VIROLOGY

Compiled by: Janine Teza S. Villena, RMT

3. Can cause congenital infection

DNA VIRUSES
• Generally classified as “double-stranded” (except for Parvovirus – SS-DNA) viii. Common infection among:
• Mnemonics: H-H-A-P-P-P-P-I 1. Food handlers
o H – hepadnavirus 2. School children
o H – herpesvirus 3. Prisoners
o A – adenovirus ix. Prevention:
o P – parvovirus 1. Proper sanitation
o P – papovavirus 2. Proper hygiene
o P – poxvirus x. Laboratory Diagnosis:
o I – iridovirus 1. May be detected in stool in 10-30 days after infection
2. Serological method (detection of):
1. HEPATITIS VIRUS a. Anti-HAV: total antibody to HAV
a. Currently 5 recognized hepatitis viruses: b. Anti-HAV (IgM-specific antibody): acute infection
i. HAV c. Anti-HAV IgG: past infection
ii. HBV xi. Remember!
iii. HCV 1. Self-limiting infection
iv. HDV 2. Incubation period: 15-40 days (average: 25 days)
v. HEV 3. Asymptomatic during the period of incubation (wherein 1% of
b. Generally, all hepatitis viruses are classified as RNA-containing viruses cases result in mortality)
(except: Hepadnavirus – which is the causative agent for Hepatitis B 4. Relapse is possible
infection and is a DNA virus)
d. HEPATITIS B VIRUS
c. HEPATITIS A VIRUS i. Partially Double-Stranded DNA virus (DsDNA) and particularly Single-
i. Single-stranded RNA Stranded DNA virus (SsDNA), circular with complex capsid
ii. Icosahedral symmetry ii. Dane Particle: whole viral particle, attributed to the complex
iii. Family: Picornaviridae double-shelled form which consists of:
iv. Gens: Enterovirus 1. HBsAg: outer lipid component
v. Acid stable 2. HBcAg: surrounds the genetic material
vi. Methods of decontamination: 3. HBeAg: component of the core antigen
1. Autoclaving for 30 minutes iii. Replication takes place in the LIVER and is shed into the
2. Boiling for 20 minutes bloodstream
3. Dry heat sterilization (1600C) for 1 hour iv. Known as “SERUM HEPATITIS” during WWII, however no longer valid
vii. Mode of Transmission because HBV can be isolated from:
1. Fecal-oral route 1. CSF
2. Ingestion of contaminated shellfish 2. Feces
3. Saliva

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Compiled by: Janine Teza S. Villena, RMT

4. Tears d. Disappears as the patient recovers

5. Urine e. Persists for 6 months
6. Semen f. May indicate Acute and Active states
v. Mode of Transmission: 2. Anti-HBs
1. Transfusion through contaminated blood/blood products a. Appears 2-6 weeks after HBsAg is gone
2. Accidental needle sticks b. Persists for life
3. Tattoos c. Indicates recovery or immunity after immunization
4. Piercing 3. Anti-HBcAg (IgM)
5. Contaminated razors a. Indicator of recent acute infection
6. Intravenous drug abuse b. Present in 6 months
7. Hemodialysis 4. Anti-HBcAg
8. Congenital transmission a. Appears before Anti-HBsAg is detected
vi. Individual with high risks of acquiring the HBV infection: b. Indicator of “core window phase”
1. Non-immunized health workers c. High levels may be observed during the onset of signs and
2. Crowded quarters symptoms and significantly drops after the incubation
3. Drug users stages
4. Institutionalized person (prisoners) d. Persist for 5-6 years
5. Frequent IV procedures e. Indicates current or previous infection but not associated
6. Homosexuals with recovery
vii. Prevention: 5. HBeAg
1. Screening of blood donors a. Present in acute and chronic hepatitis
2. Screening of blood units b. Marker of infectivity
3. Sterilization of dental and medical instruments c. Presence usually indicates chronic liver disease
4. Passive immunization through HBV vaccine (3 IM doses) 6. Anti-HBe
viii. Pathogenesis: a. Marker if immunity
1. Acquisition b. Associated with favorable outcome
2. Window period (6 weeks)
3. Incubation (50-180 days, average of 90 days) e. HEPATITIS C VIRUS
4. Initial signs: FEVER, RASH, ARTHRITIS i. Agent of NANB hepatitis
5. Jaundice may occur 4-6 weeks after initial signs occur ii. RNA-containing virus
6. Fulminant, Fatal, Chronic hepatitis are possible complications iii. Associated with viral family – “Flaviviridae”
of primary infection iv. First isolated in 1984
ix. HBV Markers: v. Related to as Non-A Non-B hepatitis
1. HBsAg vi. Most common cause of post transfusion hepatitis
a. Present at the onset of infection vii. Mode of Transmission:
b. First marker to appear 1. Non-parenteral route
c. Marker of acute infection 2. Contaminated blood products

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Compiled by: Janine Teza S. Villena, RMT

