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Rhino virus an update

Rhino virus an update

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Rhino virus an update
Rhino virus an update

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Published by: doctorrao on Jul 06, 2013
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11/30/2014

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Rhinovirus

an update
Dr.T.V.Rao MD

Dr.T.V.Rao MD

1

Viral Organisms in U.R.I.
Adults
Common cold Pharyng Tracheobronchitis Pneumonia

RHINOVIRUSES
INFLUENZA type A INFLUENZA type B CORONAVIRUSES ADENOVIRUSES (types 1-5,7) EPSTEIN-BARR VIRUS RSV PARAINFLUENZA (types 1-3) COXSACKIE (group A & B) ECHOVIRUS

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Dr.T.V.Rao MD

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Viral Organisms in U.R.I.
Children
Coryza RSV PARAINFLUENZA (type 3) PARAINFLUENZA (type 2) PARAINFLUENZA (type 1) RHINOVIRUSES INFLUENZA type A INFLUENZA type B ADENOVIRUSES (types 1-3,5) ++ ++ ++ ++ ++ ± ± + Pharyngitis + + + + + + + + Croup + + ± +++ ± + ± ± Tr.bronchitis ++ ++ + ± + + ± Pneumonia +++ ++ ± + + + ± ±

CORONAVIRUSES
EPSTEIN-BARR VIRUS COXSACKIE (group A & B) ECHOVIRUS

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Dr.T.V.Rao MD

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Rhinoviruses
• Rhinoviruses (from the Greek (gen.) "nose") are the most common viral infective agents in humans and are the predominant cause of the common cold. Rhinovirus infection proliferates in temperatures between 33–35 °C (91–95 °F), and this may be why it occurs primarily in the nose. Rhinovirus is a species in the genus Enterovirus of the Picornaviridae

family of viruses.
Dr.T.V.Rao MD 4

Viral Rhinitis
 sites infected
Rhinovirus nose > pharynx > saliva
90% 70% Coronavirus ?nose U & L.RT 50%

Parainfluenza, RSV, adenovirus

Influenza extensive destruction of U & L.RT (ciliated, intermediate and basal cells of epithelium)
Dr.T.V.Rao MD

Ebisava et al, 1969) 5

 Rhinoviruses are the most commonly
isolated viruses from persons with mild upper respiratory illness.

Rhinoviruses are ..

 Rhinoviruses are a genus of picornaviridae  In contrast to enteroviruses they do not
replicate in the intestinal tract, they have an extreme species specificity and more fastidious growth requirements

Dr.T.V.Rao MD

6

RHINOVIRUS GROUP
• Produces Common Cold. • Mild respiratory Illness. • More than 100 serotypes • Nasal secretions are infective. Mistaken with Infections with Corona viruses, Adenovirus. Para influenza viruses. Influenza viruses
Dr.T.V.Rao MD 7

Properties of Rhinoviruses.
• Gross appearance like Entero viruses, • Acid Labile destroyed at 3.0 pH. • Grown in Human Cell lines, WI – 38 MRC -5 • Cultivated at 330 c
Dr.T.V.Rao MD 8

Rhinovirus
• • • • Picornoviridae family Size Single stranded Incubation period of 1 to 3 days • Optimum growth occurs between 33 and 34 deg Celsius (93 deg F) • Not stable below the pH of 5-6
Dr.T.V.Rao MD 9

Rhino Virus

Dr.T.V.Rao MD

10

Structure

Dr.T.V.Rao MD

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Entering a Cell

Rhinovirus bonded to a CAM Antibodies bonded to a 1 receptor Dr.T.V.Rao MD rhinovirus

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Understanding – Common cold
• leading cause of doctor visits and lost hours both at school and the workplace over >100 different viruses found to cause symptoms of the common cold responsible for about 70% of the cases where a virus has been found one of the most common illnesses to man 35 to 50% of the total number of common colds

Hand to hand contact
Dr.T.V.Rao MD 13

Transmission of Rhinoviruses
• There are two modes of transmission: via aerosols of respiratory droplets and from contaminated surfaces, including direct person-toperson contact.

