09/02/2022

Study of Viruses
ARJIM G. LUNA | DEPARTMENT OF PHARMACY | COLLEGE OF ALLIED HEALTH
NATIONAL UNIVERSITY MANILA

What’s on the Menu:

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Introduction to

Study of

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- Obligate intracellular parasites with both living and nonliving characteristics

Living Characteristics Nonliving Characteristic

• Can reproduce • Acellular
(but only in living host cells)
• Can mutate • No organelles
• No metabolism on their own
• Possess either DNA or RNA

HOST AFFINITY HOST RANGE

- Plants
- Bacteria
- Animals

Specific: General:
Host Bacteriophage
Cell type Viroid

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SPECIMEN FOR CULTIVATION

CULTIVATION Animal inoculation
depends on viral disease Chicken egg culture
Example: CSF for diagnosis of Cell/Tissue culture
CNS viral infections

CULTIVATION
Animal inoculation:
• Mouse
• Rabbits
• Hamsters
• Newborn or suckling rodents

• Routes of Inoculation:
• Intracerebral
• Subcutaneous
• Intraperitoneal
• Intranasal

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CULTIVATION
Chicken egg culture:
• First used by Goodpasture (1931)
• Developed by Burnet
• _____ days old chick eggs

• Routes of Inoculation:
• Chorioallantoic membrane (CAM)
• Yolk sac
• Amniotic cavity
• Allantoic cavity

CULTIVATION
Cell/Tissue culture:

• Types:
• Primary cell culture
• normal cells from the original tissues
that have not been subcultured
• Diploid cell strains
• single cell type that retains their
original diploid chromosome number
and karyotype
• Continuous cell lines
• from cancerous tissue and are
capable of continuous serial
cultivation indefinitely without
senescing

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• Cell culture
• Microscopic techniques
• Electron Microscopy
• Viral antigen detection
• Fluorescent antibody staining
• Immunoperoxidase antibody
staining
• Enzyme immunoassay
• Viral nucleic acid
• Polymerase chain reaction
• Other nucleic acid amplification
methods
• Cytology
• Histology
• Immunohistochemistry
• In situ hybridization
• Serology

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• Cell culture • gold-standard approach to the diagnosis of viruses that can be cultured
• Microscopic techniques in a medium
• Electron Microscopy
• Viral antigen detection • Cell Culture Types:
• Fluorescent antibody staining • Monkey Kidney Cell Line - Respiratory and enteroviruses
• Immunoperoxidase antibody • Human Fibroblast Line - CMV, VZV, rhinoviruses
staining • Continuous Human Epithelial Cell Line (HEp-2) - RXV
• Enzyme immunoassay
• Viral growth can be identified by observing:
• Viral nucleic acid
• Cytopathic effect (CPE): characteristic cellular change due to viral
• Polymerase chain reaction
growth
• Other nucleic acid amplification
• Hemadsorption: the envelope protein haemagglutinin (HA) causes
methods
added red blood cells to attach to the viral infected cell. Examples
• Cytology
include influenza and mumps virus.
• Histology
• Viral antibody: a positive response to the addition of viral antibody is
• Immunohistochemistry
detected by a range of methods, including ELISA and
• In situ hybridization
immunofluorescence
• Serology

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• Cell culture • Methods:

• Microscopic techniques • Light microscopy - detects inclusion within the infected cell. Some
• Electron Microscopy have a characteristic appearance such as Negri bodies with rabies
• Viral antigen detection infection
• Fluorescent antibody staining
• Immunoperoxidase antibody
staining
• Enzyme immunoassay
• Viral nucleic acid
• Polymerase chain reaction • Electron microscopy - detects viruses and viral particles
• Other nucleic acid amplification
methods
• Cytology
• Histology
• Immunohistochemistry
• In situ hybridization
• Serology

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• Cell culture • Methods:

• Microscopic techniques
• Electron Microscopy
• Viral antigen detection
• Fluorescent antibody staining
• Immunoperoxidase antibody
staining
• Enzyme immunoassay
• Viral nucleic acid
• Polymerase chain reaction
• Other nucleic acid amplification
methods
• Cytology
• Histology
• Immunohistochemistry
• In situ hybridization
• Serology
• Fluorescent antibody staining
• Immunoperoxidase antibody staining
• Enzyme immunoassay
• Fluorescent antibody staining
• Used primarily on biological samples to detect antigens in
cellular contexts using antibodies
• Fluorescence dyes
• illuminates in UV light,
used to detect the specific
combination of an antigen
and antibody
• Example: fluorescein
isothiocynate

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• Cell culture • Immunoperoxidase antibody

• Microscopic techniques staining
• Electron Microscopy • Immunostain
• Viral antigen detection • Includes
• Fluorescent antibody staining immunohistochemical
• Immunoperoxidase antibody or immunocytochemical
staining procedures in which the
• Enzyme immunoassay antibodies are visualized
• Viral nucleic acid via a peroxidase-
• Polymerase chain reaction catalyzed reaction
• Other nucleic acid amplification • used to stain viral
methods antigens or specific
• Cytology targets in clinical
• Histology pathological tissues
• Immunohistochemistry
• In situ hybridization
• Serology

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• Cell culture • Enzyme immunoassay

• Microscopic techniques • ELISA
• Electron Microscopy • conceptualized and developed by Peter Perlmann and Eva Engvall at
• Viral antigen detection Stockholm University, Sweden
• Fluorescent antibody staining • involves at least two antibodies that can specifically and independently
• Immunoperoxidase antibody bind to a viral antigen for detection
staining • used to measure the concentration of antibodies or antigens in
• Enzyme immunoassay blood
• Viral nucleic acid • typically performed in 96-well polystyrene plates
• Polymerase chain reaction
• Other nucleic acid amplification
methods
• Cytology
• Histology
• Immunohistochemistry
• In situ hybridization
• Serology

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• Cell culture • Enzyme immunoassay

• Microscopic techniques
• Electron Microscopy
• Viral antigen detection
• Fluorescent antibody staining
• Immunoperoxidase antibody
staining
• Enzyme immunoassay
• Viral nucleic acid
• Polymerase chain reaction
• Other nucleic acid amplification
methods
• Cytology
• Histology
• Immunohistochemistry
• In situ hybridization
• Serology
• Steps:
• Serum is incubated in a well (each well contains a different serum)
• Antibodies or antigens present in serum are captured by
corresponding antigen or antibody-coated onto the solid surface.
• The plate is washed to remove serum and unbound antibodies or
antigens.
• Secondary antibodies (peroxidase or alkaline phosphatase) that
are attached to an enzyme are added to each well.
• After an incubation period, the unbound secondary antibodies are
washed off.
• When a suitable substrate is added, the enzyme reacts with it to
produce a color.
• The intensity of the color gives an indication of the amount of
antigen or antibody.

