GROUP 12 - GASTROINTESTINAL VIRUSES | 3 YB-2
GASTROINTESTINAL VIRUSES
INTRODUCTION
 Rotavirus
 Norovirus (Norwalk Virus)
 Adenovirus
 Astrovirus
 Poliovirus
ROTAVIRUS
CHARACTERISTICS
 Rotavirus is a genus in the family Reoviridae that is
known as the leading cause of severe diarrhea in children
worldwide and it is commonly called Reovirus.
 The reoviruses were first isolated from
respiratory and enteric specimens and therefore
are referred to as respiratory-enteric-orphan
viruses (reoviruses).
 Reoviruses infect most mammalian species and
are readily detected in water contaminated with
animal feces.
 Common human pathogens of this family
include the rotaviruses and the agent of
Colorado tick fever.
 Rotaviruses grow in the cells lining the intestines, where
they give rise to acute gastroenteritis, particularly
conditions known as “infantile diarrhea” or “winter
diarrhea.”
 The Latin word rota means “wheel”, and thus rotaviruses
are named for their wheel-like appearance, which is
apparent under a microscope.
Transmission electron micrograph of intact rotavirus particles. This
digitally colorized image reveals more of the structure of rotavirus
virions (viral particles).
 Rotaviruses are nonenveloped, double-stranded RNA
viruses composed of three concentric protein shells, the
outer shell, the inner shell, and the core.
GROUP 12 | APOSTOL, DIMARUKOT, HUMARANG, RABANO
 Based on the proteins present in these shells,
rotavirus is further classified into seven distinct
groups, A through G; wherein groups A, B, and C
cause human disease.
 Group A - associated with acute gastroenteritis
in humans and animals.
 Group B - was detected in humans, cattle,
sheep, pigs, dogs, and rats.
 Group C - infects pigs, humans, cattle, dogs,
and ferrets.
 Rotavirus is now recognized as the major causative
agent of infantile severe gastroenteritis throughout
the world.
 Gastroenteritis caused by rotavirus can occur in children
of all ages but is most common in infants from 6 months
to 3 years old.
Symptoms:
 The disease is characterized by sudden onset of vomiting,
followed by explosive, watery diarrhea and moderate to
high fever, often accompanied by dehydration.
 The severity of the disease often is worse for
children in developing countries because of
malnutrition and limited or delayed health care.
LABORATORY TESTS
 Rotavirus can be detected directly in the stool using:
 Latex Agglutination - offers rapid results with
limited laboratory equipment, an advantage in
developing countries where resources are limited.
 Nucleic acid detection PCR assays - for rotavirus
alone or in multipathogen panels.
 Antigen-detection Immunoassays on stool
specimens - to rapidly detect rotavirus RNA or
antigens.
 Rotavirus is difficult to cultivate from human specimens.
Viral isolation is not normally attempted.
Specimen Collection:
 Whole stool is the preferred specimen.
 Collect a minimum of 1 mL of stool for basic confirmatory
testing; 2 mL or more may be needed for additional
testing, such as genotyping.
 A stool specimen should be obtained within 48 hours of
hospital admission to avoid detection of nosocomially
acquired infections.
 Avoid using rectal swabs or swabs placed in bacterial
media, which are not optimal for rotavirus detection or
characterization.
Specimen Handling:
 Stool specimens should be placed in sterile screw-top
containers, and properly labeled.
 Samples can be stored temporarily at 4–8°C for up to one
month. Ice packs can be used to keep samples cool.
Freeze-thaw cycles should be avoided where possible.
 If prolonged storage is necessary, store at -70°C, as
evidence suggests that the ability to characterize
rotaviruses declines during storage for years at -20°C.
 If stool samples are also tested for bacterial or parasitic
pathogens by conventional methods, the specimens
should be transported to the lab within two hours of
collection and placed on appropriate media.
 Specimens should then be stored in a freezer at -20°C or
colder until testing is performed.
