УДК 579

Марфина О.В., Правосудова Н.А.

Рабочая тетрадь

Special microbiology and virology

Workbook 4

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Рабочая тетрадь разработана на кафедре «Микробиология, эпидемиология и
инфекционные болезни» Медицинского института ПГУ. Тетрадь
рекомендована студентам второго курса специальностей «Фармация» для
работы на практических занятиях.

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 Lesson 4.1. Pathogenic spirochetes: Treponema, Borrelia, Leptospira.
Chlamydia, mycoplasma

1. Morphology and structure of spirochetes.

2. Treponema pallidum. Characteristics.
3. Syphilis. Manifestation. Laboratory diagnosis. Prevention and
treatment.
4. Borrelia. Characteristics.
5. Relapsing fever. Manifestations. Laboratory diagnosis. Prevention and
treatment.
6. Lyme disease. Manifestations. Laboratory diagnosis. Prevention and
treatment.
7. Leptospirosis. Manifestations. Laboratory diagnosis. Prevention and
treatment.
8. Mycoplasma. Morphology and structure.
9. M. pneumoniae. Clinical disease, treatment, prevention
10.M. hominis. Clinical disease, treatment, prevention.
11.Chlamydia. Morphology and structure.
12.C. trachomatis. Clinical disease, treatment, prevention
13.C. psittaci. Clinical disease and treatment , prevention
14.C. pneumonia. Clinical disease and treatment, prevention

Task 1. Comparative characteristic of spirochetes. Complete table

Treponema pallidum Borrelia spp Leptospira

Morphology

Disease
Epidemiology

Manifestations

Laboratory
diagnosis

Treatment

Prevention
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Task 2. Manifestations of which stages of syphilis are shown on these figures?

__________ ___________

_______________
_________

___________ ___________
____

_________________ ________________
_ _

Which tests would be a good screening test to use for this patient’s condition?
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

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Task 3. Complete the table “Comparative characteristic of Borrelia sp. “
Borrelia recurrentis Borrelia burgdorferi

Morphology
Disease Epidemic form of The endemic form of
relapsing fever relapsing fever
Epidemiology

Manifestation

Prevention

Task 4 . Stages of which disease are shown on this

graph?_____________________________

Task 5 .Which of the main virulence factor gives ability of B. recurrentis to escape
from immune clearance of the host?
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

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Clinical case 1. A 40-year-old man has spent the past week hiking various trails in
Connecticut, Rhode Island, and Massachusetts. Toward the end of the trip, he states
that he began to experience fever, malaise, and myalgia. While taking a shower this
morning, he said that he noticed a rash on his upper right arm, similar to that shown
in the figure below. After further questioning, the patient remembers removing a
tick from his arm 2 days ago.

Which of organisms is the most likely cause of this patient’s condition?

___________________________________________________________________
Describe the clinical manifestation which is shown on the figure
___________________________________________________________________

Which of is the most appropriate treatment for this patient’s condition?

___________________________________________________________________

Late persistent Lyme borreliosis is usually characterized by which type of clinical

manifestation?
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

Explain the differences between icteric and anicteric leptospirosis.

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

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Clinical case 2. A 3-year-old boy attended the Medicine OPD with symptoms of
sudden onset of fever, chills, pleuritic pain, and expectoration of blood-tinged
sputum. Routine bacteriological culture was negative. Serum for cold agglutination
test was positive.
Diagnose the disease. _______________________________________________
Which microorganism could cause disease?_______________________________
What are the other laboratory tests used for the diagnosis of the condition?
___________________________________________________________________
List other pathogens causing the disease.
___________________________________________________________________

Task 6. Complete the table “Human infections caused by Chlamydia species”

Pathogen Diseases Way of

transmission
C. trachomatis (15 serovars)
Biovar trachoma, serovars
А-С (А, В, Ва, С)
Biovar LGW, serovars D-K
(D, E, F, G, H, I, J, K)
serovars L1-L3 (L1, L2, L3)

С.pneumoniae 4 Biovars
TWAR, AR, KA, CWL.
Biovar TWAR
С. psittaci 13 serovars

Task 7. Label inclusion, elementary, and reticulate bodies of Chlamydia.

RB_______________________________
_________________________________
_________________________________
EB_______________________________
_________________________________
_________________________________
IB

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Lesson 4.2. The causative agents of rickettsial diseases

1. Morphology, structure and growth.

2. Typhus group.
Epidemic typhus
Endemic typhus.
Recrudescent typhus (Brill’s disease)
3. Spotted fever group. Rocky mountain spotted fever.
4. Q fever.

