Chickenpox (Varicella)

• Chickenpox (varicella) is a highly contagious skin disease

primarily of children two to seven years of age. Humans are
the reservoir and the source for this virus, which is acquired
by droplet inhalation into the respiratory system
• The causative agent is the enveloped, double-stranded (ds)
DNA varicella-zoster virus (VZV; species Human herpesvirus
3), a member of the family Herpesviridae.
• incubation period of 10 to 23 days,
• small vesicles erupt on the face or upper trunk, fill with pus,
rupture, and become covered by scabs
• Laboratory testing for VZV is not normally required, as the
diagnosis of chickenpox is typically made by clinical
assessment. Laboratory confirmation is recommended,
though, to confirm the diagnosis of severe or unusual cases of
chickenpox.
• in the 1990s has drastically reduced the incidence of
chickenpox
• Chickenpox infection can be shortened with the drug acyclovir.
The vaccine is recommended for ages twelve months to
twelve years and can be administered separately or as a
combined measles, mumps, rubella (MMR) and varicella
(MMVR) vaccine.
SARS
Introduction
◆ Severe acute respiratory syndrome (SARS) is a highly
infectious disease with a significant morbidity and case
fatality.
◆ Severe acute respiratory syndrome (SARS) is a viral
respiratory disease of zoonotic origin caused by the
SARS coronavirus (SARS-CoV).
◆ Between November 2002 and July 2003, an outbreak of
SARS in southern China caused an eventual 8,098 cases,
resulting in 774 deaths reported in 37 countries, No
cases of SARS have been reported worldwide since
2004.In late 2017, Chinese scientists traced the virus
through the intermediary of civets to cave-dwelling
horseshoe bats.
Causes
SARS is caused by a member of the coronavirus
family of viruses (the same family that can cause
the common cold).
When someone with SARS coughs or sneezes,
infected droplets spray into the air. You can catch
the SARS virus if you breathe in or touch these
particles. The SARS virus may live on hands,
tissues, and other surfaces for up to several hours
in these droplets. The virus may be able to live for
months or years when the temperature is below
freezing.
Symptoms usually occur about 2 to 10 days after
coming in contact with the virus. In some cases, SARS
started sooner or later after first contact. People with
active symptoms of illness are contagious
Signs & Symptoms
The main symptoms are:
•Cough
•Difficulty breathing
•Fever of 100.4°F (38.0°C) or higher
•Other breathing symptoms

The most common symptoms are:

•Chills and shaking
•Cough, usually starts 2 to 3 days after other symptoms
•Headache
•Muscle aches
•Tiredness

Less common symptoms include:

•Cough that produces phlegm (sputum)
•Diarrhea
•Dizziness
•Nausea and vomiting
 Diagnosis
Tests used to diagnose SARS might include:
•Arterial blood tests
•Blood clotting tests
•Blood chemistry tests
•Chest x-ray or chest CT scan
•Complete blood count (CBC)

Tests used to quickly identify the virus that causes SARS include:
•Antibody tests for SARS
•Direct isolation of the SARS virus
•Rapid polymerase chain reaction (PCR) test for SARS virus
 Treatment
● People who are thought to have SARS should be checked right away by a
provider. If they are suspected of having SARS, they should be kept isolated
in the hospital.

● Treatment may include:

•Antibiotics to treat bacteria that cause pneumonia (until bacterial
pneumonia is ruled out or if there is bacterial pneumonia in addition to
SARS)
•Antiviral medicines (although how well they work for SARS is unknown)
•High doses of steroids to reduce swelling in the lungs (it is not known how
well they work)
•Oxygen, breathing support (mechanical ventilation), or chest therapy

● In some serious cases, the liquid part of blood from people who have
already recovered from SARS has been given as a treatment.

● There is no strong evidence that these treatments work well. There is

evidence that the antiviral medicine, ribavirin, does not work
 Prevention
◆ When possible, avoid direct contact with people
who have SARS until at least 10 days after their
fever and other symptoms are gone.
•Hand hygiene is the most important part of
SARS prevention. Wash your hands or clean
them with an alcohol-based instant hand
sanitizer.
•Cover your mouth and nose when you sneeze
or cough. Droplets that are released when a
person sneezes or coughs are infectious.
•DO NOT share food, drink, or utensils.
•Clean commonly touched surfaces with an
EPA-approved disinfectant.