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GROUP 12 - GASTROINTESTINAL VIRUSES | 3 YB-2
EPIDEMIOLOGY  Human adenoviruses belong to the genus
 Rotaviruses are transmitted by the fecal-oral route, Mastadenovirus (encompassing all mammalian
although airborne transmission has been suspected as adenoviruses) and are further divided into seven
the cause of nosocomial infections and outbreaks in subgroups (A to G) based on their hemagglutination
nursing homes, hospitals, and daycare centers. characteristics.
 Many outbreaks probably develop when infected Structure:
food handlers contaminate foods that require no  The adenovirus particle consists of an icosahedral protein
further cooking, such as salads, sandwiches, and shell surrounding a protein core that contains the linear,
fruits. double-stranded DNA genome.
 The usual sanitary measures that prevent  The shell, which is 70 to 100 nm in diameter, is made up
infection by bacteria or parasites, such as cooking of 252 structural capsomeres. The 12 vertices of the
and use of antimicrobial cleaners, often fail to icosahedron are occupied by units called pentons, each
control rotavirus contamination. of which has a slender projection called a fiber.
 Rotaviruses can infect domestic and wild animals,  The 240 capsomeres that make up the 20 faces and the
providing further opportunities for spreading edges of the isocahedron are called hexons because they
infection. form hexagonal arrays.
 In countries with a temperate climate, such as the United NOTE: The Roman numerals refer to the standard
States, acute gastroenteritis due to rotavirus is most designations of the viral structural proteins according to their
frequent during the cooler months: major outbreaks decreasing molecular masses. FP stands for fracture plane in
occur between December and June. freeze etching.
 In tropical areas, infection occurs year-round. The peak
age of risk runs from six months to two years.
PREVENTION AND CONTROL
 The two rotavirus vaccines approved for use in infants in
the United States are safe and effective. During the first
year of an infant’s life, rotavirus vaccine provides 85% to
98% protection against severe rotavirus illness and
against hospitalization from rotavirus illness, and 74% to
87% protection against rotavirus illness of any severity.
 The CDC recommends routine vaccination of infants with
either of the two available vaccines:
 RotaTeq® licensed in 2006, is given in three
doses at ages 2 months, 4 months, and 6 months
 Rotarix® licensed in 2008, is given in two doses at
LABORATORY TESTS
ages 2 months and 4 months
Laboratories can detect and type human adenoviruses using:
 The vaccines differ in how they are made and the
 Molecular detection (e.g. PCR)
number of doses, but both are given orally.
 Partial or full genome sequencing
 More recently, another live oral monovalent vaccine
 Antigen detection
(ROTAVAC®) was licensed in India after it was found to be
 Virus isolation
effective in a large clinical trial. This vaccine is given in
 Virus neutralization with type-specific antisera
three doses to infants.
Specimen Collection:
 As part of a comprehensive package of diarrhea
The types of specimens you should collect for human
prevention and treatment measures that include access
adenovirus detection depend on the patient’s clinical
to safe water and sanitation as well as early treatment
presentation and type of infection. To improve human
with rehydration therapy.
 Vaccines are the most effective way to prevent adenovirus detection, you should collect specimens within a
rotavirus diarrhea. week of symptom onset:
ADENOVIRUS  Respiratory Infections: For respiratory infections, you
CHARACTERISTICS should typically collect upper respiratory specimens such
 The adenoviruses are common pathogens of humans and as a nasopharyngeal swab and/or oropharyngeal (throat)
animals. Moreover, several strains have been the subject swab. If there is evidence of a lower respiratory infection,
of intensive research and are used as tools in mammalian you should also collect a lower respiratory specimen such
molecular biology. as sputum. In some instances, a serum specimen may be
 The family Adenoviridae is divided into two Genera, the helpful.
mammalian adenoviruses (astadenoviruses) and the  Eye Infections: If there is clinical evidence of a
avian adenoviruses (aviadenoviruses). The adenoviruses conjunctival or eye infection, you should collect a
are named after the human adenoids, from which they conjunctival swab.
were first isolated.  Gastroenteritis Infections
 In permissive cells, the virus multiplies productively and
kills the host cell. Other cells are semipermissive,
allowing replication at low efficiency, whereas in still
others replication is blocked and the infection is abortive.