Task 1.Write the main components of morphological structure of Rickettsia.

Which forms of bacteria are shown there?

___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________

Task 2. Rickettsia possesses three different types of antigens as follows

1_________________________________________________________________
2_________________________________________________________________
3_________________________________________________________________

Task 3..Suggest a hypothesis to explain why rickettsias are obligate parasites

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

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 Typhus Fever Group

Task 4. Typhus refers to a group of infectious diseases that are caused by different
rickettsial organisms.Complete the table
Infectious Species Vector Reservour Vaccine
diseases
Epidemic A live vaccine
typhus containing
attenuated “E”
strain of R.
prowazekii is
available and is
recommended for
use in high-risk
population
Relapsing louse-borne
typhus or
Brill–Zinsser’s
disease
Endemic or Rickettsia typhi
murine typhus

Task 5. The main virulence factors of Rickettsia prowazekii

1_________________________________________________________________
2_________________________________________________________________
3_________________________________________________________________

Task 6. Describe the pathogenesis of disease

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 Spotted Fever Group

Task 7. Describe the pathogenesis of disease

Task 8. What is the most severe rickettsial disease?

Clinical case 1. A 30-year-old farmer from Himachal Pradesh attended the

Medicine OPD with symptoms of fever, headache, and appearance of rashes over
surface of the body. He gave the history that the rash appeared on fifth day of the
fever, which first appeared on trunk and then spread to the extremities. On
examination, the rashes were found to be maculopapular. These rashes were not
found on the face, palm, and sole. Serum was sent for febrile agglutination tests.
Widal and standard agglutination test for brucellosis were negative. Paul–Bunnell
test was also negative. ELISA for HIV was also negative. Weil–Felix test showed
agglutination with OX19 and OX2 but not with OXK.
What is the most probable diagnosis? _____________________________
What are the other tests that can be carried out to diagnose the condition?

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How will you treat the condition?
__________________________________________________

Q fever
Task 9. Complete sentences.
Primary reservoirs of infection__________________________________________
Humans acquire diseases by __________________________________________
Coxiella burnetii causes infection by penetrating through
______________________________
C. burnetii affects ____________________________________________________
C. burnetii can be diagnosed by________________________________________
Preventive measures for Q fever include: _________________________________

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 Lesson 4.3. Cultivation techniques and display viruses.
Causative agents of acute respiratory viral infections. Influenza.

1. The morphology and physiology of virus

2. Classification of viruses
3. Laboratory diagnosis of viral diseases (cytologic examination, electron
microscopy, virus isolation and growth, detection of viral proteins (antigens
and enzymes), detection of viral genomes, serology)
4. Viral isolation and growth (cell culture, viral cytopathologic effects) Viral
Cytopathologic Effects
a. Cell death. Cell rounding. Degeneration. Aggregation. Loss of
attachments to culture dish
b. Characteristic histologic changes: inclusion bodies in the nucleus or
cytoplasm, margination of chromatin
c. Syncytia: multinucleated giant cells caused by virus-induced cell-to-
cell fusion
d. Cell surface changes. Viral antigen expression. Hemadsorption
(hemagglutinin expression)
5. Ways of transmission
6. Targets for antiviral drugs
7. Infection control. Prevention
8. Acute respiratory disease (ARD)
9. Influenza viruses. Structure. Antigenic changes, reassortment, immunity
10.Influenza viruses. Transmission, pathogenesis, manifestations
11.Influenza viruses. Treatment and prevention.

Task 1. Write the general structures of viruses and describe their function.

Naked virus (A) Enveloped vires (B)

What is the capsid and how are the two types of capsids constructed?
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
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What is a nucleocapsid?
___________________________________________________________________
___________________________________________________________________
What is an enveloped virus, and how does the envelope arise?
___________________________________________________________________
___________________________________________________________________
What are spikes and what is their function?
___________________________________________________________________
___________________________________________________________________
Write the general parameters used to classify viruses
___________________________________________________________________
___________________________________________________________________

Task 2. According to Baltimore classification, viruses are divided into the

following seven classes (fill table)

Class Description of genome and replication strategy

I

II

III

IV

VI

VII

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 Task 3..Describe the stages of a viral growth cycle. The growth cycle of
adenovirus, a nonenveloped DNA virus, is shown.