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• Cell culture
• Microscopic techniques
• Electron Microscopy
• Viral antigen detection
• Fluorescent antibody staining
• Immunoperoxidase antibody
staining
• Enzyme immunoassay
• Viral nucleic acid
• Polymerase chain reaction
• Other nucleic acid amplification
methods
• Cytology
• Histology
• Immunohistochemistry
• In situ hybridization
• Serology

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• Cell culture • PCR

• Microscopic techniques • an enzymatic process in which a specific region of DNA is
• Electron Microscopy replicated over and over again to yield many copies of a particular
• Viral antigen detection sequence
• Fluorescent antibody staining
• Immunoperoxidase antibody
staining
• Enzyme immunoassay
• Viral nucleic acid
• Polymerase chain reaction
• Other nucleic acid amplification
methods
• Cytology
• Histology
• Immunohistochemistry
• In situ hybridization
• Serology

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• Types of PCR • Repetitive sequence-based PCR

• Real-time PCR • Overlap extension PCR
• Quantitative real time PCR (Q-RT • Assemble PCR
PCR) • Intersequence-specific
• Reverse Transcriptase PCR (RT- PCR(ISSR)
PCR) • Ligation-mediated PCR
• Multiplex PCR • Methylation –specifin PCR
• Nested PCR • Miniprimer PCR
• Long-range PCR • Solid phase PCR
• Single-cell PCR • Touch down PCR
• Fast-cycling PCR
• Methylation-specific PCR (MSP)
• Hot start PCR
• High-fidelity PCR
• In situ PCR
• Variable Number of Tandem
Repeats (VNTR) PCR
• Asymmetric PCR

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General

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• Size
• 10-400 nm

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NUCLEIC ACID
• Classifications:
• DNA viruses
• RNA viruses
• Shape:
• Circular
• Linear
• Strands:
• ss
• ds
• + or – (if RNA)

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CAPSID
• Functions:
• protein coat for protection
• aids in host cell invasion
• Uncoated for replication
• Accounts for most of the mass of a virus
• Structure:
• Protein coat
• ______________ – protein subunits of capsid
• ______________ – nucleic acid + capsid

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CAPSID
• Capsomeres Arrangements:
• ______________
• resembles long rods that may be rigid or flexible
• nucleic acid is found within a hollow, cylindrical capsid that has a helical structure
• ______________
• 20 triangular faces and 12 corners, polyhedral
• Capsomeres of each face form an equilateral triangle
• ______________
• bacteriophage

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ENVELOPE
• Lipid bilayer membrane
• Phospholipid
• Proteins
• Glycoprotein spikes (+/-)
• Surrounds the capsid
• Classifications:
• Naked (nonenveloped)
• Enveloped

__________ – either naked or enveloped

__________ - enveloped

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ENVELOPE
• Glycoprotein spikes (+/-)

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Viral Replication

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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• Phases
• Extracellular
• Intracellular

• Stages:
• Attachment
• Penetration
• Direct Penetration
• Membrane fusion
• Endocytosis
• Uncoating
• Synthesis
• Assembly
• Release

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Viral Exocytosis

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- Groupings into families, subgroups, and genera:

- -viridae : family
- -virinae : subgroup
- -virus : genus
- Example:
- Parvoviridae (family)
- Parvovirinae (subgroup)
- Parvovirus (genus)
- Erythrovirus (genus)

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- Groupings into families:

- Nucleic acid
- ds or ss RNA
- ds or ss DNA
- atypical viruses
- Morphology of virion
- Principle of viral replication

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Atypical

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1. VIROIDS
• are infectious agents that consist only of ____ (circular without a protein coat or enveloped)

• causes plant diseases: potato spindle-tuber disease, exocortis disease of citrus trees, and
chrysanthemum stunt disease
• Examples: potato spindle tuber viroid, hop stunt viroid, coconut cadang-cadang viroid, apple
scar skin viroid, avocado sun-blotch viroid, peach latent mosaic viroid

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2. PRIONS
• Infectious proteins that cause a group of
universally fatal neurodegenerative disease
• was coined by Stanley B. Prusiner in 1982

• Prion diseases in animals:

• ______________ – sheep, mice, hamster
• Bovine spongiform encephalopathy (BSE) - mad cow disease, cattle
• Transmissible mink encephalopathy
• Chronic wasting disease (CWD) of deer, mule, and elk

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2. PRIONS
• Prion diseases in humans:
• ______________ – among people from New Guinea who practiced a form of cannibalism
• Creutzfeldt-Jacob disease (CJD) - a degenerative brain disorder that leads to dementia
and, ultimately, death. Sporadically, caused by the spontaneous transformation of normal
prion proteins into abnormal prions
• Variant Creutzfeldt-Jacob disease (vCJD) - eating beef and beef products contaminated
with the infectious agent of BSE
• Gerstmann-Straussler-Scheinker (GSS) syndrome - mutations in the PRNP gene
• Fatal familial insomnia (FFI) - affects the thalamus, the part of the brain that controls the
sleep-wake cycle
• Sporadic fatal insomnia (SFI) - occurs when a person experiences prion protein
abnormalities associated with FFI, even though they lack the genetic mutation found in
people with that disorder

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DNA

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General Characteristics:
• Double Stranded, except ______________
• Icosahedral size, except ______________
• Replicate in nucleus except ______________
• All are enveloped except PAP (Papova, Adeno, Parvo)

Families:
• Adenoviridae
• Hepadnaviridae
• Herpesviridae
• Papoviridae
• Parvoviridae
• Poxviridae

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• Linear ds DNA
• Icosahedral, Nonenveloped
• Replicates in the nucleus
• Transmission:
• close personal contact, such as touching or
shaking hands
• the air by coughing and sneezing
• touching an object or surface with
adenoviruses on it, then touching your
mouth, nose, or eyes before washing your
hands

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• CM:
• Respiratory:
• Common cold or flu-like symptoms
• Sore throat
• Acute bronchitis
• Pneumonia
• Eye:
• Pink eye (______________)
• Gastrointestinal
• Acute gastroenteritis
• Vaccine: Adenovirus vaccine is for the U.S.
military only
• Treatment: symptomatic