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GROUP 12 - GASTROINTESTINAL VIRUSES | 3 YB-2
EPIDEMIOLOGY
 The main target for human adenoviruses is the
respiratory tract.
 Various adenoviruses can also cause acute follicular
conjunctivitis, epidemic keratoconjunctivitis, and, less
frequently, cystitis and gastroenteritis.
 In infants, the most common clinical manifestations of
adenovirus infections are acute febrile pharyngitis and
pharyngeal-conjunctival fever.
 In military recruits, acute respiratory disease is the
predominant form of adenovirus disease, with
adenovirus pneumonia as a not infrequent complication.
 The virus is probably transmitted via droplets of
respiratory or ocular secretions.
 Acute follicular conjunctivitis - is a mild eye infection
most commonly due to a bacterial or viral infection.
Chlamydia and molluscum contagioscum are among the
most common causes. Follicular conjunctivitis is typically
a short-term infection that goes away after a few weeks
without treatment.
 Keratoconjunctivitis (also sometimes referred to as viral
keratoconjunctivitis) is a highly contagious viral infection
of the eye. Symptoms can last up to two weeks or more.
It is caused by adenoviruses and there is no specific
treatment.
 Pharyngoconjunctival fever is characterized by the
concurrent presence of fever, pharyngitis, and
conjunctivitis. It is caused by adenovirus (serotypes 3 and
7) and usually affects children younger than 10 years.
PREVENTION AND CONTROL
 Stay home when you are sick.
 Cough and sneeze into a tissue or your upper shirt sleeve,
not your hands.
 Avoid sharing cups and eating utensils with others.
 Refrain from kissing others.
 Wash your hands often with soap and water for at least
20 seconds, especially after using the bathroom.
 Frequent hand washing is especially important in
childcare settings and health care facilities.
 Maintain proper chlorine levels to prevent outbreaks.
Treatment
 There are no approved antiviral medicines and no
specific treatment for people with adenovirus infection.
Most adenovirus infections are mild and may be
managed with rest and over-the-counter pain medicines
or fever reducers to help relieve symptoms. Always read
the label and use medications as directed.
GROUP 12 | APOSTOL, DIMARUKOT, HUMARANG, RABANO
NOROVIRUS (NORWALK VIRUS)
CHARACTERISTICS
 Family: Caliciviridae
 Common Name: Caliciviruses (Norovirus)
 (formerly known as Norwalk-like viruses, named
after Norwalk, Ohio)
 Members of the Norovirus and Sapovirus genera
are the primary cause of viral gastroenteritis in
humans and are referred to as the human
caliciviruses (HuCV). Previously called “Norwalk-
like viruses” and “Sapporo-like viruses,” the viruses
were named after their prototype strains, the
Norwalk virus and the Sapporo virus, respectively.
These viruses are now referred to as the norovirus
and sapovirus.
 Caliciviruses are small (30-38 nm), rounded,
nonenveloped, single-stranded, positive RNA
viruses that cause acute gastroenteritis in humans.
 Norovirus is a type of single-stranded, non-enveloped
RNA virus known as “Norwalk-like viruses” (NLV), after
the first outbreak in Norwalk, Ohio.
 The first norovirus outbreak occurred in Norwalk,
Ohio, USA, in a school in 1968. For this reason, the
first strain of norovirus was known as the Norwalk
virus.
 Genotype GII is the most common in humans, accounting
for 95% of all infections.
 These viruses are further classified into six
genogroups (GI-GVI) based on the sequence of the
major capsid protein, with only three (GI, GII, and
GIV) known to cause human disease. Among these,
(GV infects mice; GIII infects cattle.)
