‭UNIT 5: CLINICALLY SIGNIFICANT VIRUSES‬

‭I.‬ ‭THE VIRUS‬

‭VIRUS‬
‭➢‬ ‭Inert/non-living outside host cells.‬
‭➢‬ ‭Very minute. In order to see them, we use electron microscopes‬
‭➢‬ ‭They are energy less; they float around until they meet an appropriate cell.‬
‭➢‬ ‭Viruses are considered LIVING when they multiply within host cells they infect‬
‭➢‬ ‭Replication of the genetic material occurs when the virus takes control of the host‬
‭cell’s machinery.‬
‭➢‬ ‭Does not have organelles‬

‭II.‬ M ‭ AIN COMPONENTS OF A VIRUS‬

‭A.‬ ‭CORE‬
‭➢‬ ‭Made up of only one type of nucleic acid. It can be either DNA or RNA.‬

‭TYPES OF CORE‬
‭A.‬ ‭DNA‬
‭➢‬ ‭If the virus is a DNA virus, it would simply follow the usual steps of central‬
‭dogma‬
‭➢‬ ‭Undergoes transcription and translation.‬
‭B.‬ ‭POSITIVE SENSE RNA‬
‭➢‬ ‭Assumes the role of an mRNA‬
‭➢‬ ‭Will directly undergo translation.‬
‭C.‬ ‭NEGATIVE SENSE RNA‬
‭➢‬ ‭It cannot assume the role of a mRNA‬
‭➢‬ ‭In order to create the template mRNA, it must contain the enzyme Viral RNA‬
‭dependent RNA poly‬
‭EXEMPTION‬
‭●‬ ‭Reverse Transcriptase - from RNA, they will synthesize first a DNA, from which the‬
‭DNA will follow the pathway. It will be transcribed into RNA, that will be then‬
‭translated into structural proteins and enzymes. Example: HIV, Hepatitis B virus‬
‭B. CAPSID‬
‭➢‬ ‭Protein coat surrounding the genetic material/core.‬
‭➢‬ ‭Capsomers – building blocks of Capsid‬
‭➢‬ ‭Determines the shape of the virus‬

‭C. ENVELOP‬
‭➢‬ ‭Viruses acquire this membrane by budding through the host cell where viruses tear‬
‭off a piece of the membrane as they leave‬
‭➢‬ ‭Enveloped – with membrane‬
‭➢‬ ‭Naked – without membrane‬

‭III. VIRION‬

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‭ ‬ ‭Mature virus‬
‭➢‬ ‭Capable of infecting other cells‬
‭IV. REPLICATION‬
‭1.‬ ‭Attachment- the virus would try to enter a host cell‬
‭2.‬ ‭Penetration‬
‭●‬ ‭Naked: Endocytosis‬
‭●‬ ‭Enveloped: Fusion‬
‭3.‬ ‭Uncoating – the virus will go into the target site of the cell where nucleic acid‬
‭synthesis and protein synthesis will happen‬
‭4.‬ ‭Synthesis – utilizes the host’s machinery in order to reproduce‬
‭5.‬ ‭Assembly‬
‭6.‬ ‭Release – release.‬
‭●‬ ‭Naked: Lysis‬
‭●‬ ‭Enveloped: Budding‬

‭V. ATYPICAL VIRUS‬

‭A.‬ ‭RNA-ONLY VIRUS‬

‭ .‬
B ‭ ROTEIN-ONLY VIRUS‬
P
‭➢‬ ‭aka Prions‬
‭➢‬ ‭Proteinaceous infectious agents‬
‭➢‬ ‭Lacks instructional nucleic acid‬
‭➢‬ ‭Disease:‬
‭○‬ ‭Fatal neurological degeneration‬

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 ‭‬
○ ‭ eposition of fibrils in the brain‬
D
‭○‬ ‭Loss of brain matter‬
‭○‬ ‭VARIANT CREUDZFELDT-JAKOB DISEASE‬
‭○‬ ‭BOVINE SPONGIFORM ENCEPHALOPATHY‬

