OVERVIEW

OF
VIRAL INFECTIONS
• Anurag Kumar • Diksha Jha
• Anushka Gupta • Fahad Khan
• Ashi Tripathi • Fatima Bushra
• Chaturvedi Aastha • Ganesh Dutta
• Deepak Raj • Gauri Middha
 INTRODUCTION
• Viruses are smallest (unicellular) obligate intracellular infective agent. It has no metabolic activity
outside host cells.

• Viruses comprises of:-

(i) Envelope

(ii) Protein coat (capsid)

(iii) Nuclei acid (DNA or RNA)

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ENVELOPE
• It surrounds nucleocaspid and is lipoprotein in nature.

• Lipid part is from host cell and protein part is bacterial coded,

subunit called Peplomere.

• This peplomere are antigenic and bind to speci c receptors on host cell.

PROTEIN COAT - CAPSID

It is composed of number of repeated subunits called as Capsomere.
Functions of capsid:-
• Protects the nuclei acid core.

• In non enveloped virus, role in viral replication by attaching to speci c receptor o host cell

• It is antigenic and speci c for each virus.

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 Nucleic acid classi cation of viruses

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VIRAL REPLICATION
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PATHOGENESIS
Most of the viral infections progress through the

following steps inside the human body:-

• Transmission (entry into the body)

• Primary site replication

• Spread to secondary site

• Manifestations of the disease.

 HERPES VIRUS
HERPES SIMPLEX VIRUS
• Belongs to alpha sub family of Herpesviridae

• Replication:- 12-18hrs

• 2 types:-
\ HSV-1;HSV-2

PATHOGENESIS :-

• HSV-1 oropharyngeal contact (above the waist)

• HSV -2 sexual contact (below the waist)

CLINICAL MANIFESTATION :-

• Oral facial mucosal lessons

• Cutaneous lessons

• Herpetic whitlow

• Febrile blisters
EPIDEMIOLOGY :-
• HSV -1. Infected secretion ( saliva)

• HSV -2. Sexual or vertical routes

CYTOPATHOLOGY :-
• Ballooning of infected cell

• Margination
\ of chromatin

VARICELLA ZOSTER VIRUS

1) Chickenpox

• Generalised di used bilateral vesicular rashes

• Highly contagious

2) Zoster or shingles
• Reactivation of latent VZV in adult life

• Rashes (unilateral and segmental)

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PARVOVIRUS
• Simplest and Smallest (28-/26nm) animal virus.

• DNA Virus Single stranded DNA

• Most common Parvovirus: B19

• Transmission:- Respiratory rouge, Blood transfusion,

Trans placental route

• Clinical
\ manifestation:-

• Erythema Infectiosum

• Transient apalstic crisis

PAPILLOMA VIRUS
•DNA Virus

•Belongs to Papillomaviridae family

Infections caused:
•Benign wart

•Common skin wart

•Plantar wart

•Anogenital wart

 POX VIRUS
• Largest virus (40×230 nm).

• Brick shaped or ellipsoid.

• Single linear ds-DNA.

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• Pox virus of human importance

SMALLPOX
• Variola: Causative Agent
• First infectious disease

• Highly contagious

• Severe exanthema (rashes)

ADENOVIRUS
• Double Stranded DNA virus

• Non enveloped virus

• Adenovirus infect and replicate in epithelial cells and produce

various infections for example infection of respiratory tract
(upper
\ respiratory tract infections, pneumonia)

• Associated in recombinamt vaccines

• Human adenovirus vector Covishield chimpanzee adenovirus

BACTERIOPHAGE
Bacteriophages are the virus that infect bacteria.
 Bacteriophage - Life cycle

Signi cance /Uses of

bacteriophage
• Phage typing

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• Used in treatment

• Used as cloning vector

• Transfer drug resistance

• Code for toxins

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 MYXOVIRUS
Myxoviruses are a group of viruses that bind
to mucin receptors on the surface of RBCs
(myxo in Greek meaning 'mucin'); resulting in
clumping of RBCs together to cause
hemagglutination.

Myxoviruses are divided into two families:-

(1) Orthomyxoviridae

(2) Paramyxoviridae

Both di er from each other in various aspects;

the most important di erence is the presence
of segmented RNA in Orthomyxoviridae family.
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 ORTHOMYXOVIRIDAE
In uenza viruses are the members of
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Orthomyxoviridae family. They are one of the
major causes of morbidity and mortality and
have been responsible for several epidemics
and pandemics of respiratory diseases in the
last two centuries.
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PARAMYXOVIRUS
Paramyxoviridae contains of a group of viruses, which are
transmitted via the respiratory route following which:

• They may cause localized respiratory infection in

children ( e.g. respiratory syncytial virus and the
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parain uenza viruses)

• They may disseminate throughout the body to cause

highly contagious diseases of childhood such as mumps
virus (parotid enlargement) and measles virus (rashes).

