Alimentary system infections

• Rotavirus and Norwalk (Norovirus) virus

Gastroenteritis
• Symptoms:
– Vomiting and slightly fever
– Watery diarrhea
– Symptoms are gone in about 3-7 days
• Pathogenesis
 The viruses infect the epithelium in the upper
part of small intestine, causing decreased
production of digestive enzymes
Rotavirus and Norwalk virus Gastroenteritis
• Epidemiology
– Spread by oral-fecal route
– Generally occur in winter (Children)
• Prevention
– Handwashing, disinfectant use limit the spread of
viruses
– Attenuated vaccine (Rotavirus) approved in 1998,
then withdraw the next year (Bowel obstruction)
– No vaccine for Norwalk viruses
 Hepatitis
• Viral hepatitis is an infection of the liver hepatocytes by
viruses. There are 5 known viruses that infect the liver.
• The 5 RNA viruses are:
• 1) Hepatitis A virus (HAV).
• 2) Hepatitis C virus (HCV), which was previously called NON-A
NON-B until it was isolated.
• 3) Hepatitis D virus (HDV).
• 4) Hepatitis E virus (HEV).
• 5) Hepatitis G virus.(HGV)
• There is 1 DNA virus called:
• 1) Hepatitis B virus (HBV)

ABCDE, A = Anal, E = Enteric (Fecal oral route)

• BCD = Blood (parenteral)
 • VIRAL HEPATITIS
1. Acute viral hepatitis
 can be caused by all of these viruses.
 Symptomatic, patient may develop jaundice
 Elevation liver-function enzymes aspartate
aminotransferase (AST), alanine aminotransferase
(ALT), gamma-glutamyl transpeptidase (GGT), and
alkaline phosphatase.

2. Chronic viral hepatitis.

 The parenterally (blood-to-blood) transmitted HBV,
HCV
 Is more difficult to diagnose because the patient is
often asymptomatic with only an enlarged tender liver
and mildly elevated liver function enzyme levels.
 Hepatitis
• Hepatitis A (HAV)
• Symptoms:
• Fatigue, fever, loss of appetite, nausea, dark-
colored urine, clay-colored feces and jaundice
• Pathogenesis:
– Following ingestion, the virus reach the liver
– Replication and tissue damage
– The virus released into bile
– The virus eliminated with feces
 HAV
• Epidemiology:
– Spread by fecal-oral route
– Fecal contamination of hand, food and
water
– Children with HAV can eliminate the virus
with their feces for several months after
symptoms begin
 HAV
• Prevention and treatment
–Inactivated vaccine available since 1995
–IgG to HAV as passive immunization of
people exposed to virus
–No antiviral is available, just supportive
 HBV
• Symptoms:
– Similar to HAV, except that HBV tend to be more
sever. Cause death in 1% - 10% of hospitalized
cases.
• Causative agent
The important HBV antigens are:
– Surface antigen (HBsAg)
– Core antigen (HBcAg)
– Soluble component of core (HBeAg)
 HCV
• Symptoms
– The same of A and B, except is milder
– About 65% have no symptoms
– Only 25% have jaundice
• Pathogenesis:
– Spread mainly by blood
– Infect the liver (incubation 2 – 6 weeks)
– 80% develop chronic infection
– Liver wax
– After years cirrhosis and liver cancer develop in 10-
20% of patients
 Genitourinary tract infections (Viral STDs)
Genital Herpes Simplex (HSV)
• Symptoms: Itching, burning pain, painful
urination, tiny blisters
• Incubations: Usually 1 week
• Causative agent: HSV-2, HSV-1 can also be
responsible. Enveloped, dsDNA
• Pathogenesis: Lysis of infected epithelial cell,
fluid filled blister containing virions. Rupture of
these vesicles causes ulceration. Recurrent
symptoms supplied by nerve
• Epidemiology: Human is the only reservoirs,
through sexual intercourse or direct contact
• Prevention and treatment: Medication can only
prevent recurrence. No cure
 Papillomavirus (HPV)
Genital warts and cervical cancer
• Symptoms: Many have no symptoms, skin warts the most
common
• Incubations: Usually 3 months
• Causative agents: Human papillomaviruses, naked dsDNA,
different types infect different tissues
• Pathogenesis: Virus enter through damaged skin, infect
deep layer, establishes latency, cancer-associated viruses
• Epidemiology: Asymptomatic individuals can transmit the
disease, through sexual contact
• Prevention and treatment: Yearly Pap test is advised, warts
removal (Freezing or cauterization and laser therapy) does
not cure the infection
• Malignant lesions treated surgically
Papillomavirus (HPV)
Skin warts
Nervous System Infections
Asymmetric poliomyelitis
 Salk and Sabin vaccine
• Salk
The dead or inactivated vaccine has the advantage of a
long stability period and application safety. The
disadvantages of this vaccine form are its high cost, the
requirement for three injections .
• Sabin
The advantages of the live vaccine are its oral
application route, low price and high level of efficiency.
One disadvantage is presented by the (1 in 1 x 106)
cases of paralysis (vaccination-associated paralytic
poliomyelitis, VAPP) resulting from a vaccination.