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• Nomenclature:
• Enveloped, spherical
• Icosahedral, ds DNA
• Genus Orthohepadnavirus
• Hepatitis B virus (HBV) – humans, chimps,
gibbons, wooly monkeys
• Ground Squirrel Hepatitis B - ground
squirrels, woodchucks, chipmunks
• Woodchuck Hepatitis B – woodchucks
• Genus Avihepadnavirus
• Duck Hepatitis B - ducks, geese
• Heron Hepatitis B - herons

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• Hepatitis B
• Transmission: blood, semen, or other body fluids
• S/Sx: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-
colored stool, joint pain, and jaundice.
• Treatment: tenofovir, entecavir
• Vaccine: Single-antigen hepatitis B vaccine, Combination vaccines (Pediatrix® - heap B +
DTaP + IPV)
• Serology:
• HBsAg -
• Anti-HBsAg - immunity
• IgM anti-HBcAg -
• IgG anti-HBcAg -
• HBeAg -
• Anti-HBeAg -

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• 150-200 nm diameter
• Linera, ds DNA
• Icosahedral, enveloped
• Asymmetrical tegument between
capsid and envelope
• Glycoprotein spikes
• 8 human serotypes
• Latent, recurring infections
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HERPESVIRIDAE SUBGROUPS:
• Alphaherpesvirinae
o Herpes Simples Virus type 1 - ___________
o Herpes Simples Virus type 2 - ___________
o Varicella-zoster Virus - ___________
• Betaherpesvirinae
o Cytomegalovirus - ___________
o Human Herpesvirus type 6 - ___________
o Human Herpesvirus type 7 - ___________
• Gammaherpesvirinae
o Epstein-Barr Virus - ___________
o Human Herpesvirus type 8 - ___________
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HSV-1 HSV-2
• Gingivostomatitis • Genital Herpes
• Acute necrotizing encephalitis • Considered STD
• Encephalitis • Eruption last 14 days
• Herpetic keratitis of the eye (retinitus) • Neonatal Herpes
• Transmission: Oral contact • Transmission: Sexual contact
• DOC: ___________ • DOC: Acyclovir

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HSV-1

Infection/Disease CA S/Sx Transmission DOC

Herpetic recurrent pharyngitis, stomatitis Oral contact Acyclovir
HSV-1
Gingivostomatitis
Herpetic Keratitis scars, damage, blindness Oral contact Acyclovir
HSV-1
(Retinitus)
Eczema herpeticum people with eczema, infection of damaged Oral contact Acyclovir
HSV-1
skin

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HSV-2

Infection/Disease CA Notes Transmission DOC

Genital Herpes primary asymptomatic or with fever, Sexual contact Acyclovir
HSV-2
lymphadenitis
HSV Proctitis HSV-2 among homosexual men Sexual contact Acyclovir
Meningitis HSV-2 complication of genital infection Acyclovir
Encephalitis acute febrile disease – destruction of Acyclovir
HSV-2
temporal lobe
Neonatal Herpes HSV-2 lethal, absence of cell mediated immunity Mother→ baby Acyclovir

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• Varicella
• Aka ___________
• Primary infection
• 21-day incubation
• S/Sx: itchy vesicular rash, fever, tiredness,
headache
• itchy, fluid-filled blisters → scabs
• Transmission: Direct or droplet
• Treatment: Acyclovir
• Supportive: Calamine lotion, cool bath,
trim fingernails
• Severe complications in adults, perinatal, or
immunocompromised individuals

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• Zoster
• Aka ___________
• Reactivation of VZV
• Associated with immunosuppression
• S/Sx: painful rash occurs in a single stripe
around either the left or the right side of the
body
• Shingles on the face can affect the eye
and cause vision loss
• Treatment: Acyclovir
• Supportive: Calamine lotion, cool bath,
trim fingernails

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• CMV or HHV-5
• most common congenital infection
• Direct contact, blood, saliva, urine, tears,
mucus
• Congenital Diseases
• Infant
• Causes birth defects and
developmental disabilities
• Immunosuppressed
• Retinitis
• Enteritis
• Transmission: congenital, oral, sexual,
blood derivates, transplantation grafts
• Treatment: Ganciclovir

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Human B Lymphotrophic virus (HV-6) • Cryptic Infection of Helper T cells

• ___________ – Sixth disease • HV-7
• Lymphoproliferative • Fatal encephalitis

• Karposi’s Sarcoma
• HV-8
• tumor in AIDS patients

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First Disease Rubeola Measles Virus

Second Disease Scarlet Fever S. pyogenes
Third Disease Rubella Rubella Virus
Fourth Disease Filatow-Duke's Disease S. aureus
Fifth Disease Erythema infectiosum Parvovirus B19
Sixth Disease Roseola Herpes Virus 6B or 7

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EBV or HHV-4
• Burkitt’s Lymphoma – cancer starts with highly-aggressive, fast-growing B-cells,
associated with impaired immunity and is rapidly fatal if left untreated
• Kissing Disease – aka infectious mononucleosis or ___________
• Transmission:
• Typical: saliva, sharing food or drinks
• Other: blood and semen during sexual contact, blood transfusions, and organ
transplantations
• S/Sx: Fatigue, sore throat, perhaps misdiagnosed as strep throat, that doesn't get better
after treatment with antibiotics, Fever, Swollen lymph nodes in your neck and armpits,
Swollen tonsils, Headache, Skin rash, Soft, swollen spleen

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• Naked icosahedral
• dsDNA circular
• Replicates in the nucleus

• Papilloma virus - ___________

• Polyomavirus – ___________
• Vacuolating virus – vacuoles (open areas) in cells of
monkey

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• Second smallest DNA virus

• CM: Papillomas - thickening of the
epidermis
• Common Warts
• Genital Warts
• CA: HPV genotypes 1 to 46
• Transmission: direct contact,
sexual contact
• Treatment: surgical therapy
(excision, curettage, laser),
application of caustic agents,
cryotherapy, interferon

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• CM: Cervical carcinoma

• CA: 95% of cases caused by HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 68, and 59
• Vaccination: HPV types 16 and 18
• S/Sx:
• Early stage:
• irregular blood spotting or light bleeding between periods
• postmenopausal spotting or bleeding;
• bleeding after sexual intercourse; and
• increased vaginal discharge, sometimes foul smelling
• Severe stage:
• persistent back, leg or pelvic pain;
• weight loss, fatigue, loss of appetite;
• foul-smell discharge and vaginal discomfort; and
• swelling of a leg or both lower extremities