1__________________________________________________________________
2__________________________________________________________________
3_________________________________________________________________
4__________________________________________________________________
5__________________________________________________________________
6__________________________________________________________________
7__________________________________________________________________
8__________________________________________________________________
9__________________________________________________________________
10_________________________________________________________________

Task 4..What are three ways that animal viruses penetrate the host cell?
1__________________________________________________________________
___________________________________________________________________
2__________________________________________________________________
___________________________________________________________________
3__________________________________________________________________
_____________________________________________________________

Task 5.. Describe the two ways that animal viruses leave their host cell.
1._________________________________________________________________
___________________________________________________________________
2._________________________________________________________________
___________________________________________________________________
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Task 6.. Fill the table
Family Genus Type of NA Disease
Paramyxoviridae

Reoviridae

Picornaviridae

Coronaviridae

Adenoviridae

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 Influenza viruses
Task 7.. Write the general components of the Influenza virus using the following
definitions:

Segmented ssRNA(-) linear genome,

encapsidated by nucleoprotein (NP).

Viral RNA polymerase

Matrix protein(M1)

HA

NA

Task 8. .Antigenic drift is_____________________________________________

__________________________________________________________________
__________________________________________________________________
Describe the development of new strains of influenza viruses by way of antigenic
drift
1____________________________________________
_____________________________________________
_____________________________________________
2____________________________________________
_____________________________________________
_____________________________________________
3____________________________________________
_____________________________________________
______________________________________________

Task 9..Antigenic shift is_____________________________________________

__________________________________________________________________
Describe the development of new strains of influenza viruses
by way of antigenic shift
1____________________________________________
_____________________________________________
2____________________________________________
_____________________________________________
3____________________________________________
_____________________________________________

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Task 10..Which of these graphs corresponds to the antigenic shift and antigenic
drift? Define.

Task 11.. Fill the table «Types of vaccines, available against of influenza viruses»
Types of Advantages Disadvantages
vaccine
Whole virus
vaccines
Split virus
vaccines
Subunit virus
vaccines
Live attenuated
vaccines
Task 12..Fill the table
Taxonomy Orthomyxoviridae: Influenza viruses
Genome
Virulence factors

Transmission

Diseases

Treatment

Prevention

Laboratory diagnostics

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 Lesson 4.4. Enteroviruses.
1. Picornaviridae. Characteristics, classification.
2. Enteroviruses. Reproduction, pathogenesis.
3. Polioviruses. Epidemiology, pathogenesis.
4. Polioviruses. Four outcomes in unvaccinated people (depending on the
progression of the infection)
5. Polioviruses. Laboratory diagnosis, prevention
6. Coxsackieviruses and echoviruses. Epidemiology, clinical syndromes
7. Coxsackieviruses and echoviruses. Manifestations.

Task 1..Write the general components of the Picornaviridae

The important human pathogenic genera of picornaviruses are:

— Enteroviruses with the polioviruses (poliomyelitis), cocksackieviruses and
echoviruses.
— Parechoviruses types 1 and type 2.
— Hepatoviruses with the hepatitis A virus.
— Rhinoviruses, common cold viruses (rhinitis).

Task 2.. Describe the main

stages of the Picornavirus
infection cycle
1._______________________
2._______________________
3._______________________
4.________________________
5.________________________
6._______________________
7.________________________
8.________________________
9.______________________
10._______________________

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Task 3.. Write the major diseases caused by Enteroviruses
Virus type (group, Major diseases and clinical syndroms
serotypes)
Polioviruses (1-3)

Coxsackieviruses (A1-
A24)
Coxsackieviruses (B1
-B6)
Echoviruses (l-33)

Enteroviruses (68-71)

Task 4.. Describe the main stages of Polioviruses pathogenesis.

Task 5.. Fill the table

Presentation of poliovirus Clinical features
infections
1

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Task 6.. Write advantages and disadvantages of poliovirus vaccines
Types of Advantages Disadvantages
vaccine
Sabin vaccine
(live oral polio
vaccine –
OPV)
Salk vaccine
(parenteral
inactivated
polio vaccine –
IPV

Task 7.. Fill the table

Taxonomy Polioviruses (1-3) Coxsackieviruses Echoviruses
Genome

Virulence
factors
Transmissio
n

Diseases

Treatment

Prevention

Laboratory
diagnostics

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 Lesson 4.4. Causative agents of viral hepatitis.