◆ Masks and goggles may be useful for

preventing the spread of the disease. You may
use gloves when handling items that may have
touched infected droplets.
Complications
Complications may include:
•Respiratory failure
•Liver failure
•Heart failure
•Kidney problems
Measles (Rubeola)
• there were about 175,000 deaths due to measles in 2012
outside the United states
• Measles virus (MeV) is a negative-strand, enveloped RNA
virus in the genus Morbillivirus and the family
Paramyxoviridae
• A measles infection, as well as immunization with measles
vaccine, still provides a lifelong immunity against reinfection.
• MeV enters the body through the respiratory tract or the
conjunctiva of the eyes.
• The incubation period for measles is usually 10 to 14 days,
and visible symptoms begin about the tenth day
• Symptoms: The measles prodrome is characterized by nasal
discharge, cough, fever, headache, and conjunctivitis, which
intensify several days prior to the onset of rash. Within 3 to 5 days,
skin eruptions occur as erythematous (red) maculopapular
(discolored area of small bumps) lesions that are at first discrete but
gradually become confluent. The rash normally lasts about 5 to 7
days. Lesions of the oral cavity include the diagnostically useful
bright-red Koplik's spots with a bluish-white speck in the center of
each. Koplik's spots represent a skin eruption (viral exanthem)
occurring in the form of macules or papules on the mucosal lining of
the mouth. Recovery from measles begins soon after the rash is
reported. Very infrequently a progressive degeneration of the
central nervous system called subacute sclerosing panencephalitis
occurs.
• No specific treatment is available for measles. The use of
attenuated measles vaccine or in combination with mumps and
rubella {MMR vaccine) or as a combined measles, mumps, rubella,
and varicella vaccine is recommended for all children
Mumps
• Mumps is an acute, highly contagious disease
• Mumps virus (MuV) is a member of the genus Rubulavirus in
the family Paramyxoviridae
• The virus is transmitted in saliva and respiratory droplets
• The most prominent manifestations of mumps are swelling
and tenderness of the salivary {parotid) glands 16 to 18 days
after infection of the host by the virus. The swelling usually
lasts for 1 to 2 weeks and is accompanied by a low-grade
fever. Severe complications of mumps are rare; however,
meningitis, encephalitis, and inflammation of the epididymis
and testes {orchitis) leading to sterility can occur, especially in
the postpubescent male.
• Therapy of mumps is limited to symptomatic and supportive
measures. A live, attenuated mumps virus vaccine is available.
It usually is given as part of the trivalent or tetravalent MMR
vaccine
Rubella (German Measles)
• It is a moderately contagious disease that occurs primarily in
children five to nine years of age.
• It is caused by rubella virus, an enveloped, positive-strand
RNA virus that is a member of the family Togaviridae.
• Rubella is worldwide in distribution, being spread in droplets
that are shed from the respiratory secretions of infected
individuals.
• Once the virus is inside the body, the incubation period
ranges from 12 to 23 days.
• A rash of small red spots, usually lasting no more than 3 days,
and a light fever are the normal symptoms
• However, because rubella is usually such a mild infection, no
treatment is indicated.
• All children and women of childbearing age who have not
been previously exposed to rubella should be vaccinated.
• The live attenuated rubella vaccine is recommended
Smallpox (variola)
• Smallpox (variola) is a highly contagious illness of humans
caused by orthopoxviruses
• Vaccinia virus (VACV) is the virus that causes cowpox and
serves as the antigen in the smallpox vaccine
• Characteristic symptoms of infection also include acute onset
of fever 101°F (38.3°C), followed by a rash that features firm,
deep-seated vesicles or pustules in the same stage of
development without other apparent cause
• There are two clinical forms of smallpox. Disease caused by
variola major virus is more severe and the most common
form of smallpox, with a more extensive rash and higher fever.
Historically, this form of smallpox had an overall fatality rate
of about 33%, with significant morbidity in those who did not
die. Variola minor is a less common form of smallpox, with
much less severe disease and death rates of 1% or less.
• Variola virus is generally transmitted by direct and fairly
prolonged face-to-face contact. It also can be spread through
direct contact with infected bodily fluids or contaminated
objects such as bedding or clothing. Smallpox has been
reported to spread through the air in enclosed settings such
as buildings, buses, and trains. Smallpox is not known to be
transmitted by insects or animals.
• average incubation period is 12 to 14 days but can range
from 7 to 17 days
• There is no FDA-approved treatment for smallpox, although
several antiviral agents have been suggested as adjunct
therapies.
• Protection from smallpox is through vaccination. The
smallpox vaccine contains live vaccinia virus, which is related
to variola virus
Equine encephalitis
• Equine encephalitis is caused by viruses in the genus