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• ss DNA (+ or -)
• Icosahedron, Nonenveloped
• Replicates in the nucleus
• Smallest DNA virus
• Subtypes:
• ___________
• Infects insect
• ___________
• Infects humans and animals
• ___________
• Depends on other viruses to replicate

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• Parvovirus B19 virus

• Infects only humans
• CM: Erythema Infectiosum
• Aka: slap cheek appearance or ___________
• S/Sx: mild rash illness that usually affects children, fever, runny nose, headache

• CM: Septic arthritis

• Most common cause of viral arthritis
• S/Sx: painful or swollen joints (polyarthropathy syndrome), which is more common in
adults, and severe anemia

• Transmission: respiratory secretions (saliva, sputum, or nasal mucus), blood or blood

products, transplacental,
• Treatment: Symptomatic

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• Largest of all viruses

• Linear ds DNA
• Enveloped, brick-shaped
• Replicates in the cytoplasm

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Genus Virus Primary Hosts Clinical Manifestations in Humans

Orthopoxvirus Variola Man Smallpox
Vaccinia Man Vesicular vaccination lession
Cowpox Cattle, cats, rodents Lesions on hands
Monkeypox Monkey, squirrels Resembles smallpox
Parapox Pseudopox Cattle Localized nodular lesions (milkers’ nodes)
Yatapox Orf Sheep, goats Localized vesiculo. Granulomatous lesions
Tanpox Monkeys Vesicular skin lesions and febrile illness
Human infections very rare and accidental;
Yabapox Monkeys
localized skin tumors
Molluscipoxvirus Molluscum
Man Multiple small skin nodules
contagiousum

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• CM: Smallpox
• Transmission: respiratory droplets,
contact with the virus on fomites
• Clinical Varieties:
• Variola Major – classical smallpox,
complicated, highly fatal disease
typically seen in Asia
• Variola Minor – alastrim, mild,
nonfatal disease typically seen in
Latin America
• Vaccine: attenuated vaccinia virus Two Smallpox Patients From 1901 Show Us Why We Should Get
Vaccinated
• last naturally occurring case in the
world was in Somalia in 1977

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• CM: Vaccinia
• Hybrid of variola and cowpox
• directly responsible for the successful
eradication of smallpox (variola)

• Smallpox vaccines:
• ACAM2000® and JYNNEOSTM – only two
licensed smallpox vaccines in the US
• Aventis Pasteur Smallpox Vaccine
(APSV) - an investigational vaccine that
may be used in a smallpox emergency
under the appropriate regulatory
mechanism

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• CM: Cowpox
• Zoonosis
• Transmission: lesions are seen on the udder and
teats of cows and may be transmitted to humans
during milking

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• CM: Monkeypox
• First human case: 1970,
Democratic Republic of Congo
• Zoonosis
• S/Sx: similar to but milder than the
symptoms of smallpox
• Transmission: seen mainly in
children who may acquire it from
playing with captive animals
• Main Reservoir: Squirrels

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• CM: Orf (contagious pustular dermatitis or sore

Mouth)
• Zoonosis, sheep and goats
• S/Sx: single papulovesicular lesion with a central
ulcer usually on the hand, forearm, or face
• Transmission: contact with contaminated animal
(sheep/goat handlers)

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• CM: Molluscum contagiosum

• S/Sx: a benign, mild skin disease
characterized by lesions (growths) that
may appear anywhere on the body
• Transmission: person to person direct
contact, fomites
• Treatment: Podophyllotoxin cream
(0.5%)

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RNA

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General Characteristics:
o All RNA viruses are single stranded except
___________ (+)Sense (-)Sense
o Most are enveloped, except Picornavirus, - Picornavirus - Rhabdovirus
Reovirus, Calicivirus - Calicivirus - Paramyxovirus
o Most RNA viruses replicate in cytoplasm, except - Togavirus - Orthomyxovirus
Retrovirus, Orthomyxovirus - Flavivirus - Bunyavirus
o All are helical except (+) sense RNA virus - Coronavirus - Arenavirus
o All are non-segmented except BORA (Bunya, - Reovirus - Filovirus
Orthomyxo, Reo, Arena)
o ___________ – bullet shaped

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• ssRNA, (-) sense, segmented, enveloped

• Infects rodents and occasionally humans
Virus Arenavirus Group CM Reservoir/Host Distribution
Lymphocytic Lymphocytic House mouse
Old World Worldwide
choriomeningitis virus choriomeningitis (Mus musculus)
Junin virus Argentinian Drylands Vesper Mouse
New World Argentina
Hemorrhagic Fever (Calomys musculinus)
Machupo virus Bolivia Hemorrhagic Large Vesper Mouse
New World Bolivia
Fever (Calomys callosus)
Guanarito virus Venezuelan Short-tailed Cane Mouse
New World Venezuela
Hemorrhagic Fever (Zygodontomys brevicauda)
Lassa virus Natal Multimammate Mouse
Old World Lassa Fever West Africa
(Mastomys natalensis)

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• LCMV
• The first arenavirus identified (1933)
• CM: Lymphocytic Choriomeningitis (LCM)
• Primary Host: House mouse (Mus musculus)
• Transmission: exposure to fresh urine,
droppings, saliva, or nesting materials from
infected rodents (broken skin, nose, mouth,
eyes, bite of infected rodent)
• S/Sx: Neurological: meningitis, encephalitis
(drowsiness, confusion, sensory disturbances,
and/or motor abnormalities, such as paralysis),
or meningoencephalitis
• Treatment: Ribavirin (not yet proven for human
LCM)

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• CM: Hemorrhagic Fever and Lassa

fever
• Transmission: contact with feces/urine
from infected rodents or with
contaminated dust
• S/Sx: fever, headache, dizziness,
asthenia, sore throat, pharyngitis,
cough, retrosternal and abdominal pain,
and vomiting
• Severe: facial edema is associated
with hemorrhagic conjunctivitis,
moderate bleedings (nose, gums,
vagina), and exanthema
• Treatment: Ribavirin

95

• (+) ssRNA, non-segmented, naked, icosahedral

• Clinically Important: ___________ or Norwalk virus
• Aka: winter vomiting bug
• CM: Acute gastroenteritis
• S/Sx: vomiting, nausea, diarrhea, stomach
pain, fever, headache, body aches
• Transmission: direct contact (person to
person), ingestion of contaminated food,
touching a contaminated surface
• Treatment: rehydration, symptomatic

