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Paramyxoviruses and Rubella

Virus

Paramyxoviruses and Rubella Virus
•  Infections by paramyxoviruses and rubella virus are
common and cause highly contagious diseases in
children.
•  The paramyxovirus family contains viruses that
cause respiratory infections as well as systemic
disease like measles and mumps.
•  Rubella is caused by a togavirus.
•  Humans are the only reservoirs for these infections

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Paramyxovirdae •  Paramyxoviridae – Paramyxovirnae •  Paramyxovirus genus – Parainfluenza viruses 1 and 3 •  Rubulavirus genus – Mumps. Parainfluenza viruses 2 and 4 •  Morbillivirus genus – Measles Virus – Pneumovirinae •  Respiratory Syncytial Virus .

Paramyxovirus Structure .

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10 genes.Paramyxovirus Genome •  RNA –  Single stranded –  Negative polarity –  Single segment •  6 . depending on virus type •  Virion contains virus-encoded RNA-dependent RNA polymerase .

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Paramyxovirus Attachment •  Attachment Glycoproteins –  Parainfluenzaviruses & Mumps Virus •  HN (hemagglutinin/neuraminidase) –  Receptor : sialic acid –  Morbilliviruses (Measles) •  H (hemagglutinin) –  Receptor : CD46 –  Respiratory Syncytial Virus •  G (glycoprotein) –  Receptor : unknown .

viruses are protected against neutralizing antibody.direct fusion of virion envelope and plasma membrane •  F0 (precursor) .Paramyxovirus Penetration •  F (fusion) glycoprotein •  Penetration .cleaved by cellular protease: F0 –> F1 + F2 •  F1 mediates fusion •  Fusion of cells causes formation of syncytia (giant multinucleated cells). •  Because of fused cells. .

Paramyxovirus Replication •  Occurs in the cytoplasm •  Negative strand genome transcribed by virionassociated template –> mRNAs –> full-length positive strands (“antigenome”) •  Full-length positive strands are templates for progeny negative-strand genomes •  Assembly of nucleocapsids in cytoplasm •  Budding through the plasma membrane .

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PATHOGENESIS & IMMUNITY .

Mild Upper Respiratory Illness •  Parainfluenzaviruses 1. 4 •  Pharyngitis •  Tracheobronchitis . 2.

Croup • Parainfluenzaviruses 1. 3 • Laryngotracheobronchitis – Typically occurs in children (usually under 5 years) – Characteristic cough and wheezing due to swelling of larynx . 2.

Severe Lower Respiratory Tract Disease •  Parainfluenzavirus 3 •  Typically occurs in infants •  Bronchiolitis •  Pneumonia .

Respiratory Syncytial Virus (RSV) •  Major cause of pneumonia and bronchiolitis in infants under 6 months –  Obstruction of the brochioles •  Incubation period is short: 1 to 4 days •  Especially high risk in infants with heart disease or immunodeficiency •  Croup. in older children.R.T. mild U. tracheobronchitis. adults –  Possibility of nosocomial infections of hospital staff .

RSV: Pathogenesis and Prevention 1. . fatal respiratory tract infections in infants. 2.  Most common cause of acute.  Virtually everyone infected by age 3 years.

& Control Yearly. Epidemiology.Transmission. winter .

Clinical Disease: .

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followed by malaise. 18 . anorexia •  Salivary gland infection. swelling (not all cases) •  Males over 13 years may develop orchitis . viremia •  Approx.Mumps •  Caused by infection with Mumps Virus •  Spread by close contact (saliva. aerosols) •  Entry by Resp.painful swelling of testicles .21 day incubation. Tract (?). inflammation. replication in lymphoid tissue.

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Mumps .

ACUTE PAROTITIS (MUMPS) .

Epidemiology. Control & Prevent: .Transmission.

RUBEOLA (MEASLES) .

  2 million deaths – 3rd world countries & nonvaccinated in USA!!! 1/3 of American babies not vaccinated!!! 4.  Highly contagious .  Immunocompromised people – Defect in Cellular immunity . also!! .at very high risk.Measles: Facts: 1. 5.95% of people in a household will become infected.  7th most frequent cause of death worldwide!!! 2.  40 million infected annually 3.

Measles Pathogenesis •  •  •  •  •  Transmission by respiratory secretions Initial replication in Upper Respiratory Tract Infection of lymphoid tissues Spread throughout the reticuloendothelial system Secondary viremia spread virus to skin. conjunctiva . resp. tract.

about 9 to 11 days •  Symptoms: –  Fever. coryza –  Koplik’s spots –  Maculopapular rash –  Conjunctivitis may occur •  Severity related to nutritional status .Clinical Findings •  Incubation period . cough.Measles .

Koplik’s Spots .Measles .

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1 in 500 children in US who get the disease DIE!!! .

. Direct neuronal infect. Immune mediated (delayed) disease 3.CCC-P SSPE: caused in three ways: 1. 2. Mutant varient of the virus – caused by acute infection.

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Measles .Rash .

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Measles .Rash .

Measles Complications •  •  •  •  •  Bronchitis Depresses Cell Mediated Immunity Bacterial superinfection Acute encephalomyelitis (rare: 1/1000 cases) Subacute sclerosing panencphalitis (very rare: 1/300.000 cases) .

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PIE: postinfectious encephalomyelitis MIBE: measles inclusion body encephalitis SSPE: subacute sclerosing panencephalitis .

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Epidemiology.Transmission. Control & Prevent: .

Vaccines •  MMR vaccine –  Trivalent vaccine for Measles. Mumps and Rubella –  Live attenuated vaccine –  Subcutaneous administration •  Monovalent vaccines also available •  Older vaccines no longer recommended .

Laboratory Diagnosis:

Slide 9.45

Rubella Virus
(German or 3-Day Measles, )

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Pathogenesis of Rubella Virus Infections •  Transmission by respiratory secretions •  Systemic infection involving viremia •  Can invade many different organs •  Invades placenta and embryonic cells •  Cell immune responses and circulating viral immune complexes may be involved in inflammatory responses (rashes and arthritis) .

Prodromal Rash on Palate in Rubella .

temporary arthritis .Clinical Responses -Rubella (German or 3 day.measles) •  Acute Infection –  Incubation period is 16 days –  Often subclinical infection –  Mild fever and macular rash lasting 1-3 days –  Complication of acute disease .

Rash develops If mother sero neg. 2.1. .

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mother may be asymptomatic –  Causes severe malformations or death of developing fetus –  Occurs if pregnant women are infected during first trimester –  Expressed as chronic infection .Clinical Responses -Rubella (German or 3 day.measles) •  Congenital Rubella Syndrome –  Acquired by transmission of virus through placenta .

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Immunity and Diagnosis of Rubella Virus •  Permanent immunity if disease acquired after 6 months of age •  Presence of antibodies that inhibit hemagglutination is a good indicator of immunity and should be performed prior to pregnancy to ascertain risk of congenital rubella. •  Presence of Anti-Rubella IgM indicates recent infection .

Immunity and Control of Rubella Infections •  MMR vaccine provides protection for at least 18 years. •  Should not be administered to pregnant women. .