 Noroviruses are the most common cause of acute
gastroenteritis (stomach flu) in humans, accounting for
more than 60% of cases.
 It affects people of all ages, but it causes severe
acute gastroenteritis in children under the age of
five. Norovirus is the most common cause of illness
and outbreaks due to contaminated food.
Signs and Symptoms:
Nausea Vomiting
Diarrhea Stomach pain
Headache Fever
Body aches
 (Symptoms usually appear 12 to 48 hours after exposure
to the virus and last one to three days.)
 (If you have norovirus, you’ll feel very sick. This can cause
you to throw up and have diarrhea. When you’re unable
to keep nutrients in your body, you’re at risk of
dehydration.)
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Mode of Transmission:
 Fecal-Oral Transmission
 Close contact with someone who has the virus.
 Having direct contact with someone with norovirus,
such as by caring for them, sharing food or eating
utensils with them, or eating food handled by
them.
 Touching contaminated surfaces and then touching your
mouth or nose.
 Eating or drinking contaminated foods or beverages.
 Food is placed on a counter or surface that has
poop or vomit particles on it.
 Tiny drops of vomit from a person with norovirus
spray through the air and land on the food.
 Food is grown with contaminated water, such as
oysters, or fruit and vegetables are watered with
contaminated water in the field.
LABORATORY TESTS
CLINICAL SPECIMEN
 Stool
 Stool specimens should be collected during the acute
phase of illness (up to 72 hours after symptoms start)
while the stool is still liquid or semisolid. The greatest
amount of virus is shed during the acute phase of
illness.
 Norovirus can sometimes be detected in stool
specimens that are collected later in the illness
or after the symptoms have resolved (up to 7 to
10 days after onset). The number of specimens
collected should be increased if collected after
GROUP 12 | APOSTOL, DIMARUKOT, HUMARANG, RABANO
the acute phase of illness or for large or
protracted outbreaks.
 If testing occurs within 2 to 3 days or within 2-3
weeks, specimen should be refrigerated (4°C) and
frozen (-20°C), if testing occurs beyond this times.
 If testing occurs within 2 to 3 days from
collection for whole stool and Cary-Blair
specimens, and within 2 to 3 weeks for stool
specimens, samples should be refrigerated at
39°F (4°C). If testing occurs beyond these times
or are to be archived, samples should be frozen
ideally at -94°F (-70°C) or at -4°F (-20°C) if
storage at -94°F (-70°C) is not available.
 Vomitus
 Samples should always be stored frozen at -4°F (-
20°C) or at -94°F (-70°C).
 Serum
 Not recommended for routine laboratory diagnosis.
 Acute-phase serum specimens should be
collected during the first 5 days after the
symptoms start.
 Convalescent-phase specimens should be
collected during the third to fourth week after
the symptoms start.
LABORATORY DIAGNOSIS
Diagnostic tests are available at all public health laboratories
and many clinical laboratories, and most use reverse
transcription- real-time polymerase chain reaction (RT-qPCR)
assays to detect norovirus.
 RT-qPCR Assays
 The preferred method to detect norovirus because
they are very sensitive and specific.
 Multiplex Gastrointestinal Platforms
 Commercial platforms for detection of multiple
gastrointestinal pathogens.
 A multiplex real-time PCR test, able to detect 19
stool bacterial, viral and parasitic pathogens
 Enzyme Immunoassays
 Rapid commercial enzyme immunoassays (EIAs)
that detect norovirus antigen in stool samples.
 However, these kits have poor sensitivity (50 to 75%)
 Samples that test negative should be confirmed by
a second technique, such as RT-qPCR. Thus, EIA kits
should not replace RT-qPCR during outbreak
investigations.
EPIDEMIOLOGY
 Norovirus has been the leading cause of acute
gastroenteritis outbreaks around the world since 2002.