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• (+) ssRNA, enveloped, spherical,

helical, replicates in cytoplasm

• Structural Proteins:
• Spike (S) – large protein projection, aka
peplomers, mediates receptor binding
• Membrane (M) - triple-spanning
transmembrane protein, assists viral
assembly
• Nucleocapsid (N) - regulation of viral RNA
synthesis
• Small Envelope Protein (E) - function
necessary but not fully understood
• Hemagglutinin (HE) - esterase
glycoprotein; enhances uptake into
mucosal cells

97

• Clinically important viruses:

• SARS-CoV-1
• SARS-CoV-2
• MERS-CoV

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• CM: Middle East respiratory syndrome (MERS)

• 1st report: Saudi Arabia, 2012
• 1st case: Jordan, 2012
• History of traveling to Arabian Peninsula
• Philippines – 2 cases
• S/Sx: fever, cough, shortness of breath, diarrhea
and nausea/vomiting, pneumonia and kidney
failure
• Transmission: respiratory secretions
• Treatment: no specific antiviral treatment

99

• CM: Severe acute respiratory syndrome (SARS)

• 1st outbreak: Guangdong, China
• 2002-2004 outbreak
• Philippines: 16 cases ( 2 deaths)
• S/Sx: high fever, chills, headache, general
feeling of discomfort, body aches, respiratory
symptoms, diarrhea, dry, nonproductive cough,
hypoxia, pneumonia
• Transmission: respiratory secretions
• Treatment: no specific antiviral treatment

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101

• CM: COVID-19
• Emerge from Hubei Province, China
• December 2019

• Origin:
• Bat → mammal → human
• Pangolins used in Chinese medicine
• Probable link to seafood/exotic animal
market
• Other plausible theory:
• Wuhan Level 4 Biohazard lab
experimental animals sold for human
consumption

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• CM: COVID-19
• Transmission:
• Respiratory droplets
• Hand to mucus membranes
• Solid surfaces (viable for 3 days)

103

• CM: COVID-19
• Symptoms:
• Week 1: Fever (77-98%) (intermittent or persistent), Fatigue/Malaise (11-52%), Dry
cough (46-82%), dyspnea (3-31%);
• Less common: Sputum (33%), Myalgia (15%), Headache (13%), Sore throat
(14%), Diarrhea (4%), Nausea/Vomiting (5%), Nasal congestion (4%),
Hemoptysis (1%)
• Week 2 (~ day 6-9 of symptoms): ~ 15-20% develop severe dyspnea due to viral
pneumonia
• Hospitalization, supportive care, oxygen
• Week 2-3: Of hospitalized patients, 1/3 ultimately need ICU care, with up to half
needing intubation (i.e., ~5% of total diagnosed cases need ICU)
• Can rapidly decline (over 12-24 hrs) from mild hypoxia to frank ARDS
• Cytokine Storm, Multi-organ failure
• Late-stage sudden cardiomyopathy/viral myocarditis, cardiac shock

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• CM: COVID-19
• Comorbidities and Risk Conditions:
• Age
• HTN
• Diabetes
• Coronary Heart Disease
• Hep B
• Cerebrovascular Disease
• COPD
• Cancer

105

• CM: COVID-19
• Vaccines:

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• CM: COVID-19
• Variants:

107

• (-) ssRNA, enveloped, helical

• Causes severe hemorrhagic fever (HF) in humans
• Ebolavirus
• Ebola HF

• Marburgvirus
• Marburg HF

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• Marburgvirus (MV)
• 1967 - first discovered filovirus, lab workers in
Marburg, Germany, and Yugoslavia (now
Serbia) (tissues from green monkeys)
• CM: Marburgvirus Disease (MVD)
• S/Sx: Onset: fever, chills, headache, and
myalgia
• Day 5: maculopapular rash, nausea,
vomiting, chest pain, and diarrhea
• Progression: jaundice, inflammation of
the pancreas, severe weight loss,
delirium, shock, liver failure, massive
hemorrhaging, and multi-organ
dysfunction

109

• Marburgvirus (MV)
• CM: Marburgvirus Disease (MVD)
• Transmission: animal to person, contact
with infected bat feces or aerosols, person
to person (body fluids)
• Treatment: supportive treatment

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• Ebolavirus (EV)
• 1976 – two consecutive outbreaks of fatal
hemorrhagic fever occurred in different parts of
Central Africa (Ebola river and South Sudan)
• Ebolavirus species in humans:
• Zaire ebolavirus (Ebola virus, EBOV)
• Sudan ebolavirus (Sudan virus, SUDV)
• Tai Forest ebolavirus (Tai Forest virus, TAFV)
• Bundibugyo ebolavirus (Bundibugyo virus,
BDBV)

111

• CM: Ebolavirus Disease (EVD)

• S/Sx:
• Dry symptoms: fever, aches and pains, and fatigue
• Wet symptoms: gastrointestinal symptoms including abdominal pain, diarrhea, and
vomiting
• Unexplained hemorrhaging, bleeding or bruising
• Transmission: contact with an infected animal (fruit bat, nonhuman primate) → person to
person (body fluids)
• Treatment:
• ___________ (atoltivimab, maftivimab, and odesivimab-ebgn)
• ___________ (Ansuvimab-zykl)
• Vaccine: Ebola vaccine rVSV-ZEBOV (Ervebo®)

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• (+) ssRNA, enveloped, icosahedral

• Replicates in cytoplasm
• primarily spread through arthropod vectors (ticks and mosquitoes)
• Clinically important genera:
Genus Host Transmission Species
Flavivirus Humans; mammals; Zoonosis; arthropod Dengue virus, Japanese encephalitis virus,
mosquitoes; ticks bite Yellow fever virus, Zika virus
Hepacivirus Humans Sex; blood Hepacivirus C (Hepatitis C virus)

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• CM: Dengue Fever or Dengue Hemorrhagic Fever

• Transmission: bite of infected Aedes aegypti, Ae. Albopictus; pregnant mother to fetus,
breast milk (1 case)

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• CM: Dengue Fever or Dengue Hemorrhagic Fever

• Phases:
• Febrile Phase:
• 2-7 days
• Mild hemorrhagic manifestations (petechiae) and mucosal membrane bleeding (e.g
nose and gums)
• Monitoring of warning signs is crucial to recognize its progression to the critical
phase.
• Critical Phase:
• 3-7 days (patient can either improve or deteriorate)
• Recovery Phase:
• Next 48-72 hours, body fluids go back to normal