3. Organ transplantation 2. HERPESVIRUSES

4. Hemodialysis a. Family: Hepatoviridae
5. IV drug use b. Morphology:
viii. Laboratory Tests: i. Enveloped
1. Anti-HCV (immunochromatography) ii. Double-Stranded DNA virus
2. Anti-HCV (ELISA) iii. Icosahedral symmetry
3. ALT (elevation may not only indicate HCV infection) c. Causes latent viral infection which can be reactivated after years of
ix. Incubation: 2-26 weeks after exposure (average of 8 weeks) infection
x. Remember: Infection may be milder than HBV d. Reactivation is commonly observed among:
i. Immunosuppressed patients
f. HEPATITIS D VIRUS ii. Cancer patients (undergoing chemotherapy)
i. Also known as Delta Virus iii. Patients undergoing corticosteroid therapy
ii. Single-Stranded RNA virus iv. Individuals with underlying medical conditions
iii. Infective only in the presence of HBV infection e. Viruses:
iv. Mode of Transmission: Same with HBV i. Herpes Simplex Virus (HSV) 1
v. Serological Detection: 1. Common among childhood
1. HDV Ag 2. Most adult has antibody to this virus
2. Anti-HDV IgM 3. Mild infection and less resistant to treatment
3. Total Antibody detection 4. Infection is commonly seen in the upper part of the body
(above the waist)
g. HEPATITIS E VIRUS (HEV) 5. Disease Association:
i. Single-Stranded RNA virus a. Gingivostomatitis (accounts to 90% of HSV-1 infection)
ii. Enterically transmitted NANB hepatitis – found in contaminated b. Ulcerative mouth lesions
water in underdeveloped countries c. Fever blisters
iii. Endemic to places such as: 6. Primary lesions may be accompanied by fever, malaise,
1. Mexico cervical lymphadenopathy
2. Pakistan
3. India ii. Herpes Simplex Virus (HSV) 2
4. Indonesia 1. Attributed to 80-90% of all cases of genital herpes infection
iv. Resembles HAV 2. Mode of Transmission: Sexually transmitted (commonly)
v. No routine laboratory test is available, however: 3. Signs and Symptoms:
vi. Special Serologic Procedures are available such as: a. Fever
1. Westernblot b. Malaise
2. PCR c. Inguinal lymphadenopathy
3. Electron microscopy d. Infection is commonly seen in the lower part of the body
(below the waist)

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Compiled by: Janine Teza S. Villena, RMT

e. Primary lesions typically appear on the vagina, cervix, 1. Lesions appear on scalp and trunk (warm areas
glans penis, or penile shaft of the body)
4. A link between HSV-2 and Cervical Carcinoma has been 2. Lesions on arms and legs
established in some of the current researches 3. Vesicle with clear fluid
5. Neonatal HSV-2 Infection: Is acquired by the infant during 4. Pustule with purulent fluid
delivery from an actively infected mother (causes 5. Scab and crusting phase
developmental defects) 6. Contagious 24-48 hours before eruption of the
rash and remain infectious until all lesions have
Other Infections Caused by HERPESVIRUS: scabbed
▪ Herpetic keratitis viii. Reye’s Syndrome
▪ Herpetic Whitlow: Infects fingers (occupational hazard)
1. Caused by treatment with aspirin
▪ CNS Infections
▪ Co-infection of AIDS or immunocompromised patients 2. Common among children
Specimen: Lesion or Conjunctival Scrapings ix. Note: Primary Varicella is more serious in adults than in
Laboratory Tests: children
▪ Direct microscopy (Electron) b. Herpes Zoster
▪ Papanicolau smear i. Reactivation of VZV
▪ DFA
ii. Due to virus that remains latent in the dorsal root
▪ IFA
ganglia of peripheral or cranial nerves after the
▪ Immunoperoxidase
▪ Cell culture primary infection
Note:
▪ After 7 days, round syncytial giant cells are present c. Shingles
▪ Serological test is not recommended since uninfected individuals may i. Predominantly a disease of the elderly and
possess antibodies against HSV-1 and HSV-2 therefore infected and immunocompromised patients
uninfected individuals may not be differentiated
ii. Complications:
iii. Varicella Zoster Virus 1. Neuralgia
1. Agent of Varicella: Chickenpox, Herpes Zoster, Shingles 2. Keratitis
a. Chickenpox 3. Ophthalmia
i. Generally, a childhood infection (children: <10 years 4. Hearing loss
of age) 5. Facial paralysis
ii. Characterized by generalized skin rash with raised, 6. Aseptic meningitis
fluid filled lesions iii. Diagnosis:
iii. Mode of Transmission: Respiratory route 1. Based on Clinical Signs and Symptoms
iv. Incubation: 10-20 days 2. Vesicular lesions can be directly examined for
v. Signs and Symptoms: Fever, Rash, Headache the appearance of intranuclear inclusions and
vi. Rash: Resembles “dew drop on a rose petal” multinucleate giant cells
vii. Stages of lesion: 3. Cell culture and serological tests are also
available

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Compiled by: Janine Teza S. Villena, RMT

iv. Cytomegalovirus h. Prevention:

1. Subfamily: Betaherpesvirinae i. Screening of blood donors and organ donors
2. Other Name: “Salivary Gland Virus” ii. Seropositive products should not be transfused
3. Mode of Transmission: via
a. Saliva v. Epstein Barr Virus
b. Blood transfusion 1. Family: Gammaherpesvirinae
c. Through organ transplant 2. First to be isolated malignant Burkitt’s Lymphoma cells
4. Individuals that are >30 years of age are seropositive 3. Disease: Infectious Mononucleosis (IM)
5. Congenital CMV: 4. Mode of Transmission: Oral route
a. Primary infection during pregnancy if mother lacks the 5. Incubation Period: 1-2 months (disseminates in the RES: liver,
antibody to the virus spleen, lymph nodes)
b. Is also caused by latent viral reactivation 6. Recover: 2-3 weeks
c. May be transmitted through milk and during delivery 7. Signs and Symptoms:
d. Signs and Symptoms: a. Fever, sore throat, enlarged lymph nodes, enlarged tonsils
i. Developmental abnormalities b. Splenomegaly, hepatomegaly (increased liver enzymes)
ii. Mental retardation c. During Recovery: splenic rupture, hemolytic anemia,
iii. Deafness encephalitis and chronic EBV infection
iv. Jaundice d. Chronic fatigue syndrome accompanied by: fever and
v. Hepatosplenomegaly lymphadenopathy
vi. Microencephaly 8. Infectious Mononucleosis:
vii. Lung disease a. 50% lymphocytes appear as atypical lymphocytes
e. “40-Day Fever”: Infection manifests as pneumonia more b. Presence of heterophile antibody
than one month after the transplant i. Reacts with antigen of different species
f. Specimens: ii. May be present with:
i. Saliva 1. IM
ii. Urine 2. Forsmann antibody
iii. Tears 3. Serum sickness
iv. Feces iii. Agglutinates sheep and horse RBC
v. Milk iv. Guinea pig cells are used to adsorb human serum
vi. Semen (Used to remove Forsmann antibodies and Serum
g. Diagnosis: sickness antibodies)
i. Direct cytological examinations: characterized by
“Owl’s Eye”- Large basophilic staining inclusions within vi. Human Herpesvirus Type 6 (HHV-6)
nucleus 1. Family: Gammaherpesvirinae
ii. Cell culture 2. Other Name: Human Lymphotrophic Virus
iii. Fluorescent antibody stain a. Known to infect B cells
iv. ELISA and Latex agglutination b. First isolated in saliva and mononuclear cells of PBS in 1986

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Compiled by: Janine Teza S. Villena, RMT

c. Mode of Transmission: Respiratory route iii. Icosahedral symmetry

3. Agent of Exanthem Subitum (Ruseola) iv. Causes infections to animals
a. 6th disease v. Parvovirus B-19:
b. Benign childhood disease frequently seen in children 6 1. Known to cause human infection
months to 3 years 2. Agent of Erythema infectiosum
c. Signs and Symptoms: 3. 5th disease (after: Measle, Rubella, Varicella Zoster and Ruseola)
i. Sore throat and high fever that persist for 3-5 days 4. Mode of Transmission: Respiratory route
ii. Presence of maculopapular rash in neck and trunk 5. Signs and Symptoms:
develops within 24-48 hours after fever subsides a. Fever
iii. NOTE: rarely causes infection among adults b. Rash (Slapped-Cheek appearance)
c. Mild anemia
3. PAPOVAVIRUSES d. Chronic anemia
a. Family: Papoviridae
b. Morphology: 5. POXVIRUSES
i. Double-Stranded a. Enveloped
ii. Icosahedral symmetry b. With complex coats
iii. Non-enveloped c. Variola: (Chinese: variolation – inhalation of crust lesions to produce
iv. Size: 45-55 nm antibodies)
v. Members: i. Agent of small pox, vaccinia virus and cowpox
1. Papillomavirus ii. Small-pox: a historical disease
2. Polyomavirus 1. Mode of Transmission: Respiratory contact and multiplication on
3. Simian vacuolating virus lymph nodes
vi. Human Papillomavirus (HPV) 2. Viremic Phase: Dissemination to various organs
1. Causes variety of cutaneous lesions 3. Pox lesion develops after viremic phase
2. Benign growths 4. Edward Jenner:
a. Plantar warts a. Developed the world’s first vaccine
b. Common warts b. Coming from the Greek word: “Vacca” – which means cow
c. Venereal warts c. Developed the vaccine from cowpox infection
3. Signs and Symptoms: 5. In 1979: WHO declared that the world was free of smallpox
a. Genital infections may be associated with neoplastic lesions
b. Cervical carcinoma
4. Mode of Transmission:
a. Respiratory secretion References:
b. Sexual contact
• Forbes, B. A., et. al., Bailey and Scott’s Diagnostic Microbiology, 12 th ed.,
2007
4. PARVOVIRUS
• Joel D. Hubbard, A Concise Review of Clinical Laboratory Science, 2nd ed.,
a. Morphology: 2010
i. Single-Stranded • Mahon, C. R., et. Al., Textbook of Diagnostic Microbiology, 5 th ed., 2011
ii. Non-enveloped