 A highly contagious virus that most people will
contract five times in their lifetime. Hospitalization
and death are the most serious consequences of
the disease,
 They are far more common in children and the elderly, as
well as in low- and middle-income countries. In addition,
it is a common cause of endemic diarrhea.
 Norovirus is responsible for one out of every five cases of
acute gastroenteritis (inflammation of the stomach or
intestines), which causes diarrhea and vomiting around
the world.
 Each year, an estimated 685 million cases of acute
gastroenteritis are caused by norovirus. Annually,
approximately 200 million cases are seen among
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children under the age of five, resulting in an
estimated 50,000 child deaths, the majority of
which occur in developing countries. Norovirus kills
over 200,000 people each year and costs the global
economy more than $60 billion.
 Norovirus illness can occur at any time of year, but
outbreaks are more common in colder climates during
the fall and winter months.
 The illness is easily transmitted in crowds, such as
schools, hospitals, childcare facilities, nursing homes,
cruise ships, and passenger trains.
PREVENTION AND CONTROL
 Wash hands frequently with soap and water.
 Handle and prepare food safely.
 Do not prepare and handle food or care for others when
you are sick.
 Clean and disinfect surfaces.
Human Astrovirus
 Wash laundry well.
 Despite having nothing to do with influenza, it is
Treatment:
occasionally referred to as a "stomach bug" or "stomach
 There is no specific medicine to treat people with
flu."
norovirus illness.
 Most cases are short-lived and mild.
 Drink plenty of liquids.
 The main symptom of an astrovirus infection is mild,
 If you have norovirus illness, you should drink
watery diarrhea, but can also cause nausea, vomiting,
plenty of liquids to replace fluid lost from vomiting
fever, lethargy, and stomach discomfort.
and diarrhea. This will help prevent dehydration.
 Most of the diseases are self-limiting.
 Sports drinks and other drinks without caffeine or
 Some people may have an astrovirus that is
alcohol can help with mild dehydration. However,
asymptomatic.
these drinks may not replace important nutrients
 Incubation period: 4-5 days.
and minerals. Oral rehydration fluids that you can
Mode of Transmission:
get over the counter are most helpful for mild
 The disease is very contagious
dehydration.
 The fecal-oral route is the most typical way that
ASTROVIRUS
astrovirus spreads.
CHARACTERISTICS
 It can also occur by ingestion of contaminated water and
 Family: Astroviridae
food.
 Genus:
 Touching contaminated surfaces or objects.
 Mamastrovirus: Natural hosts are humans,
Diagnosis and Sample Collection:
mammals and vertebrates.
 Physicians rarely test for astrovirus, but instead diagnose
 Avastrovirus: Natural hosts are birds.
it based on the symptoms or by ruling out another
 Genome: ranging from 7 to 9 kb (kilobase)
medical condition.
 If the symptoms are severe or the patient has a
 The Greek term “astron”, which means “star”, is the
weakened immune system, they will be ordered to do a
source of the family name.
stool testing.
 Astrovirus looks to have a star-like form when examined
 Obtain an adequate amount of feces (1-2 g or mL for a
under a microscope (electron microscopy) because of
liquid sample). It is best to gather stool samples in dry,
their protruding spikes, which extend around 41 nm from
clean containers without any transport medium or
the capsid surface.
preservatives. Before testing, the samples can be kept for
 Astroviruses are positive-sense, unsegmented RNA
one to two days in a refrigerator at 2-4°C/36-40°F.
viruses.
LABORATORY TESTS
The sample will be sent to a lab where technicians will look
for the presence of astrovirus. A few tests they could employ
are:
 Enzyme immunoassay (EIA) test - This test detects viral
antigens (unique elements of the virus) in stool samples.
 Polymerase chain reaction (PCR) test - This test finds the
virus's genetic material in stool samples.
 Both tests are extremely sensitive, detecting even trace
amounts of antigens (in the EIA test) or viruses (in the
PCR test) in the feces.