117

• CM: Dengue Fever or Dengue Hemorrhagic Fever

• Diagnosis:
• Dengue NS1 RDT: detect virus antigen
• Dengue IgM/IgG: detect antibodies
• PCR
• DOH Strategy: 4S
• S - earch and Destroy
• S - eek Early Consultation
• S - elf Protection Measures
• S - ay yes to fogging only during outbreaks
• Vaccine: dengue vaccine for 9-16 y/o

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• 1947 - first isolation of ZIKV in rhesus monkeys in the Zika

forest in Uganda.
• 1952 - first isolation of ZIKV in humans in Uganda and
Tanzania.
• Vector: Aedes aegypti and Ae. Albopictus
• Transmission:
• Bites of mosquito, from a pregnant woman to her fetus,
sex, blood transfusion
• S/Sx: fever, rash, headache, joint pain, red eyes, muscle pain
• Complications:
• Pregnancy – microcephaly, birth defects, miscarriage,
stillbirths
• Guillain-Barré syndrome (GBS) - person’s own immune
system damages the nerve cells, causing muscle
weakness, and sometimes, paralysis

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• leading cause of vaccine-preventable

encephalitis in Asia and the western
Pacific
• Vector: Culex tritaeniorhynchus
• S/Sx: headache, high fever,
disorientation, coma, tremors, and
convulsions
• Treatment: symptomatic
• Vaccine: Inactivated Vero cell culture-
derived Japanese encephalitis (JE)
vaccine (IXIARO)

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• CM: Yellow Fever

• Demographic: tropical and
subtropical areas of Africa and
South America
• Transmission: bite of infected
Aedes or Haemagogus species
mosquitoes
• S/Sx: fever with aches and
pains to severe liver disease
with bleeding and yellowing
skin (jaundice)
• Treatment: supportive
• Vaccine: live, weakened
yellow fever virus

121

• (+) ssRNA, enveloped, icosahedral

• Replicates in cytoplasm
• primarily spread through arthropod vectors (ticks and mosquitoes)
• Clinically important genera:
Genus Host Transmission Species
Flavivirus Humans; mammals; Zoonosis; arthropod Dengue virus, Japanese encephalitis virus,
mosquitoes; ticks bite Yellow fever virus
Hepacivirus Humans Sex; blood Hepacivirus C (Hepatitis C virus)

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• Linear, segmented, ssRNA, enevloped

• Enveloped proteins:
• Hemagglutinin (HA)
• Neuraminidase (NA)
• Types:
• A – humans, some animals
• B – only infect humans, less severe S/Sx
• C – humans, does not cause disease
• Hosts: Avian, mammals, humans
• Infect epithelial cells
• Genome constantly changes:
• Antigenic drift - minor change caused by
mutations
• Antigenic shift – major alteration occurring
when segments recombine

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• Three types affect humans: A, B, C

• Type B lineage: B/Yamagata and B/Victoria

• Subtypes that infect humans:

• H1, H2, H3, H5, H6, H7, H9, H10
• N1, N2, N6, N7, N8, N9

• Influenza B – common in children

• Influenza C - rare

• CM: Influenza, flu

• Infection can be asymptomatic or result in mild
to severe disease

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• Transmissions: respiratory, aerosol, fomites

• Incubation period: 2 days (1-4 days)
• S/Sx: cough, sore throat, runny or stuffy nose, fever, chills,
headache, malaise, myalgia, vomiting, diarrhea
• Vaccines:
• Inactivated influenza vaccine (IIV)
• Live, attenuated influenza vaccine (LAIV)
• Recombinant influenza vaccine (RIV)
• Trivalent: type A(H1N1), type A(H3N2), and type B
• Quadrivalent: additional type B strain
• Treatment: oseltamivir (Tamiflu®), amantadine,
rimantadine

127

• Enveloped, ssRNA
• Envelope spikes: HN and F
• Respiratory transmission
• Subtypes:
• Paramyxoviruses (parainfluenza, mumps
virus)
• Morbillivirus (measles virus)
• Pnuemonovirus (respiratory syncytia
virus)

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• HPIVs
• CM: Parainfluenza, URTI, LRTI
• widespread as influenza but more benign
• seen mostly in children
• Transmission: respiratory, person to person
contact (shaking hands, touching), objects
• S/Sx: fever, runny nose, cough, bronchitis,
bronchiolitis, pneumonia, croup, sore throat, ear
pain
• HPIV-1 and HPIV-2 – cause croup, URTI,
LRTI
• HPIV-3 – bronchiolitis, bronchitis, pneumonia
• HPIV-4 – rare, mild to severe RI
• Treatment: symptomatic

129

• CM: Mumps, Epidemic parotitis

• Humans are the only reservoir
• Transmission: saliva or respiratory droplets
• S/Sx:
• Incubation: 2-3 weeks, fever, muscle pain &
malaise, classic swelling of both cheeks
• Males: 20-30%, epididymis, orchitis, sterility
(rare)
• Complications: orchitis, oophoritis, mastitis,
[pancreatitis, encephalitis, meningitis, deafness
• Treatment: symptomatic
• Vaccine: MMR
• 1st dose: 12-15 mons of age
• 2nd dose: 4-6 years of age

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• Aka Measles virus

• CM: Measles, red measles, rubeola
• Transmission: coughing, sneezing, breath contaminated air,
infected surfaces
• S/Sx:
• 1st symptoms: (7-14 days) high fever, cough, coryza,
conjunctivitis
• 2nd symptoms: (2-3 days after 1st symptoms begin)
Koplik spots (tiny white spots) inside the mouth
• 3rd symptoms: (3-5 days after 1st symptoms begin)
Measles rash (small raised bumps may also appear on
top of the flat red spots)

131

• Complications: hospitalization (1 in 5 unvaccinated),

pneumonia, encephalitis, death
• Treatment: symptomatic, vitamin A
• Vaccine: MMR
• 1st dose: 12-15 mons of age
• 2nd dose: 4-6 years of age
• ASAP- teenagers and adults with no evidence of
immunity (1 dose)

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• Aka Pneumonovirus, RSV

• CM: most common cause of bronchiolitis and
pneumonia in children younger than 1 year of
age in the US
• Syncytium or multinucleate giant cells -
virus causes infected cells to fuse with
neighboring cells
• Transmission: coughing, sneezing, breath
contaminated air, infected surfaces
• S/Sx: runny nose, decrease appetite,
coughing, sneezing, fever, wheezing,
bronchiolitis, pneumonia, apnea
• Adults: mild or no symptoms, URTI
• Prophylaxis: Palivizumab (IM during RSV
season in US)

