VIROLOGY

1.
 01 COXSACKIEVIRUSES
TABLE OF CONTENTS

03
RHINOVIRUS

02 LASSA FEVER
COXSACKIEVIRUSES
 INTRODUCTION AND HISTORY

❏ Coxsackieviruses belong to the family Picornaviridae and

the genus Enterovirus, which also includes poliovirus and
echovirus.
❏ Coxsackieviruses are so named, because the viruses were
first isolated in Coxsackie village in New York, United
States, by Dandruff and Sickle in the year 1985.
❏ These viruses based on the pathological changes
produced in suckling mice are classified into two groups:
● Coxsackie-A causes flaccid paralysis.
● Coxsackie-B causes paralysis with spasms.
 MORPHOLOGY
● The structure and morphology of the
coxsackieviruses and the RNA genome are
similar to those of poliovirus.
● But unlike poliovirus, they can infect
mammals other than primates.
● Replication cycle is similar to that of
poliovirus.
● Coxsackieviruses are nonenveloped viruses
with linear single-stranded RNA.
 Epidemiology

● Coxsackievirus infection occurs worldwide.

● Humans are the only natural hosts. The
viruses are transmitted primarily by
fecal–oral route.
● Coxsackievirus infections occur in all age
groups but are more common in young
children and infants.
● Children are at higher risk for infection
during the first year of life.
● The rate of incident infection decreases
substantially after the first decade of life.
 Pathogenesis

● Coxsackie A viruses show tropism for

skin and mucous membranes.
● Coxsackie B viruses show predilection for
visceral organs, such as liver, heart,
pancreas, and pleura.
● Both the viruses infect anterior horn cells
of the motor neurons and meninges and
cause paralysis.
● They replicate first in the
oropharynx and gastrointestinal
tract from where they spread by the
blood circulation.
● Host immunity is IgG-antibody
mediated and is type specific.
 Clinical manifestations
A. Diseases caused by Coxsackie A

Herpangina: This condition is caused by coxsackie A

virus serotypes 2, 4, 5, 6, 8, and 10. The infection is
most commonly seen in children between 1 and 7
years.
The symptoms include sudden
● Onset of fever
● Sore throat
● Difficulty in swallowing.
● The classical finding is a painful vesicular
eruption of the oral mucosa around the soft palate
and uvula
The condition is self-limiting.
Hand-foot-and-mouth disease: This is a vesicular
exanthema usually caused by coxsackie virus serotypes 5 and
16.
This is mainly a disease of children, seen most commonly in
patients younger than 10 years. After an incubation period of
3–6 days, the infection begins with prodromal symptoms, such
as;
● Fever
● Cough
● Sore throat
● Malaise
● Anorexia.
After 12–36 hours, vesicular eruptions appear on the hands,
feet, and oral cavity. This is a self-limiting condition and the
illness subsides in a few days.
B. Diseases Caused by Coxsackie B
Pleurodynia:
● This condition, also known as epidemic myalgia or
Bornholm disease, is caused by coxsackie B virus
serotypes 3 and 5.
● This condition is an acute illness, which manifests with a
sudden onset of fever accompanied by muscular
pain and pain in the chest and abdomen.
● The pain is spasmodic in nature.
● The condition usually lasts for 4 days but may relapse
again after the condition has been asymptomatic for
several days.
Myocarditis:
● This is a serious condition caused by coxsackie B
virus, mostly in newborn infants.
● Shortness of breath, dull or sharp chest pain, and
fever are the common manifestations of the
condition.
● This is a life-threatening condition mostly in
newborns.
● In adults, the condition presents with myocardial
infection with fever.
● The condition is associated with a high morbidity.
C. Diseases Caused by both Coxsackie
A and B

Aseptic meningitis:
● The condition is caused by coxsackie
A serotypes 2, 4, 7, and 9 and by
coxsackie B viruses.
+ Caused by
- Not caused by
 Laboratory diagnosis
● The type of infection affects how specimens are collected.
● Important samples include CSF, feces, and throat swabs.