• It also includes viruses such as Newcastle Disease virus

(cause self limited conjuctivitis in poultry workers), Nipah
and Hedra viruses.
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 RUBELLA VIRUS
It is in paramyxoviridae but belongs to togaviridae arbovirus.

It is highly teratogenic and causes congenital malformation

a ecting organs such as eyes ear and heart in fetus.

Infectivity
\ period _rash 1 week before and 1 week after

Incubation period 2-3 weeks

Congenital rubella syndrome had it classical triad

• Cataract

• Heart disease

• Deafness

Live attenuated vaccine is available for rubella ; recommended

for children and young women.
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 CORONAVIRUS
• Coronaviruses (CoV) cause Respiratory tract infections in humans.
• Coronaviruses causing human infections mostly belong to the Betacoronavirus.
• SEVERE DISEASES :-

➢ SARS-CoV (Severe acute respiratory syndrome)

➢ MERS-CoV (Middle east respiratory syndrome)
➢ SARS-CoV-2 (Severe acute respiratory syndrome coronavirus-2)

• MORPHOLOGY :-
➢ They are linear, enveloped ssRNA.
➢ Club shaped or Crown like peplomer spikes giving appearance of a Solar
Corona.
➢ They are spherical large (12-160 nm) viruses having Helical symmetry.

 COVID-19
• COVID-19 is a acute respiratory disease caused by SARS-CoV-2.
• This virus caused a pandemic which originated in Wuhan, China in December 2019 and
subsequently spread to the world over 3-4 months.
• Over 67 crore cases with >67 lakh deaths were reported as of
January 2023, with overall mortality rate of 1%.
• India experienced 3 different COVID waves and accounts for
Second highest number of cases.

• SARS-CoV-2 VARIANTS :-
➢ Alpha, Beta, Gamma, Delta (2nd wave), Omicron (3rd wave).

• MORPHOLOGY :-
➢ RNA virus comprises of nucleocapsid with Helical symmetry
surrounded by an envelope.
➢ 4 Structural Proteins:
Nucleocapsid protein, Spike protein, Membrane glycoprotein, Envelope protein.

CLINICAL MANIFESTATIONS :-
• Incubation Period: 5-6 days but can be long as 14 days.
• Symptomatic patients :-
➢ MILD: ILI (Influenza like illness)
➢ MODERATE: Pneumonia
➢ SEVERE: Severe Pneumonia with Complications like Acute respiratory distress syndrome, Sepsis,
Septic shock, etc.
TRANSMISSION :-
# Respiratory droplets # Contact routes # Aerosol transmission
PREVENTION & CONTROL:-
# Hand hygiene # Social distancing # Sanitization # Masks # PPE # Quarantine
VACCINES :-
# Covishield # Covaxin # Sputnik V vaccine
LAB DIAGNOSIS :-
• Real time RT-PCR
• Antigen Detection Assay
• Antibody (IgG) detection assay

 PICORNAVIRUS
POLIOVIRUS
• Poliovirus, the causative agent of poliomyelitis.
• PATHOGENESIS: transmitted by faeco-oral route Spreads to CNS/
spinal cord by hematogenous route.
• CLINICAL MANIFESTATIONS: rarely progresses to aseptic
meningitis.
• And paralytic polimyelitis.
• VACCINE: killed injectable and live oral polio vaccine.
• ERADICATION: it is now at the verge of eradication as extensive
immunization program are being conducted globally.

COXSACKIEVIRUS
• It is a type of Enterovirus
• Produces a variety of clinical illnesses in human:
- Meningitis
- Conjunctivitis
- Myocarditis
- Pericarditis
- Pancreatitis

 ARBOVIRUS
• Arbovirus(arthropod-borne viruses) diverse group of RNA viruses
• PATHOGENESIS: Transmitted by blood sucking arthropods
• CLINICAL MANIFESTATION: hemorrhagic fever and encephalitis

• Some of the arbovirus which are prevalent in India are;

DENGUE VIRUS
• VECTOR: Aedes aegypti & Aedes albopictus
• CLINICAL MANIFESTATION: present in three stages
-Dengue fever
-DENGUE hemorrhagic fever
-Dengue shock syndrome
DIAGNOSTIC TEST: ELISA and reverse transcripts PCR

CHIKUNGUNYA VIRUS
• VECTOR: Aedes aegypti mosquito
• CLINICAL MANIFESTATION: fever, arthritis, rarely hemorrhagic fever

JAPANESE B ENCEPHALITIS
• VECTOR: Culex tritaeniorhynchus

 RABIES
• It causes Acute infectious disease of the CNS in humans & animals
• TRANSMISSION: another infected animal bite( most commonly dog)
• CLINICAL MANIFESTATION: - spread from Site of bite CNS
• - Produces acute neurologic phase which
maybe an encephalitic or paralytic type.
-Encephalitic type causes hyperexcitability,
hydrophobia.
-Gradually develops coma & leads to death
• LAB DIAGNOSIS: detection of rabies by. •Direct IF test •RT PCR

