum hepa) Orthohepadnavirus transplacental, chronic hepa to liver
(50-180 days inc.) sexually cirrhosis
transmitted, needle
prick

HEPA. C Flaviviridae/Hepacivirus RNA Same with Hepa. B Chronic liver dse. is

(Post (2-25 weeks) MORE common than
transfusion Hepa. B
hepa)

HEPA. D Unclassified/ RNA Once the px failed Co-infection & super-

(co-infection Deltavirus to produce an anti- infection in patients
with hepa-B HBs infected w/ Hepa. B

HEPA. E Hepeviridae or RNA Same w/ Hepa. A w/ high mortality rate

(enterically caliciviridae/ (Fecal-oral) in pregnant women
transmitted) Hepevirus

HEPA. G Flaviviridae RNA Direct contact w/ Infection common

bld.,transplacental, worldwide but not
sexually transmitted pathogenic.

Virus Family: Hepadnaviridae

 Specific virus: HEPA. B
 Agent of Hepa. B infection/serum hepatitis.
 Prevention & Tx:
o Serologic test on blood donors.
o Active immunization
o Anti-viral agents
o Anti-HIV drug Lamivudine
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 o Suppress HBV DNA to undetectable levels.
o Tx. w/ interferon alpha

Serologic Markers:
1. HBsAg: Present in acute & chronic infection; will disappear when anti-HBs appear.
2. Anti – HBs: indicates immunity
3. HBcAg: not detectable in serum
4. Anti-HBc:
 IgM anti-HBc does not indicate immunity, new infection, appear during core phase
 IgG anti-HBc: past/old infection, also appears in resolving infection
5. HBeAg: high infectivity & active dse.
6. Anti-HBe: low infectivity & good prognosis.

Hepatitis D virus:
 Virus Family: Unclassified
 Genus: Deltavirus
o An incomplete RNA virus. Why???
o Only replicates in cells infected w/ HBV.
o Co-infection
o Markers: HBsAg, IgM anti-HDV and IgM anti-HBc

o Super-infection
o Most severe than co-infection.
o Markers: absence of IgM anti-HBc indicates super infection.

RNA VIRUSES
General Characteristics:
 All are ss-RNA except Reovirus.
 All are helical except Calicivirus, Picornavirus, Flavivirus, Togavirus, Reovirus & Retrovirus.
 All are enveloped except PCR: Picornaviridae, Caliciviridae and Reoviridae.
 All replicate inside the CYTOPLASM except Orthomyxoviridae & Retroviridae.
 Arthropodborne: Arbovirus:
 Bunyaviridae, Flaviviridae & Togaviridae
 Size: largest – Paramyxovirus
 smallest – Picornavirus
o other reference: specifically poliovirus

ENVELOPED RNA VIRUS: single stranded, helical

Virus family: Orthomyxoviridae

 Genome: ssRNA
 8 segments of RNA
 Enveloped
 Capsid: Helical
 Specific virus:
o Influenza virus

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 1. Influenza A:
 Causes acute, highly contagious respiratory illness. Infect humans, birds
and swine.
 Croup
2. Influenza B
 Causes mild influenza & Reye syndrome Infect only humans
3. Influenza C
 Causes only minor, respiratory disease. Infect only humans

Inf. A Inf. B Inf. C

RNA Segments 8 8 7

Antigenic Drifts Yes Yes Yes

Antigenic Shift Yes No No

Hemagglutinin Yes Yes Yes

Neuraminidase Yes Yes No

Virulence Factor
 Antigenic Variation
 Antigenic Drifts
o Minor mutation in antigenic structure
o Due to point mutation
 Antigenic Shifts
o Major antigenic changes
o Results to new H or N antigen
o Due to genetic re-assortment

INFLUENZA OUTBREAK:
 2 – 3 years. Period between epidemic waves of influenza A.
 3 – 6 years. Inter-epidemic period for influenza Type B.
 Every 10 – 40 years when a new subtype of Influenza A appears, a PANDEMIC result.
Subtypes: cause of epidemic:
1890 – H2N8
1900 – H3N8
1918 – H1N1
1957 – H2N2
1968 – H3N2
1977 – H1N1 reemerged
2009 – a novel swine-origin H1N1 virus appeared and reached PANDEMIC spread.
Latest subtype – H7N7
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Virus Family: Paramyxoviridae
1. Parainfluenza virus
 Virulence factor: Hemmagglutinin and Neuraminidase Ag; Fusion Ag
 MOT: Respiratory secretions/ Aerosols & direct contract
 Disease:
i. PIV-1 & 2: Croup
ii. PIV-3: Bronchiolitis & pneumonia
iii. PIV-4: Upper RT infection
2. Mumps virus
 Virulence factor: HN & F surface Ag
 MOT: Saliva droplets
 Disease: Mumps
i. inflammation of parotid gland
3. Measles virus/Rubeola/Morbilivirus
 MOT: Aerosol
 Disease: Red Measles (Rubeola) =causes macula popular rash, fever and koplik’s spots
i. Complication: SSPE
 Specimens & Lab Dx.:
i. Nasopharyngeal swab
ii. Urine
 Culture Isolation & serology
i. Spindle shape/multinucleated cells
4. Respiratory Syncytial virus
 MOT: Large particle droplets
 Disease: Lower RT infections (infants), Croup, bronchitis, pneumonia
 No. 1 or leading cause of pneumonia among children
5. Human Metapneumovirus
 MOT: Large particle droplets
 Disease: Mild upper RT to acute lower RT infection.