1. Hepatitis viruses. Characteristics, classification. Comparison of A, B, D (Delta),

C, and E hepatitis.
2. Hepatitis A virus. Characteristics, pathogenesis
3. Hepatitis A. Manifestations, diagnosis. Treatment and prevention
4. Hepatitis B virus. Structure.
5. Hepatitis B. Pathogenesis.
6. Hepatitis B. Manifestations and diagnosis. Treatment and prevention.
7. Hepatitis D virus. Characteristics.
8. Hepatitis C virus. Characteristics.
9. Hepatitis E virus. Characteristics.

Task 1..Fill the table «Comparison of A, B, D (Delta), C, and E Hepatitis»

FEATURE HAV HBV HDV HCV HEV
Family-
Genus
Genome
Transmission

High-risk
group
Incubation
period
Chronicity
Carrier
Laboratory
diagnostics
Treatment

Vaccine

Hepatitis A virus.
Task 2..Write the general components of the Hepatitis A virus

Hepatitis B virus
Task 3..Write the general components of the Hepatitis B virus

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Task 4..Describe the main stages of the HBV replication cycle

1._______________________________
2._______________________________
3._______________________________
4._______________________________
5._______________________________
6._______________________________
7._______________________________
8._______________________________

Task 5.. Write nomenclature for Hepatitis B Virus Antigens and Antibodies
Abbreviation Description

HBsAg

HBcAg

HBeAg

AntiHBs

AntiHBc

AntiHBe

Hepatitis D virus
Task 6..Write the general components of the Hepatitis D virus

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 Hepatitis C virus
Task 7..Write the general components of the Hepatitis C virus

Hepatitis E virus
Task 8..Write the general components of the Hepatitis E virus

Task 10.. Using the following terms, fill in the following concept map that
describes viral hepatitis .

Acute
Hepatitis B vaccine
Blood test for antibodies (IgM) Hepatitis B virus (HBV)
Carrier state Hepatitis C
Chronic Hepatitis C virus (HCV)
Chronic disease Mild
Cirrhosis of the liver PCR or blood test for antibodies
Hepatitis A
Hepatitis A vaccine
Hepatitis A virus (HAV)
Hepatitis B
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Task 11.. A 30-year-old student goes to the emergency room because of fever and
anorexia for the past 3 days. She appears jaundiced. Her liver is enlarged and tender.
A laboratory test shows elevated aminotransferases. She reports a history of having
received hepatitis B vaccine 2 years ago but has not had hepatitis A vaccine. The
results of her hepatitis serologic tests are as follows: HAV IgM-negative, HAV
IgG-positive, HBsAg-negative, HBsAb-positive, HBcAb- negative, HCV Ab-
positive. The most accurate conclusion is that she probably
___________________________________________________________________
__________________________________________________________________
Task 12.. A 36-year-old nurse is found to be both HBsAg- positive and HBeAg-
positive. The nurse most
likely______________________________________________________________
___________________________________________________________________
______________________________________________________________

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 Lesson 4.5. Causative agents of dangerous viral infections.
1. Rabies. Epidemiology, pathogenesis.
2. Rabies. Manifestations and diagnosis
3. Rabies. Treatment and prevention.
4. Arboviruses. Epidemiology.
5. Flaviviruses. Russian spring–summer encephalitis (tick-borne encephalitis).
6. Bunyaviruses. Hemorrhagic fever with renal syndrome (HFRS).
7. Retroviruses. Characteristics and structure.
8. Human immunodeficiency virus. Epidemiology
9. HIV. Pathogenesis.
10.HIV. Diagnosis.
11.HIV. Treatment and prevention.

Rhabdoviridae

Task 1.. Write the general components of the rabies virus

Task 2.. Write the differences between street and fixed rabies viruses
Street virus Fixed virus Street virus Fixed virus

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 Task 3.. Describe the main steps in the
replication of a Rhabdovirus

1________________________________________________________________
2________________________________________________________________
3________________________________________________________________
4________________________________________________________________
5________________________________________________________________
6________________________________________________________________
7________________________________________________________________
8________________________________________________________________
9________________________________________________________________
Task 4.. . Describe the main steps of Rhabdovirus pathogenesis
1________________________________________________________________
2________________________________________________________________
3________________________________________________________________
4________________________________________________________________
5________________________________________________________________
6________________________________________________________________
7________________________________________________________________
8________________________________________________________________
9________________________________________________________________
Task 5.. Write the clinical syndromes of each period of rabies disease
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Period Clinical syndromes
Incubation period
Prodromal period

Acute neurologic period

Furious rabies

Paralytic rabies

Coma

Task 6.. Write guidelines for post-exposure treatment and immunoprophylaxis

against rabies
Category Type of contact with Recommended treatment and
suspected animal immunoprophylaxis

i. Touching, feeding of
animals or licks on intact
skin
ii. Minor scratches or
abrasions without bleeding
or licks on broken skin
Nibbling of uncovered
skin
iii Single or multiple
transdermal bites,
scratches or contamination
of mucous membrane with
saliva (i.e., licks)

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 Arboviruses.
Task 7.. Describe the epidemiology of the Arboviruses
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________
__________________________________

Flaviviruses. Russian spring–summer encephalitis (tick-borne encephalitis)

Task 8.. Write the general components of the Flaviviruses

Bunyaviruses. Hemorrhagic fever with renal syndrome (HFRS).