133

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• Tiny, linear, ssRNA, nonenveloped

• Icosahedral

• Human Picornaviruses:
Genus Representative Clinical Manifestations in Humans
Enterovirus Poliovirus Poliomyelitis
Coxsackievirus A Focal necrosis, myositis
Coxsackievirus B Myocarditis of newborn
Echovirus Aseptic meningitis, enteritis
Hepatovirus Hepatitis A Hepatitis A
Rhinovirus Rhinovirus Common colds
Genus Representative Clinical Manifestations in Animals
Cardiovirus Cardiovirus Encephalomyocarditis
Aphthovirus Aphthovirus Foot and mouth disease (rarely in humans)

135

• First described by Michael Underwood in England, 1789

• Rapidly inactivated by heat, formaldehyde, chlorine, ultraviolet light
• Serotypes: type 1, type 2, type 3

• CM: Polio, Poliomyelitis

• Highly infectious, peaks in summer
• Reservoir: Human
• Transmission: fecal-oral, oral-oral
• Pathogenesis:
• Entry: mouth
• Replication: oropharynx, GI
• Invasion: lymphoid tissue, bloodstream, CNS
• Destruction of motor neurons → paralysis

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• CM: Polio, Poliomyelitis

• Clinical Features:
• Incubation period:
• 3 to 6 days for nonparalytic poliomyelitis
• 7 to 21 days for onset of paralysis in
paralytic poliomyelitis
• Paralysis is often permanent
• Vaccines:
• OPV – Oral poliovirus vaccine
• IPV – Inactivated poliovirus vaccine
• DTaP-HepB-IPV (Pediatrix)
• DTaP-IPV/Hib (Pentacel)
• DTaP-IPV (Kinrix and Quadracel)

137

• Transmission: person to person contact, feces

• Very contagious

• CM: mild flu-like infections

• fever, headache, muscle aches

• CM: Hand, foot, and mouth disease

• CA: Coxsackievirus A16 & A6, Enterovirus 71
• S/Sx: painful red blisters in the throat and on
the tongue, gums, hard palate, inside of the
cheeks, and the palms of hands and soles of
the feet
• Treatment: symptomatic

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• CM: common colds

• S/Sx: runny nose, sneezing, sore
throat, headache, cough, body aches,
fever
• Transmission: respiratory droplets

139

• HAV
• Humans are the only natural host
• Stable at low pH
• Inactivated by the temperature of 185°F or higher,
formalin, chlorine
• CM: Hepatitis A, epidemic jaundice, infectious
hepatitis, epidemic hepatitis
• Transmission: fecal-oral
• Incubation: 28 days (15-50 days)
• S/Sx: abrupt onset of fever, malaise, anorexia,
nausea, abdominal discomfort, dark urine, jaundice
• Serology:
• Anti-HAV IgM - Active
• Anti-HAV IgG - Old Infection, no active disease

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• CM: Hepatitis A, epidemic jaundice, infectious hepatitis,

epidemic hepatitis
• People at risk:
• International travelers
• Men who have sex with men
• People with occupational risk for exposure
• People who anticipate close personal contact with an
international adoptee
• People experiencing homelessness
• Vaccine:
• Single-antigen vaccine: HepA (Havrix, Vaqta)
• Combination vaccine: HepA-HepB (Twinrix)

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• segmented dsRNA, nonenveloped

• icosahedral
• Rotavirus – enterovirus, leading cause of
death of 3rd world countries because of
diarrhea
• CM: Children diarrhea
• S/Sx: severe watery diarrhea, vomiting,
fever, and/or abdominal pain
• Transmission: fecal-oral, contaminated
surfaces, food
• Treatment: symptomatic, IV fluids, ORS
• Vaccine:
• RotaTeq® - (RV5) 3 doses at 2,4,6 mons of age (Philippines: 6 weeks, 2nd after 2 mons)
• Rotarix® - (RV1) 2 doses at 2 and 4 mons of age

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• Enveloped, spherical to pleomorphic in shape, ssRNA (+), linear

143

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• Clinically Important viruses and diseases:

• Human T-cell lymphotropic virus type 1
• Aka Human T-lymphotropic virus (HTLV-I), adult T-cell lymphoma virus type 1
• CM: Adult T-cell leukemia (ATL)
• rare and often aggressive (fast-growing) T-cell lymphoma that can be found in the blood
(leukemia), lymph nodes (lymphoma), skin, or multiple areas of the body

• Human Immunodeficiency Virus

• CM: HIV Infection and acquired immunodeficiency syndrome (AIDS)
• attacks the body’s immune system
Species Virulence Infectivity Prevalence Origin
HIV-1 High High Global Chimpanzees
HIV-2 Lower Low West Africa Sooty mangabey

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147

• S/Sx:
• Initial: people may experience no
symptoms or an influenza-like
illness including fever, headache,
rash, or sore throat
• Disease: swollen lymph nodes,
weight loss, fever, diarrhea, and
cough
• Secondary infections: tuberculosis
(TB), cryptococcal meningitis,
severe bacterial infections, and
cancers such as lymphomas and
Kaposi's sarcoma

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• Transmission:
• Can be passed from person to person:
• blood
• semen (including pre-cum)
• vaginal fluid
• anal mucous
• breastmilk
• Infected body fluids enter your bloodstream via:
• unprotected sex (including sex toys)
• from mother to child during pregnancy,
childbirth, or breastfeeding
• injecting drugs with a needle that has infected
blood in it
• infected blood donations or organ transplants

149

• Transmission and Geographic Distribution:

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• Treatment: Antiretroviral (ARV) drugs

• Diagnosis:
• Antigen/antibody tests:
• ELISA, serum
• HIV-1 & -2 antibodies, HIV-1 CA (p24) antigen
• Screening of blood donors
• Western Blotting
• Nucleic acid test (NAT test)
• Home Access Express Test (Home test, USFDA)
• Saliva test
• Viral load test (PCR)

151

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• ssRNA, enveloped, bullet-shaped

• Genus: Lyssavirus
• Zoonotic
• Aka Rabies virus
• CM: Rabies
• Diagnosis: Negri bodies - viral RNA-
nucleoprotein complexes found in the
cytoplasm of virus-infected cells