Virus Family: Arenaviridae

 Sandy appearance
 MOT:
o Rodent-borne: Rodents are reservoir (zoonotic): rats, mice, hamster
o Shed in Urine, feces and saliva
o Inhalation of aerosolized virus
o Contact with contaminated fomites or virus through breaks in skin
 Disease:
o LFV – Lassa Fever Virus: Hemorrhagic fever
 LCM- Lymphocytic Choriomeningitis Virus: Aseptic meningitis

Virus Family: Rhabdoviridae

 Specific Virus: Rabies Virus (Genus: Lyssa)
o Bullet shaped virus.
o Shows “Negri bodies” inclusion.
o 1st reservoir : wild or domestic animals.
o Has a wide host range, all warm blooded animals including humans
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 o MOT: bites, scratches & inhalation of droplets.
o Virulence Factor: The G protein (neuroinvasiveness)
o Disease:
 Causes Zoonotic dse.
 Causes Rabies.
 Fatal encephalitis
o Specimens & Lab Dx: Isolation and IF (Negri bodies)

Virus Family: Coronaviridae

 w/ club or petal-shaped spikes w/c resembles crown like.
 Virulence Factor: S glycoprotein.
 MOT: droplets or direct contact.
 Outstanding characteristics/Diseases:
o Common Colds-adult (Alpha)
o SARS and MERS (Beta)
o Diarrhea (Torovirus)
 Specimens & Lab Dx
o EM, ELISA and PCR
 Tx: No proven tx yet
 Prevention and Control
o Isolation of patients
o Use of PPE
 2 Genera:
1. Corona virus
o 1.1. Alphacoronavirus
 229E: aminopeptidase N receptor
 NL63
o 1.2. Betacoronavirus
 OC43, HKU1,
 SARS-CoV: angiotensin-converting enzyme,
 Outbreak :2003, China
 MERS-CoV: dipeptyl peptidase 4 aka CD26,
 Outbreak: 2012, Middle East
2. Torovirus
o Associated with diarrheal diseases.

Virus Family: Bunyaviridae

 Triple segmented
 MOT:
1. Arthropod borne: Orthobunya virus (La Crosse) and Phlebovirus (mosquitoes, sandflies,
ticks)
2. Rodent borne (contaminated excreta): Hanta virus

 Specific virus:
1. Orthobunya virus: La Crosse virus
 Causes California Encephalitis (La Crosse)

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 2. Phlebovirus
 Causes Rift Valley Fever/Sandfly Fever
3. Hanta Virus
 1ST reservoir: deermouse
 Causes Hanta virus Pulmonary Syndrome

Virus Family: Filoviridae

 “Filo” means long filaments; highly pleomorphic.
 Highly virulent and require maximum containment.
 Origin : African Green Monkey
 Dse: rare but w/ high mortality rate. Infections usually ending in death.
 MOT:
o Contact with infected monkeys (African Green Monkeys).
o Direct contact with body fluid
 Specific Virus:
 Ebola Virus (1976) and Margburg Virus (1967)
 : largest Ebola outbreak (2014) in Western Africa.
o Both cause Severe Hemorrhagic Fever
 Specimens & Lab Dx: Shed Urine, feces and saliva
 Isolation: PCR and ELISA, IF
 Tx: No specific tx yet. No vaccine yet

