CNS VIRUS

ENTEROVIRUS
ENTEROVIRUSES Polioviruses ECHOviruses Other Enteroviruses
General  Picornaviridae family  Brunhilde, Lansing, and Leo  Enteric Cytopathogenic Human  Enterovirus 68
 Relatively resistant to acid,  distinguished by Neutralization Orphan Viruses  Enterovirus 71
chemical and physical test  differentiated on basis of cross-  Enterovirus 70
extremes (survive passage  inactivated by heat at 55ºC for Neutralization and cross-
thrustomach) 30 mins. Complement
 fixation test
 Small naked
 Icosahedral
(+) ssRNA

Surface  Hemagglutinin-  complement fixing antigens

antigens Neuraminidase (HN)  N (native antigen)
 Fusion (F antigen)  H (heated antigen)

Mode of  fecal-oral route  close personal contact

transmissio  Portal of entry: alimentary  flies (house flies)
n tract via mouth  food
 milk
 water
Clinical  Poliomyelitis  Aseptic meningitis  Enterovirus 68
manifestati  Abortive Poliomyelitis  Febrile illness with or without  bronchitis or pneumonia in
on  Nonparalytic poliomyelitis rash children
 Paralytic poliomyelitis  Common cold  Enterovirus 71
 Progressive post-poliomyelitis  Acute hemorrhagic  CNS infections (encephalitis,
muscle atrophy conjunctivitis meningitis, paralysis)
 HFMD (Japan and Sweden)
 Enterovirus 70
 epidemic acute hemorrhagic
conjunctivitis

Incubation  7-14 days  3-10 days

period  3-35 day
Specimen  throat swabs (soon after onset)  throat swabs
 rectal swab/feces (longer  stool rectal
periods)  Swab
 CSF
Culture  Monkey Kidney
 Human cell
Isolates  CF  pMK  pMK,
identified  Neutralization test  diploid fibroblast  HDF
by  early stage : H antibodies  human embryonal  HEp2
only rhabdomyosarcoma (RD) cells,  A549
 - 1-2 weeks : both H and N  A549
antibodies
 - late convalescent : only N
antibodie
Serological  Microneutralization test  Neutralization test (LBM)
tests
Treatment  Killed vaccine
 Live, attenuated vaccine

ARBOVIRUSES
General  Picornaviridae family
 fragile, sensitive to lipid
solvents, detergents and
extremes of pH and
temperature
 small, roughly
 spherical,
 enveloped viruses
 (+) ssRNA
ARBOVIRUS
TOGAVIRIDAE FLAVIVIRIDAE Family
Family
 Alphaviruses
 Rubivirus
 Positive ss RNA,
 Nonsegmented
 enveloped
 Icosahedral
symmetry
 Replicate in the
cytoplasm
CNS VIRUS
Rabies Virus
BUNYAVIRIDAE Family
 California encephalitis
virus
 Rift Valley fever virus
 Sandfly fever virus
 Positive (+) ss RNA,  Negative (-)  Bullet-shaped,
nonsegmented;  ss RNA;  enveloped virus with linear
 enveloped  segmented (3)  (-) ssRNA
 Icosahedral symmetry  Helical  Helical nucleocapsid
 Replicate in the cytoplasm

    
Mode of  Vectors Vector: mosquito  Vector: mosquito Vector: Arthropod  1. Bite of rabid animal
transmission  biting arthropods  Aedes : Yellow and Dengue (except Hantavirus)  2. Superficial abrasion of
fevers skin
 Culex : St. Louis, Japanese  3. Human to human
encephalitis, West Nile
 virus
Clinical Viral encephalitis  Furious Rabies
manifestation  Dumb Rabies
Incubation 3-8 weeks to 1 year
period
Culture  suckling or young adult
mice murine
neuroblastoma and related
cell lines
 hamster and mouse cell
line
Lab diagnosis  Direct IFA
 RFFIT – Rapid Fluorescent
Focus Inhibition Test (US)
Serological  ELISA
tests  IF
 Nt
 CSF – (+) only in infected
but not in vaccinized
individual
Treatment  Vaccination  NO treatment for “clinical
 Vector control rabies”
 Prevention of insect  Prophylaxis : vaccine +
bite Immune globulin

TOGAVIRIDAE Family FLAVIVIRIDAE Family

EEE, VEE, WEE virus St. Louis Encephalitis Yellow Fever Virus Dengue Fever Viruse

 General  Eastern Equine
Encephalitis (EEE)
 Venezuelan Equine
Encephalitis (VEE)
 Western Equine
Encephalitis (WEE) Viruses
Mode of transmission swamp dwelling
mosquitoes that
normally grow on horses
Clinical manifestation
Incubation period
Culture
Isolates identified by
Serological tests
Virus
 mosquito-borne  Mosquito-borne
encephalitis
(stagnant water)
 Sylvan (Jungle) Yellow Fever
 canopy dwelling monkeys
 tree- hole mosquitoes
 Urban Yellow Fever
 Aedes aegypti
 Sylvan (Jungle) Yellow Fever
 Urban Yellow Fever
3-6 day
 Mosquito cell lines :
 Monkey Kidney cell lines:
REC of many organs (replication)
 DEN-1,DEN-2, DEN-3, DEN-4
 Classic Dengue Fever
 Dengue Hemorrhagic fever
 Dengue Hemorrhagic Shock
1. C6/36 – most widely used
2. AP-61
3. TRA-248-SFG
1. LLC-MK2
2. VERO
 mammalian or insect cell
culture (blood or CSF)
 mouse macrophage cell line
with patient’s
 blood + specific antibody to
flavivirus
 HI
 CF
 FAT (difficult to
interpret in endemic cases)
 Neutralization
test (only for primary
infection)