153

• Transmission:
• Direct contact: broken skin or
mucous membranes (eyes, nose,
mouth) by saliva or brain tissue from
an infected animal
• Bite of a rabid animal: dogs, bats,
raccoons, skunks, foxes, mongooses
• Uncommon: aerosolized exposure
(lab workers), organ donation

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• Infectious Path:

155

• S/Sx in humans:
• Initial: weakness, discomfort, fever
headache, itching sensation at the site of
the bite
• Progression: cerebral dysfunction, anxiety,
confusion, and agitation, delirium, abnormal
behavior, hallucinations, hydrophobia, and
insomnia
• Fatal if clinical signs appear

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• Treatment:
• Postexposure prophylaxis (PEP)
• Extensive washing and local treatment of the bite wound (15 mins with soap and water)
Category Definition Exposure PEP Measures
Category I Contact with animal, or licks on intact Washing of exposed skin surfaces No
No exposure
skin PEP
Category II Nibbles on exposed skin
Minor Wound washing
Minor bite(s) or scratch(es) without
bleeding exposure Immediate vaccination

Category III Transdermal bite(s) or scratch(es)

Licks on broken skin Wound washing
Severe
Contamination of mucous Immediate vaccination
membranes by animal’s saliva (licks) exposure Administration of rabies immunoglobulin
Direct contact with bats

157

• ssRNA, enveloped, icosahedral

• Arbovirus

• Clinically important viruses:

• Alphaviruses:
• Eastern Equine Encephalitis Virus (EEEV)
• Western Equine Encephalitis Virus (WEEV)
• Venezuelan Equine Encephalitis Virus (VEEV)
• Chikungunya Virus
• Rubivirus:
• Rubella Virus

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• Lineages:
• Group I – endemic in North America, Caribbean (most human)
• Group IIA, IIB, III – equine illness in Central, South America
• Range: Atlantic, Gulf-coast states in Eastern US
• Vector: Culiseta melanura, Aedes, Coquillettidia, Culex (mosquitoes)
• Hosts:
• Reservoir host: avian hosts
• Definitive host: horses, humans

• CM: Eastern Equine Encephalitis (EEV)

• Highly pathogenic; causes CNS disease in humans, horses
• S/Sx: Febrile illness: fever, chills, body aches, and joint pain
• Neurologic disease: headache, vomiting, diarrhea, seizures,
behavioral changes, drowsiness, and coma
• Treatment: relieve symptoms, no vaccine

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• Range: US states, Canadian provinces west of

Mississippi River
• Vector: Culex tarsalis (mosquito)
• Hosts:
• Reservoir host: wild birds, other vertebrates
• Definitive host: horses, humans

• CM: Western Equine Encephalitis (WEV)

• S/Sx: Febrile illness: fever, chills, body aches, and
joint pain
• Neurologic disease: headache, vomiting,
diarrhea, seizures, behavioral changes,
drowsiness, and coma
• Treatment: relieve symptoms, no vaccine

161

• Range: Central, South America, Mexico

• Vector: Culex (mosquito)
• Hosts:
• Reservoir host: rodents
• Definitive host: horses, humans

• CM: Venezuelan Equine Encephalitis (VEV)

• S/Sx: fever, anorexia, depression, weight loss, dehydration,
weakness, paralysis, difficulty swallowing, gait abnormalities,
seizures, and other neurological signs
• Treatment: relieve symptoms

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• CM: Chikungunya
• Transmission: bites of
Aedes aegypti, A. albopictus
• S/Sx: fever and joint pain,
headache, muscle pain, joint
swelling, or rash
• Treatment: symptomatic

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• CM: Rubella, German measles

• S/Sx: red rash (face → body), a low-grade
fever, headache, mild pink eye (redness or
swelling of the white of the eye), general
discomfort, swollen and enlarged lymph nodes,
cough, runny nose
• Complications: arthritis (70% of women),
miscarriage, birth defects
• Transmission: nasopharyngeal secretions,
mother → baby
• Treatment: symptomatic
• Vaccine: MMR

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169

Characteristics Transmission Treatment Serology

Hepatitis A - naked icosahedral Fecal-oral - Vaccine Anti-HAV IgM - Active
HAV - (+) ssRNA Anti-HAV IgG - Old Infection
- Picornaviridae
Hepatitis B - enveloped icosahedral Blood - Vaccine HBsAg - Disease
HBV - dsDNA circular Sex - Lamivudine Anti-HBsAg - Immunity
Silent Killer - Hepadnavirus Placenta - Alpha IgM anti-HBcAg - New Infx
interferon IgG anti-HBcAg - Old Infx
- Entecavir HBeAg - High infectivity
Anti-HBeAg - Low infectivity
Hepatitis C - enveloped icosahedral Blood - Alpha Anti-HCV
HCV - ssRNA Sex interferon
- Flavivirus Placenta - Ribavirin

Free pdf summary: The ABCs of Hepatitis – for Health Professionals - CDC

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Characteristics Transmission Treatment Serology

Hepatitis D - Incomplete RNA Blood - No approved IgM antiHDV
HDV - Helical Sex treatment
- Deltavirus Placenta
Hepatitis E - Naked Fecal-oral Management of IgM antiHDE
HEV - ssRNA symptoms
- Old: Calicivirus
- Now: Hepevirus

Hepatitis G - Flavivirus Blood

HGV Sex
Placenta

171

Wrap Up!

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Methods of viral cultivation?

ELISA?

PCR?

The protein subunits of capsid?

Stages of viral replication?

Infectious agents that consist only of RNA?

173

Proteinaceous infectious particles that cause a group of universally fatal

neurodegenerative disease?

Aka mad cow disease

Prion disease among people from New Guinea who practiced a form of
cannibalism

Only ssDNA virus

Box-shaped virus

Most common cause of viral conjunctivitis

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Only dsRNA virus

Bullet-shaped virus

MERS?

SARS

Vector of dengue

Vaccines for poliovirus

175

Aka serum hepatitis

Aka epidemic hepatitis

Aka chickenpox

Aka shingles

Aka 6th disease

Aka kissing disease

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CA of genital herpes

CA of kissing disease

CA of negri bodies

Target cell of HIV

The most common cause of viral diarrhea of children/infants

Vaccine for measle

177

Aka warts

Aka 5th disease

Aka measles

Aka German measles

Aka winter vomiting bug

Aka pneumonovirus

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DOC for varicella

Most common CA of cervical carcinoma?

CA of Burkitt’s lymphoma

Fecal-oral hepatitis

CA of epidemic parotitis

Virus family of hepatitis A

179

- Rocky Balboa

180

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