ENVELOPED RNA VIRUS: single stranded, icosahedral

Virus family: Flaviviridae

 Specific virus:
1. Japanese Encephalitis virus:
 Vector: Aedes aegypti
 Causes non-specific Febrile disease
2. Dengue virus
 Vector: : Aedes aegypti and Aedes albopictus
 Causes Dengue Fever also known as “ Break Bone Fever”
3. Yellow fever virus
4. St. Louis encephalitis virus
 Vector: Culex spp.
 Causes Encephalitis, fever to meningoencephalitis
5. West Nile virus
 1st reservoir Birds
 Causes non-specific febrile illness.
6. Zika virus:
 Mosquito borne
 1st isolated from rhesus monkey in Uganda (1947)
 MOT:
 Can be passed from pregnant woman to her fetus.
 Mosquito bite
 Sexual intercourse
 Disease: Can cause serious birth defects (microcephaly)
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  Lab. Dx: PCR
 Tx: Related to symptom control
 Prevention and Control:
 No vaccine
 Prevent mosquito bites

Virus Family: Retroviridae:

 w/ 2 identical ss-RNA.
 1981 – 1st describe
 w/ retroviral enzymes at the nucleocapsid protein.
 2 GENUSES:
1. Lentivirus (has 4 genes: gag, pro, pol, and env).
• 2 Distinct type of Human AIDS viruses: HIV 1 and 2
• Nef protein downregulates expression of CD4 and MHC class 1.
• CD4 = receptor, CXCR4 = corereceptor
 Causative agent of AIDS.
 HIV 1 causes more severe infection more than HIV 2.
 HIV initially infects macrophages, & dendritic cells, then CD4+T cells.
 MOT:
 Immunologic markers:
o Immunologic Markers
o Decline in CD4+ T Cells
o NV CD4 = 1000 cells/uL (<200)
o <0.9 = CD4+ : CD8+ ratio
o Impaired monocytes/macrophages
o ↓ NK cell activity
o Anergy to recall Ag’s in skin test
 Signs and Symptoms
 Stages of HIV infection
o Clinical Latency (10 years), high level of viral replication.
o AIDS Related Complex
o Full Blown AIDS
 Method of Detection:
 ELISA –screening test
 Western Blot – 3 bands must appear: p24, gp 41, gp120/gp160
 Indirect Immunofluorescent Assay.
 The HIV RNA levels are important predictive markers of disease
progression and tools to monitor the effectiveness of antiviral
therapy.
 Antiviral drugs will only slow down the disease progress or Diminish the symptoms.

2. Oncovirus
 Are retroviruses that can cause cancer.
 HTLV-1: causes adult T cell leukemia,lymphoma.
 HTLV-2: isolated from patient w/ hairy cell leukemia.

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PREPARED BY: SDTESALONA, RMT, MSMT
2017
Virus Family: Togaviridae
 MOT:
o Group A: Alpha/Arbo virus: Mosquito-borne
 Eastern/Western/Venezuelan Equine Encephalitis
 Chikungunya
o Group B: Rubivirus: Droplet- inhalation
 Rubella (has no arthropod vector)
 Disease:
o Enquine Encephalitis
 Nonspecific febrile illness, Encephalitis
o Chikungunya
 Dengue like symptoms. KIMAKONDE language “to become contorted”.
o Rubella
 German measles
 Congenital Rubella syndrome

Naked RNA Virus: single stranded, icosahedral

Virus Family: Picornaviridae
 Specific Virus:
o Enterovirus
o MOT: fecal/oral route; tropism to intestinal epc and lymphoid cells and also neurons
1. Hepatitis virus
2. Coxsackie A and B virus
 A: Causes hand, foot & mouth dse. of human
 B: Causes Herpangina, Pleurodynia and Myocarditis
3. ECHO virus
 Along w/ coxsackie, considered the leading cause of aseptic meningitis
4. Polio virus
 Causes Poliomyelitis, Flaccid Paralysis results in the destruction of motor
neurons in the spinal cord.
 Prevention and Control: Inactivated by heat (55 deg C) for 30 mins and
by a chlorine. Not affected by ether or sodium deoxycholate.
o Live attenuated vaccine (Sabin)
o Killed-virus vaccine (Salk)
 Specimen: Can be recovered from throat and intestines.
 Lab Dx: PCR, Serology
o Rhinovirus
o MOT: Aerosols, Secretion and fomites
o Acid labile, grows best at 33⁰ C, pH (<6), resistant to detergents, lipid solvent & extreme
temp.
o Disease: Common Cold among children

Virus Family: Caliciviridae

 MOT: Fecal/Oral route
 Specific Virus:
o Norwalk Virus
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PREPARED BY: SDTESALONA, RMT, MSMT
2017
  Highly contagious
 Caused of outbreak of diarrhea in Norwalk.
 Impt. cause of GE.
 MOT: Food-borne, Waterborne, Person-to-person
o Hepatitis E Virus
 Causes high mortality rate in pregnant women.
 Resembles Hepa. A

God bless everyone!

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PREPARED BY: SDTESALONA, RMT, MSMT
2017