In mice when administered intracerebrally:

● After inoculating a tissue culture, a cytopathic effect can

be seen between five and fourteen days.
● Serology is used to detect neutralizing antibodies, but
PCR is more effective because it is quicker, more sensitive,
and serotype-specific.
 Treatment and Prevention

● There is no vaccine to prevent coxsackievirus

infection.
● There's no specific treatment.
● Hand washing is the best protection. Everyone
should wash their hands well and often,
especially after using the toilet, after changing
a diaper, before meals, and before preparing
food.
RHINOVIRUS
 INTRODUCTION

The most frequent cause of the common

cold is rhinoviruses.
• The intercellular adhesion molecule I
(ICAM-1) of the host cell serves as their
receptor.
• There are more than 100 known
serotypes.
 HISTORY AND EPIDEMIOLOGY
● Human Rhinoviruses were discovered in the 1950s in an attempt to
find the root cause of the common cold, but no cure has been
established in nearly 60 years. Furthermore, it is responsible for
more than half of all cold-like illnesses, costing billions of dollars in
hospital visits and lost work days.

● Rhinovirus is a major cause of RTI and bronchitis worldwide, and it

can be found in all nations.The prevalence of rhinovirus infection is
highest in newborns and young children and decreases as children
get older.

● Young children are more likely to have the frequent, close, intimate
contact required to spread the virus; they frequently transfer the
sickness on to family members after contracting the virus in
nurseries, daycare centers, and schools
 MORPHOLOGY

In terms of structure and traits, they resemble

enteroviruses, with the following exceptions:

● Contrary to enteroviruses, which have a buoyant

density of 1.34, cesium chloride has a buoyant
density of 1.40 g/mL.
● Acid-labile (unstable at pH levels below 6).
● Close breathing contact with contaminated
secretions results in transmission.
● 33°C is the ideal temperature for growth (as
opposed to 37°C for enteroviruses).
 PATHOGENESIS CLINICAL FEATURES
Incubation period: 2- 4 days

- Common cold syndrome: Coronaviruses, adenoviruses,

enteroviruses, parainfluenza viruses, and influenza viruses all
cause common cold syndrome, and rhinovirus symptoms are no
different. They include;

Sneezing, nasal blockage, nasal discharge, and sore

throat are common symptoms in adults, although fever is not
one of them.
- Particularly in children, secondary bacterial infection can
result in otitis media, sinusitis, bronchitis, or pneumonitis.
 CLINICAL FEATURES & LAB DIAGNOSIS
Relapse: The typical adult experiences 1-2 attacks annually.
- Only humans, gibbons, and chimpanzees may contract
rhinoviruses.
- Laboratory diagnosis: Human diploid cell lines like
MRC-5 and WI-38 can be used to generate rhinoviruses. For
some fastidious strains, ferret and human tracheal epithelium
organ cultures may be required.
The majority of strains thrive at the nasopharynx temperature
of 33' C as opposed to 37' C.
 TREATMENT

● The approach to treatment is supportive

(symptomatic).
LASSA FEVER

Western African nations are endemic for the lassa fever virus.
- House rat, Mastomys natalensis, is the reservoir.
- Damage to the heart and kidneys, pneumonia, and
hemorrhagic fever are all symptoms of human infection. A
frequent consequence that follows recovery occurs in 25% of
instances is permanent deafness.
- Pregnancy: Both maternal (30%) and fetal (90%) deaths can
happen, particularly in the third trimester.
- Treatment: Ribavirin is the drug of choice for Lassa fever
References
References
1. Parija SC. Textbook of microbiology &
immunology. 2nd ed. New Delhi, India: Elsevier;
2012
2. Jacobs SE, Lamson DM, St George K, Walsh TJ.
Human rhinoviruses. Clin Microbiol Rev
[Internet]. 2013 [cited 2023 May 21];26(1):135–62.
Available from:
http://dx.doi.org/10.1128/CMR.00077-12