Task 9.. Write the general components of the Bunyaviruses.

Retroviruses. Characteristics and structure

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Task 9.. Write the general components of the Retroviruses

Task 10.. Describe the main stages of the infection of target cell

1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
4. ___________________________________________________________
5. ___________________________________________________________
6. ___________________________________________________________
7. ___________________________________________________________

Task 11..Describe the main stages of the activation of provirus

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 1. ___________________________________________________________
2. ___________________________________________________________
3. ___________________________________________________________
4. ___________________________________________________________

Task 12.. Fill the table «Modes of transmission of HIV»

Type of Mode of transmission The ways of non-specific
transmission prevention

Sexual

Inoculation in
blood

Perinatal

Task 13. Describe each stage of HIV disease

Stages of HIV Clinical features Typical CD4 T-cell Specific
disease duration counts tests for
range/mm3 laboratory
diagnosis
Acute primary
HIV infection

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Asymptomatic

Early
symptomatic

Late
symptomatic

Advanced
AIDS

Task 14..Write the common opportunistic infections in AIDS patients.

Site of infection Disease or symptoms Caisative organism

Lung

Mouth

Esophagus

Intestinal tract

Central nervous system

Eye

Skin

Reticuloendothelial
system

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Task 15. Western blot strips. Above the strips are handwritten codes identifying
each HIV protein blotted. The “p” and “gp” in each refers to protein and
glycoprotein, respectively. The numbers are the molecular weight of each protein.
Notice that the smaller proteins are at the left. During electrophoresis, smaller
proteins migrate faster than bigger ones. Based on that, these proteins migrated
from right to left. Write test results for 4,5,6,7,8 patients

Task 16.. Write examples of antiretroviral therapy for each drug group.

___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

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 Lessons 4.7. Pathogenic fungi. Causative agents of fungal infections
1. Characteristics of fungi. Structure. Reproduction of Fungi
2. General aspects of fungal disease. Pathogenesis of Fungal Infection
3. Laboratory Diagnosis of Fungal Infection.
4. Antifungal chemotherapy
5. Classification of human mycoses.
6. The superficial fungi. Characteristic, manifestations, diagnosis, treatment
and prevention.
7. The cutaneous fungi (dermatophytoses). Characteristic, manifestations,
diagnosis, treatment and prevention
8. The subcutaneous fungi. Characteristic, manifestations, diagnosis, treatment
and prevention
9. The systemic fungi. Characteristic, manifestations, diagnosis, treatment and
prevention
10.The opportunistic fungi. Characteristic, manifestations, diagnosis, treatment
and prevention

Task 1. Complete the table: “Comparison of fungi and bacteria”

Feature Fungi Bacteria
Diameter
Morphology
Staining property
Cell wall
Cell membrane
Cytoplasm
Nucleus
Spores
Thermal dimorphism

Task 2. Which of the morphological forms of fungi are shown on the figure?
What is it dimorphic fungi?

1_________________________________________
2a_______________________________________
2b________________________________________

Task 3. The effects of fungi on humans can be

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grouped in three major ways:
1__________________________________________________________________
2__________________________________________________________________
3__________________________________________________________________

Task 4. Label which layers of skin and tissues are infected by which fungi

Task 5. Label primary sites of activity of the antifungal drugs and examples
common antifungal agents

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 Task 6. Label which species of fungi cause mycosis, what do we look in
Microscopic identification, grows on the cultural media and manifestation of
disease

Microscopic identification, grows on the cultural media and Species/ type of

manifestation of disease mycosis

________________ _____________ _________________

_______________ _______________ _____________

______________ _______________ _________________

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_____________ _______________ ___________

____________________ ____________ _______________

________________ _______________ _______________

______________ _______________ ________________

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_______________ _______________ _________________

_____________ _______________ _________________

____________ _______________ _________________

_______________ _______________ _________________

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______________ _______________ _________________

_______________ _______________ _________________

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