EPIDEMIOLOGY
 Human astroviruses have been regarded as one of the
main causes of viral acute gastroenteritis in infants since
their discovery in 1975.

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GROUP 12 - GASTROINTESTINAL VIRUSES | 3 YB-2
 The likelihood of zoonotic transmission between human
and animal astroviruses is increased by the genetic
similarity between certain of these viruses, even if it has
not been definitively identified.
 Astrovirus can affect anyone, although it's more
prevalent in:
 Children under 5 years old.
 Adults who are above 65 years old.
 Individuals whose immune systems have been
weakened (by HIV, some malignancies,
immunosuppressive drugs, etc.).
 Circulating vaccine-derived poliovirus (cVDPV): This is
 Astrovirus outbreaks can occur in childcare centers
uncommon, although it has been on the rise in recent
and long-term care institutions when a high
years due to poor immunization rates in communities.
concentration of at-risk individuals congregate due
POLIOMYELITIS
to certain risk factors.
 Infections were recognized as early as the 1800s, where
fever-accompanied paralysis were reported.
 Acute flaccid paralysis, also known as relaxed or "rag
Treatment:
doll" paralysis, struck thousands of individuals, mostly
 Astrovirus is not treated with any antiviral medication.
children, making it difficult for them to breathe.
 Individuals with healthy immune systems will often
 The virus can infect a person's spinal cord and cause
recover without medical intervention.
paralysis.
 But if the patient is experiencing diarrhea, it's important
 The more severe symptoms affecting the brain and spinal
for them to stay hydrated and attempt to obtain as much
cord are less common in individuals infected with the
nourishment as they can. Good options include water,
poliovirus.
broth, sports drinks, and oral rehydration solutions (like
Symptoms:
Pedialyte®).
 Meningitis: Infection of the membrane around the brain
 Diarrhea can be treated with over-the-counter drugs such
and/or spinal cord.
as loperamide (Imodium®) and bismuth subsalicylate
 Paresthesia: The feeling of pins and needles in the legs.
(Pepto-Bismol®, Kaopectate®).
 Paralysis: The most severe symptom. The inability to
 The physician may advise oral or IV hydration, as well as
move portions of the body or weakness in the arms, legs,
antidiarrheal drugs, if the symptoms are severe.
or both.
PREVENTION
Types of Poliomyelitis:
 Wash hands before and after eating.
 Abortive poliomyelitis: The mildest form.
 If you have diarrhea, avoid swimming. When your
 Nonparalytic poliomyelitis: Symptoms are more severe
diarrhea stops, wait two weeks before swimming.
than abortive, but not as bad as paralytic.
 If you swim in lakes, rivers, or public pools, try not to get
 Paralytic poliomyelitis: The most severe; may result in
water in your mouth.
permanent paralysis of certain muscle groups, including
 Avoid consuming raw milk or unpasteurized water.
breathing muscles and leg muscles.
POLIOVIRUS
 Post-polio syndrome (PPS): Occurs 15-40 years after the
CHARACTERISTICS
infection and recovery.
 Family: Picornaviridae
 Genus: Enterovirus
 Causes poliomyelitis
 The Greek words "polio," which means "gray," and
"myelon," which means "marrow," are the source of the
phrase "poliomyelitis.”
 The diameter of poliovirus is between 25 and 30 nm.
 The majority of poliovirus infections are asymptomatic.
 A sore throat, fever, fatigue, nausea, headache, and
stomach discomfort are among the flu-like symptoms
that affect about 1 in 4 (or 25 out of 100) persons
infected with the poliovirus. Usually lasting two to five Mode of Transmission:
days, these symptoms eventually are self-limiting.  Poliovirus is very contagious.
Types of Poliovirus:  It resides in the intestines and throat of an infected
 Wild poliovirus (WPV): The most commonly known form individual.
of the poliovirus.  It spreads through person-to-person contact.
