Reoviridae Family

Introduction -Respiratory Enteric Orphan Viruses= REO viruses

-Although found in the respiratory system they rarely cause respiratory disease mostly enteric disease!!
-Includes: Orbiviruses, Coltiviruses (Colorado Tick Fever), Orthoreoviruses (asymptomatic infections); Rotaviruses #1 cause of infant
diarrhea worldwide.
-Double layered protein capsid that can undergo antigenic shift like influenza A.
-Non-enveloped (resistant to detergents, acids, pH, drying, repeated freezing and thawing)
-BUT enveloped virus-like properties: it acquires an envelope during assembly then looses it.

Rotavirus
Pathogenesis -Spread is fecal-oral and maybe respiratory
-Absorption to columnar epithelial cells of villi of SI shorten/blunt villi and promote mononuclear cell infiltrate into lamina propria (binds to
them leading to problems with brush boarder)
-8 hours after infection:
-Notice cytoplasmic inclusions and huge numbers (billions) of virions/gm stool. (Only need 10 to cause an infection.)
-NSP4 protein (like cholera toxin) watery diarrhea and severe dehydration (5 million children die ↓ age of 2 yrs)
-Wheel like look to the bug.
Immunity and Immunity:
Epidemiology -Abs from mothers colostrums/milk (sIgA) only prevents infection for 6 mos. (remember: sIgG crosses placenta)
-Antigenic shift (like influenza)
-Without Abs, even a small number of virions (10) can cause infection.
Epidemiology:
-Ubiquitous 95% of children worldwide are infected by age 3-5
-Very contagious; transmitted on furniture, fomites, toys, and hands
-Two types cause two different diseases: Type A (infants > 24mos, + malnourished in developing nations gastroenteritis and potential
dehydration); Type B (Chinese infants, older children, adults severe gastroenteritis.
Clinical Syndromes Gastroenteritis:
-48hr incubation sudden onset of severe vomiting (PROJECTILE is KEY), watery diarrhea, fever, dehydration (electrolyte imbalance)
-Self-limiting; usually recover 5-7days without sequelae Not distinguishable from other types of gastroenteritis (Norwalk virus, bacterial) by
signs and Sx’s; no blood or leukocytes in stool.
Lab Dx/ Tx/Control Diagnosis: stool samples; Electromicroscopy: Wheel like spokes (PATHONEUMONIC)
ND TX: Bovine colostrums + probiotics (sacromices billardiae + lactobacillus)
 Coltivirus
Introduction -M/C tick borne viral disease in US (compare with Lyme Disease and Rocky Mountain Spotted Fever (RMSF)
-Similar to other reoviruses but: infects RBC precursors survives in mature RBCs (NOTE: parvo virus B-19 and Dengue Virus also attack
RBCs)
-Vector wood tick (Dermacenter andersoni), reservoir squirrels/chipmunks, hosts humans
-Invades vascular endothelium/vascular smooth mm and weakens capillaries leading to hemorrhage hypotension shock
Epidemiology/ Lab Dx Wester/North western USA and CANADA (almost exclusively needs 4000-5000 ft elevation Rocky Mountains)
-unlike other tick diseases, coltivirus must enter the blood stream quickly (KEY); RMSF1wk; Lyme Dz 24hrs
Colorado Tick Fever 3-6day incubation
Sx fever that is biphasic/saddle back fever (spike for 2-3days then none then again); maculopapular/petechial rash (like RMSF) but more
generalized and shorter lived; hemorrhage hypotension shock (like dengue fever)
Tx: none
Prevention: same as for other tick borne Dz

Poxviridae
Introduction 2 Genus:
Orthopoxvirus: variola (smallpox) Don’t mix with vericella!!
Molluscipoxvirus: Molluscum contagiosum (cause warts)
-one of the largest most complex viruses double layer envelope
**Unlike other viruses pox viruses contain all the necessary information for their own DNA and RNA synthesis.
Smallpox Virus Hx:
Historical accounts for over 2000yrs.
1st live vaccine in 1796.
1967 WHO mandated that in 10 yrs they would vaccinate all susceptible people in the world; last reported case: October 1977, in Somalia
Now:
Thought of for bioterrorism.(good for it because- it kills only 30% but very infectious; aerosole stable, small infectious does needed,
immunologically naïve population, no effective tx.
Smallpox Vaccine:
Live vaccine (modified cowpox) virus injected; SE vaccinia necrosum (can lead to eczema)
Cannot be given to pregnant, HIV+, immunosuppressed or skin Dzes like eczema (even if skin condition is in the past!), children >12-18 yoa
Virus:
Variola major: 4 types
Variola is inhaled 4-9days asymptomatic, not contagious in replication
 Prodrome 2-4days
Skin Rash:
-thick opaque fluid filled center with “belly button like depression in center”
-infectious until last scab falls off
-Unlike chicken pox, in smallpox all the lesions are at the same stage at the same time DDX FEATURE
DX & TX: M/c clinical only d/t very characteristic lesions.
Other Pox Viruses Molluscum contagiosum and other pox viruses are zoonoses. (ex: cowpox, monkey pox)
Molluscum contagiosum:
-STD, fomites, wrestling, rugby (also see herpes gladiatorium or HSV rugbytorium and ringworm)
-Genital tumours or disseminated large skin tumours (immunocompromised most likely HIV+) or small benign warts, cutaneous papules in
children/adults.
SX: fleshy, pearl-like umbilicated nodules with central caseous plug good DDX from HPV
DX: characteristic skin lesions (see above); molluscum bodies in biopsy (inclusion bodies)
Orf/erythema contagiosum:
-sheep/gaot farmers
-DDX with herpetic witlow.
-caused by direct contact with infected sheep/goats, or soil?
-contagious pustular dermatitis (mostly hands)

Scrapies-like agent
Introduction Prions (proteinaceous infectious particles)filterable (size of viruses) but no DNA or RNA
Replicate very slowly 5days to 1week doubling time
Very resistant! (weird for a protein, it even resists proteinase)
2 Types: Sporadic Creutzfeld-Jakob Dz, Varient CJD
Transmissible neurogenerative Dz to a variety of mammals including humans.
Pathogenesis & Pathogenesis:
Diagnosis Not very well known very closely associated with normal human protein PrPc (primary protein in cells)
PrPsc some variation of PrPc that might be actual infective agent.
Get aggregates of protease resistant hydrophobic glycoproteins in plaques/fibrils in CNS
Diagnosis:
Not cultivated in lab, no Abs produced, normal CT scan, normal MRI, abnormal EEG
DX with: Western blot confirm diagnosis with proteinase K resistant PrPc
Creutzfeld-Jacob Long incubation (up to 30 yrs) but rapid fatal once symptomatic (m/c only 1 yr)
Disease-Sporatic form -rapidly progressing dementia; m/c after age 70; Genetic susceptibility 10% occurs in families.
Creutzfeld-Jacob Young onset mean is 27yrs
Disease-Varient form -pyschiatric/sensory symptoms dementia at final stage only
-unlike sporadic CJD detect PrPsc in follicular dendritic cells (lymphoid tissue) Orally acquired (not just in brain)
Strong laboratory and epidemiological link to BSE (eating contaminated meats)