‭CLINICALLY SIGNIFICANT DNA VIRUS‬

‭A.‬ ‭HERPESVIRIDAE‬
‭CHARACTERISTICS‬
‭LATENCY‬
‭➢‬ ‭During the primary infection, the virus migrates up to the nerves to the‬
‭sensory ganglia and resides there (dormant). Gets reactivated upon insult‬
‭where the virus migrates out to the peripheral skin via the nerves to cause‬
‭local destruction‬
‭CYTOPATHIC EFFECT‬
‭➢‬ ‭Present in HSV1 and 2, and VZV.‬
‭➢‬ ‭Separation of the epithelium and causes blisters (vesicles).‬

‭ ERPES SIMPLEX VIRUS 1 (HSV1)‬

H
‭CLINICAL MANIFESTATION‬
‭➢‬ ‭Gingivostomatitis/Aphthous Ulcer‬
‭➢‬ ‭Reactivation‬
‭➢‬ ‭Herpetic Keratitis – most common cause of corneal blindness‬
‭➢‬ ‭Encephalitis – most common cause of viral encephalitis‬

‭ ERPES SIMPLEX VIRUS 2 (HSV2)‬

H
‭CLINICAL MANIFESTATION‬
‭➢‬ ‭Genital Herpes‬
‭○‬ ‭sexually transmitted‬
‭○‬ ‭vesicles are painful with burning sensation and itching often associated with‬
‭urination‬
‭○‬ ‭NOTE: HSV is a teratogen‬

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‭ ARICELLA-ZOSTER VIRUS (VZV)‬
V
‭CLINICAL MANIFESTATION‬
‭➢‬ ‭CHICKEN POX‬
‭○‬ ‭Transmitted by respiratory droplets and skin contact‬
‭○‬ ‭Incubation period: 2 WEEKS, followed by viremia‬
‭○‬ ‭Signs and Symptoms:‬
‭■‬ ‭Fever, malaise, Headache‬
‭■‬ ‭Vesicle (entire body including mucus membranes)‬
‭○‬ ‭DEW ON RED PETAL‬
‭■‬ ‭red base with a fluid filled vesicle on top‬
‭■‬ ‭fluid becomes cloudy and rupture‬
‭■‬ ‭lesions scab‬
‭➢‬ ‭SHINGLES (Herpes Zoster)‬
‭○‬ ‭VZV reactivation in immunocompromised individuals‬
‭○‬ ‭VZV resides in the spinal cord (Doorsal Root Ganglia)‬
‭○‬ ‭Signs and Symptoms:‬
‭■‬ ‭DERMATOMAL DISTRIBUTION‬
‭●‬ ‭certain spinal cord level; location depending on where VZV has‬
‭been dormant.‬
‭●‬ ‭almost always unilaterally‬

‭EPSTEIN BARR VIRUS (EBV)‬

‭➢‬ ‭aka HHV-4 (Human Herpesvirus-4)‬
‭CLINICAL MANIFESTATIONS‬
‭➢‬ ‭Infectious Mononucleosis‬
‭○‬ ‭aka Kissing Disease‬
‭○‬ ‭Signs and Symptoms: Flu like Symptoms – fever, chills, sweats, HA,‬
‭pharyngitis, enlarged lymph nodes‬
‭➢‬ ‭Oral Hairy Leukoplakia‬
‭○‬ ‭a precancerous change in the mucous membrane of the tongue‬
‭○‬ ‭Occurs in EBV infected hosts with severely depressed cellular immunity‬
‭➢‬ ‭Burkitt’s Lymphoma‬

‭CYTOMEGALOVIRUS (CMW)‬
‭➢‬ ‭Infected cells become swollen‬
‭CLINICAL MANIFESTATIONS‬
‭➢‬ ‭Asymptomatic infection‬
‭➢‬ ‭Congenital disease‬
‭➢‬ ‭CMV mononucleosis‬
‭➢‬ ‭Reactivation‬
‭○‬ ‭CMV Retinitis (blindness)‬
‭○‬ ‭CMV Pneumonia‬
‭HHV-8‬
‭➢‬ ‭Kaposi Sarcoma‬

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‭HHV-6‬
‭➢‬ ‭Roseola Infantum/ Infantum Subitum/ 6 th disease‬