 Poliovirus 1: Only existing poliovirus in the world  The illness is transmitted by the fecal-oral route.
that causes paralyzation  In unsanitary settings, it can contaminate food and drink.
 Poliovirus 2: Eradicated  Can also be transmitted through droplets from an
 Poliovirus 3: Eradicated infected person's cough or sneeze (less common).
Diagnosis and Specimen Collection:

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GROUP 12 - GASTROINTESTINAL VIRUSES | 3 YB-2
 The physician will admit a patient suspected of having  According to the recommended immunization schedule,
polio immediately. all children should get vaccinations, whether or not they
 Then they will perform a thorough physical examination, are included in the mass immunization campaign.
obtain a detailed medical history including vaccination  The reason behind the low incidence of paralysis due to
history and travel history, collect samples (stool, throat infections remains unknown.
swab, blood, urine, and spinal fluid), and order an MRI to  An individual with polio is more likely to become
view images of the spinal cord. paralyzed if they have some significant risk factors. These
consist of:
Immune deficiency Pregnancy
Intramuscular injections,
Tonsillectomy
such as medications
Intense workouts Injury
 The people who are most at risk of contracting the
disease are those who are not vaccinated against polio
and are exposed to the virus.
Treatment:
 Paralytic polio has no known cure and no particular
treatment.
 Instead, they can receive supportive care to relieve
 Stool samples are where poliovirus is most likely to be
symptoms such as resting, fluids and pain medication.
found.
 Iron lung: A type of negative pressure ventilator (NPV), a
 In order to maximize the chances of isolating the virus,
mechanical respirator that surrounds the majority of the
two stool samples should preferably be taken within two
body and modifies the interior air pressure to encourage
weeks, ideally separated by 24 hours.
breathing.
 The oropharynx is typically where the virus first appears
during an infection.
 Occasionally can the virus be separated from CSF in
aseptic meningitis patients.
 The virus may be isolated from blood during the first
phase of viremia, which occurs three to five days after
infection, although this is not essential to diagnosing.
LABORATORY TESTS
 Culture: The most sensitive test for determining the
presence of poliovirus infection is virus isolation in
culture. Stool specimens are the most likely source of
poliovirus isolations. Moreover, it could be separated
from pharyngeal swabs.
 Intratypic differentiation: Using a virus obtained in
culture as the starting material, real-time reverse
transcription PCR is used to distinguish between
potentially wild strains and vaccine-like strains (a process
PREVENTION
known as "intratypic differentiation").
 Polio can be prevented by two types of vaccines:
 Genome sequencing: The poliovirus genotype is verified
 Inactivated poliovirus vaccine (IPV) - Administered
and its geographic origin is identified.
as an injection in the patient's leg or arm,
 Serology: It can be useful in confirming the diagnosis of
depending on their age.
paralytic poliomyelitis, especially in cases when a
 Oral poliovirus vaccine (OPV) - It is still widely used
patient's immunization history is unknown or suspected.
across the world.
As soon as the illness is suspected, an acute serum
 Maintain proper hand hygiene by washing hands often
sample should be taken, and three weeks or more later, a
with soap and water.
convalescent specimen.
 Alcohol-based hand sanitizers do not destroy the
EPIDEMIOLOGY
poliovirus.
Poliomyelitis in the Philippines
 The Philippines had not experienced any polio-related
illnesses over the past nineteen years.
 A polio epidemic was announced in the Philippines on
September 19, 2019 that started in Mindanao and
Manila.
 A comprehensive outbreak response, including mass
polio vaccination rounds started in the same year, is
being worked on by the Philippine Department of Health
and its partners.

GROUP 12 | APOSTOL, DIMARUKOT, HUMARANG, RABANO 7

GROUP 12 - GASTROINTESTINAL VIRUSES | 3 YB-2

GROUP 12 | APOSTOL, DIMARUKOT, HUMARANG, RABANO 8