Dr.T.V.Rao MD

14

Pathogenesis - Rhinoviruses
• Entry through Respiratory tract. • Nasal Mucosa, can infect Lower Respiratory tract. • Chilling, wearing wet cloths do not produce infection. • But common cold starts with chills. • Local inflammation and cytokines may be responsible for the symptoms of common cold.
• Interferon production occurs early and specific Dr.T.V.Rao MD antibody appears in nasal secretions
15

Pathogenesis
Epithelial destruction hypothesis:

intact nasal epithelium (Winther et al) rhinovirus replication in extremely
small number of cells (Arrunda et al)

viral quantity does not influence
duration nor severity of colds (Arrunda
et al)
Dr.T.V.Rao MD 16

Pathogenesis
• Inflammatory cascade hypothesis:
Common cold symptoms result from an inflammatory cascade triggered by a viral infection

Dr.T.V.Rao MD

17

Cytokines initiate pathogenic process
Small number of virus infected cells elaborate a variety of cytokines initiating a host inflammatory response, which orchestrate chemotaxis and expression of endothelial adhesion receptor molecules resulting in the typical common cold symptoms.
Dr.T.V.Rao MD 18

Interleukin-1
• T-cell activation • B-cell profileration, antibody synthesis • up-regulation adhesion molecule expression • mediator, cytokine, growth factor induction

• increased vascular permeabilitiy
• up-regulation kinin receptor expression

• hematopoietic progenitor cell stimulation
• neuro-endocrine interactions Dr.T.V.Rao MD
19

Clinical Findings.
• Incubation 2-4 days, • Last for 7 days. • Sneezing, Nasal Obstruction, Sore throat, • May lead to secondary infection with Bacteria.
Dr.T.V.Rao MD 20

The common cold, nasal congestion is
caused by a vasodilation of the subepithelial capillaries and of the cavernous sinuses, by edema in the lamina propria and by inflammatory processes in which neutrophils and kinins play an important role.

o Histamine plays only a minor role in the symptoms of common cold o Little is known about the role of prostaglandins and leukotrienes in the common cold.
Dr.T.V.Rao MD

21

Clinical Findings.
• Incubation 2-4 days, • Last for 7 days. • Sneezing, Nasal Obstruction, Sore throat, • May lead to secondary infection with Bacteria.
Dr.T.V.Rao MD 22

Laboratory Diagnosis
• Isolation of virus may be obtained from nasal or throat swabs collected early in infection. • Culturing on MRC5 or W 138 • Appearing of CPE

Dr.T.V.Rao MD

23

Immunity – Rhinoviruses.
• Antibodies in Nose • Recurrent infections with antigenic variants, may be 2-3 attacks a year.
Dr.T.V.Rao MD 24

Prevention and Control
• No specific treatment. • Vaccines are unsuccessful. • Intranasal spray of Gamma Interferon for 5 Days

Dr.T.V.Rao MD

25

Epidemiology - Rhinoviruses.
• Prevalent all over the

world. • Close Contact. • Fingers and Hand - Hand washing. • High rate of infection in Infants and Children.
Dr.T.V.Rao MD 26

CDC Recommends
• The CDC recommends that children with symptoms lasting more than 10 days who are unresponsive to overthe-counter medications or with fevers over 100.4 degrees Fahrenheit seek medical attention.
Dr.T.V.Rao MD 27

Dr.T.V.Rao MD

28

Stop Spreading the Virus

Dr.T.V.Rao MD

29

Use Tissue Paper
• Use paper :Instead of shared cloth towels. Individuals with colds should always sneeze or cough into a facial tissue, and promptly throw it
Dr.T.V.Rao MD 30

Hand washing
• Hand washing is the simplest and most effective way to keep from getting rhinovirus colds. Children and adults should wash hands at key moments after nose-wiping, after diapering or toileting, before eating, and before preparing food.
Dr.T.V.Rao MD 31

Treatments are Still Experimental
• DRACO, a broad-spectrum antiretroviral therapy being developed at the Massachusetts Institute of Technology, has shown preliminary effectiveness in treating rhinovirus, as well as a number of other infectious viruses
Dr.T.V.Rao MD 32

Preventing Common Cold
• There is no vaccine to protect you against the common cold. However, you may be able to reduce your risk of getting a cold by taking these steps: • wash your hands often with soap and water do not touch your eyes, nose, or mouth with unwashed hands stay away from people who are sick
Dr.T.V.Rao MD 33

Prospects of Vaccine
• There are no vaccines against these viruses as there is little-to-no cross-protection between serotypes. At least 99 serotypes of Human rhinoviruses affecting humans have been sequenced. However, recent study of the VP4 protein has shown it to be highly conserved amongst many serotypes of Human rhinovirus, opening up the potential for a future pan-serotype Human rhinovirus vaccine.
Dr.T.V.Rao MD 34

• The Programme Created by Dr.T.V.Rao MD for Medical and Health care Workers in the Developing World
• Email

• doctortvrao@gmail.com
Dr.T.V.Rao MD 35

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