‭ .‬ ‭HEPADNAVIRIDAE‬
B
‭HEPATITIS B VIRUS (HBV)‬
‭➢‬ ‭aka Serum Hepatitis/ Bad Hepa‬
‭➢‬ ‭Its virion is present in all body fluids‬
‭TRANSMISSION‬
‭➢‬ ‭Blood borne‬
‭➢‬ ‭Sexual contact (unprotected)‬
‭➢‬ ‭Needle sharing‬

‭DISEASE STATES‬
‭➢‬ ‭Acute Hepatitis‬
‭➢‬ ‭Fulminant Hepatitis – severe acute hepatitis with rapid destruction of the liver.‬
‭➢‬ ‭Chronic Hepatitis‬
‭○‬ ‭Asymptomatic carrier‬
‭○‬ ‭Chronic persistent hepatitis‬
‭○‬ ‭Chronic active hepatitis‬
‭○‬ ‭Co infection with HDV‬
‭➢‬ ‭SEROLOGY‬

‭ .‬
C ‭ OXVIRIDAE‬
P
‭➢‬ ‭Box shaped (complex)‬
‭➢‬ ‭Largest virus family‬
‭➢‬ ‭Replicate in the cytoplasm because they have their own Polymerase‬
‭➢‬ ‭Pox virus pustules dry to form crusts. Because these lesions penetrate the dermis,‬
‭they may result in characteristic scars, particularly on the face. Additionally, the‬
‭disease is characterized by high fever, malaise, delirium, and prostration.‬
‭CLINICAL MANIFESTATION‬
‭➢‬ ‭SMALLPOX‬
‭○‬ ‭Aka: Variola‬
‭○‬ ‭Systemic infection‬
‭○‬ ‭1 st diseases eradicated through vaccination‬
‭➢‬ ‭COWPOX‬
‭○‬ ‭Aka: Vaccinia‬
‭○‬ ‭Used in smallpox vaccine‬

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 ‭➢‬ ‭MOLLUSCUM CONTAGIOSUM‬
‭○‬ ‭Caused by a pox virus (molluscum contagiosum virus)‬
‭○‬ ‭White bumps with a central dimple‬

‭D.‬ ‭PAPOVAVIRIDAE‬
‭ UMAN PAPILLOMAVIRUS (HPV)‬
H
‭CLINICAL MANIFESTATIONS‬
‭➢‬ ‭Warts‬
‭○‬ ‭benign hyperproliferation of the keratinized squamous epithelium‬

‭➢‬ ‭CERVICAL CANCER‬

‭○‬ ‭cervical dysplasia and carcinoma‬
‭○‬ ‭HPV 16 and HPV 18‬
‭○‬ ‭Vaccines:‬
‭■‬ ‭Cervarix® (HPV 16, 18)‬
‭■‬ ‭Gardasil® (HPV 16,18,6,11)‬
‭POLYOMA‬
‭➢‬ ‭BK VIRUS‬
‭○‬ ‭causes mild febrile reaction in children‬
‭➢‬ ‭JC VIRUS‬
‭○‬ ‭PML (Progressive Multifocal Leukoencephalopathy)‬
‭○‬ ‭opportunistic infection‬
‭○‬ ‭attacks white matter of the brain (memory loss, poor speech, incoordination)‬
‭E.‬ ‭ADENOVIRIDAE‬
‭ADENOVIRUS‬
‭CLINICAL MANIFESTATIONS‬
‭➢‬ ‭URTI (Upper Respiratory Tract Infection)‬
‭○‬ ‭can lead to pneumonia‬
‭➢‬ ‭AGE (Acute Gastroenteritis)‬
‭➢‬ ‭Sore throat‬
‭➢‬ ‭Rhinitis‬
‭➢‬ ‭Sore eyes‬

‭ .‬ ‭PARVOVIRIDAE‬
F
‭PARVOVIRUS‬
‭CLINICAL MANIFESTATIONS‬
‭➢‬ ‭ERYTHEMA INFECTIOSUM‬
‭○‬ ‭Aka: 5th disease‬
‭○‬ ‭The rash begins on the cheeks and spreads to the arms, thighs, buttocks, and‬
‭trunk (Slapped cheeks appearance)‬

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