Alphavirus, family Togaviridae. They are positive-strand,
enveloped RNA viruses.
• In humans, the disease can present as a spectrum from fever
and headache to (aseptic) meningitis and encephalitis.
However, the disease can be fatal to horses. Human disease
can progress to include seizures, paralysis, coma, and death.
The virus is transmitted to humans by Aedes and Culex spp.
mosquitoes.
• Treatment consists of the supportive care of symptoms.
• Currently no vaccine is available to prevent disease.
Preventative measures rely on common mosquito
precautions.
•
West Nile Fever
(Encephalitis)
• West Nile fever (encephalitis) is caused by a positive-strand
RNA flavivirus
• WNV is transmitted predominately to humans by Culex spp.
mosquitoes that feed on infected birds (crows and sparrows
• Although many people are bitten by WNV-infected
mosquitoes, most do not know they have been exposed;
most infected individuals remain asymptomatic or exhibit
only mild, flulike symptoms
• Human-to-human transmission has been reported through
blood and organ donation
• An enzyme-linked immunosorbent assay (ELISA) test for IgM
anti-WNV antibody is the FDA-approved diagnostic test.
There is no treatment other than hospitalization and
intravenous fluids. There is no human vaccine to prevent
WNV
AIDS (Acquired
immunodeficiency
syndrome)
• AIDS is the result of an infection by the human
immunodeficiency virus (HIV), a positive-strand, enveloped
RNA virus within the family Retroviridae
• HIV is acquired and may be passed from one person to
another when infected blood, semen, or vaginal secretions
come in contact with an uninfected person's broken skin or
mucous membranes.
• Once a person becomes infected with HIV, the course of
disease may vary greatly. Some rapid progressors may
develop clinical AIDS and die within 2 to 3 years. A small
percentage of long-term nonprogressors remain relatively
healthy for at least 10 years after infection. For the majority
of HIV-infected individuals, HIV infection progresses to AIDS
in 8 to 10 years. The CDC has developed a classification
system for the stages of HIV-related conditions: acute,
• The acute infection stage occurs 2 to 8 weeks after HIV
infection. About 70% of individuals in this stage experience a
brief illness referred to as acute retroviral syndrome, with
symptoms that may include fever, malaise(discomfort),
headache, macular (small, red, spotty) rash, weight loss,
lymph node enlargement (lymphadenopathy), and oral
candidiasis
• The asymptomatic stage of HIV infection may last from 6
months to 10 years (or longer in some individuals). During
this stage, the levels of detectable HIV in the blood decrease,
but the virus continues to replicate, particularly in lymphoid
tissues.
• During the chronic symptomatic stage, which can last for
months to years, virus multiplication continues and the
number of CD4 + T cells in the blood begins to significantly
• symptoms including fever, weight loss, malaise(discomfort),
fatigue, anorexia, abdominal pain, diarrhea, headaches, and
lymphadenopathy
• Laboratory diagnosis of HIV infection can be by isolation and
culture of the virus or by using assays for viral reverse
transcriptase activity or viral antigens However, diagnosis is
most commonly accomplished through the detection of
specific anti-HIV antibodies in the blood. For routine
screening purposes, an ELISA is commonly used because it is
sensitive and relatively inexpensive.
• The most sensitive HIV assay employs the polymerase chain
reaction (PCR). PCR can be used to amplify and detect tiny
amounts of viral RNA and proviral DNA in infected host cells
• At present there is no cure for AIDS. Primary treatment is
directed at reducing the viral load and disease symptoms, and
treating opportunistic infections and malignancies.
common cold
• The common cold (coryza: Greek koryza, discharge from the
nostrils) is one of the most frequent infections experienced
by humans of all ages. The incidence of infection is greater
during the winter months
• . About 50% of the cases are caused by rhinoviruses (Greek
rhinos, nose), which are nonenveloped, positive-strand RNA
viruses in the family Picornaviridae
• The clinical manifestations include the familiar nasal
stuffiness, sneezing, scratchy throat, and a watery discharge
from the nose. The discharge becomes thicker and assumes a
yellowish appearance over several days. General malaise is
commonly present. Fever is usually absent in uncomplicated
colds, although a low-grade (100 to 102°F, 37.8 to 38.9°C)
fever may occur in infants and children. The disease usually
runs its course in about a week.
• Diagnosis of the common cold is made from observations of
clinical symptoms. There are no procedures for direct
examination of clinical specimens or for serological diagnosis
• Sources of the cold viruses include infected individuals
excreting viruses in nasal secretions, airborne transmission
over short distances by way of moisture droplets, and
transmission on contaminated hands or fomites
• Treatment for the common cold is mainly rest, extra fluids,
and the use of anti-inflammatory agents for alleviating local
and systemic discomfort.
Reference
• Prescott’s microbiology (CH 38, 39)