 HIV
• Human Immunodeficiency Virus (HIV) is the causal agent of Acquired Immunodeficiency
Syndrome (AIDS).
• STRUCTURE :-
➢ They are spherical, ranging from 80-110 nm in size.
➢ ENVELOPE: Lipid part, Protein part (gp120 & gp41)
➢ NUCLEOCAPSID: Capsid has Icosahedral symmetry; made up of core protein.
RNA- ssRNA linear RNA
ENZYMES- Reverse transcriptase, Integrase, Proteases.
• MODE OF TRANSMISSION:-
➢ Sexual Mode – Most common; 75% of total cases
➢ Blood Transfusion – Least common; 90-95% of cases
➢ Percutaneous/Mucosal – Less transmission; about 10% of cases
➢ Perinatal Mode – 20-40% transmission; 10% of cases

VIRAL REPLICATION
Fusion

Penetration & Uncoating

Reverse transcription

Pre-Integration complex

Integration

Latency
LAB DIAGNOSIS :-
➢ Specific Tests (1) Screening Tests – Antibody detection

• ELISA (2-3 hrs)

• Rapid/Simple test (<30 min)
(2) Supplement Tests – Antibody detection
• Western blot assay
• Line immunoassay (LIA)
(3) Confirmatory Tests
• P24 antigen detection
• Viral culture – by Co-cultivation technique
• HIV RNA (Best confirmatory method)
• HIV DNA detection
➢ Non-Specific (1) Low CD4 T cell count
(2) Hypergammaglobulinemia
(3) Altered CD4:CD8 T cell ratio

TREATMENT :-
➢ Anti-Retroviral Therapy (ART)

 HEPATITIS
• Hepatitis viruses are heterogeneous group of viruses.

• These are hepatotropic and produce similar clinical

illness such as fever,nausea,vomiting and jaundice.

• Hepatitis A to E are RNA viruses except HBV which

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is a DNA virus.

• Hepatitis A and E:

-transmitted by fecooral route

-do not have carrier stage or chronicity

• Hepatitis B,C and D:

-transmitted by percutaneous,sexual or vertical routes

-disease may progress to carrier stage, chronic hepatitis or

hepatocellular carcinoma.

LABORATORY DIAGNOSIS

Includes detection of various viral markers such as:

-Detection of viral antigens ( eg-HBsAg for HBV)

-Detection of antibodies (eg-anti-HCV and anti-HEV)

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-Detection of viral nucleic acid (By PCR)

TREATMENT

Antiviral drugs are available such as:

-Tenofovir and telbivudine for HBV

-Interferon,ribavirin for HCV

Vaccines are also available for HAV and HBV.

 MISCELLANEOUS VIRUS
Rodent-borne viruses
~transmitted from rodents to man by contact with
infected
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body uids or excretions. Major viruses include:

-Hantaviruses: causes hemorrhagic fever with renal

syndrome and hantavirus pulmonary syndrome.

-Arenaviruses: cause various diseases such as

South American hemorrhagic fever
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 Filoviruses
~ Includes Ebola virus and Marburg virus.

~ Cause hemorrhagic fever

~ Transmission
\ by close contact with blood or
other body uids.

Viral gastro entritis

~ Eg- rotavirus, adenovirus, calicivirus and
astrovirus.

~ Most commonly a ects children.

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 Slow viruses and prions
~These are a group of neurodegenerative conditions

a ecting both humans and animals.

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~These are characterised by: long incubation period,

Predilection for CNS ans a strong genetic

predisposition.

~conventional slow viruses:

Eg- subacute sclerosing panencephalitis

~unconventional viruses:

Eg- prion disease

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LABORATORY DIAGNOSIS OF VIRAL DISEASES
1. Direct Demonstration of Virus
• Electron microscopy

• Immunoelectron microscopy

• Fluorescent microscopy

• Light microscopy:

- Histopathological staining: To demonstrate inclusion bodies

- Immunoperoxidase staining.

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2. Detection of Viral Antigens
• By various formats such as ELISA, direct IF, ICT, ow through
assays.

3. Detection of Speci c Antibodies

• Conventional techniques such as HAI, neutralization test and CET

• Newer diagnostic formats such as ELISA, ICT, ow through

assays.

4. Molecular Methods to Detect Viral Genes

• Nucleic acid probe--for detection of DNA or RNA by hybridization
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 TREATMENT OF VIRAL DISEASES

• Interferons

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• Viral Vaccines: Killed Viral Vaccine , Subunit Vaccines, Live vaccine

• Passive Immunization

• Combined Immunization
 BIBLIOGRAPHY
• Apurba S Sastri
• C. P. Baveja
• Ananthanarayanan and Paniker
• www.diginerve.com