Gastrointestinal Viruses

Dr: Selma Osman Ahmed

Associate prof. in
Microbiology
Gastrointestinal Viruses include:

1-Rota virus.

2-Adenovirus.

3-Norovirus.

4-Astrovirus.

5-Coxsackie virus.

6-Echo virus.
• It is thought that viruses are responsible for up to 3/4 of
all infective diarrhoeas.
• Viral gastroenteritis is the second most common viral
illness after upper respiratory tract infection.
• In developing countries, viral gastroenteritis is a major
cause of infants deaths who are undernourished.
Rotaviruses are responsible for half a million deaths a
year.
 Rotavirus
 Rotaviruses are a major cause of diarrheal illness in human infants
and young animals. Symptomatic infections are most common in
children between ages 6 months and 2 years
 Rotavirus have distinctive wheel shaped appearance.
 It is a genus of double stranded RNA in the family Reoviridae
 Non enveloped and segmented virus.
 Rotaviruses have been classified into eight species (A–H) based on
antigenic epitopes and sequence of the internal structural protein VP6.
 Rota virus A, the most common, causes more than 90% of infections
in human.
 The RNA is surrounded by a three-layered icosahedral protein capsid.
 Rotaviruses have six viral protein (VPs) that form the virus particle.

 These structural proteins are called VP1,VP2,VP3,VP4,VP6,VP7.

 In addition to the VPs, there are six nonstructural proteins

(NSPs),NSP1,NSP2,NSP3,NSP4,NSP5 and NSP6.

 Rotaviruses are fastidious agents to culture.

Pathogenesis
 Rotaviruses infect cells in the villi of the small intestine,they multiply
in the cytoplasm of enterocytes (intestinal absorptive cells)and
damage their transport mechanisms.

 One of the rotavirus nonstructural protein NSP4 act as a viral

enterotoxin to induce diarrhea.

 Damaged cells may slough into the lumen of the intestine and release
large quantities of virus, which appear in the stool.
 Viral excretion usually lasts from 2 to 12 days.

 Diarrhea caused by rotaviruses may also be due to impaired

sodium and glucose absorption as damaged cells on villi are
replaced by nonabsorbing immature crypt cells. It may take
from 3 to 8 weeks for normal function to be restored.
Transmission
 Oral –fecal route

Clinical signs
 watery diarrhea
 fever
 abdominal pain
 Vomiting
Laboratory diagnosis
 Laboratory diagnosis rests on demonstration of virus
in stool collected early in the illness and on a rise in antibody
titer.

 Virus in stool is demonstrated by antigen enzyme immunoassays

(EIAs) or PCR.

 Genotyping of rotavirus nucleic acid from stool specimens by

the polymerase chain reaction (PCR) is the most sensitive
detection method.
Treatment
 Treatment of gastroenteritis is supportive to correct the loss of
water and electrolytes that may lead to dehydration, acidosis,shock,
and death.
Adenovirus
• Adenoviruses are 70–90 nm in diameter and display icosahedral
symmetry
• Naked DNA viruses
• DNA is linear and double stranded.
• Associated with cases of endemic gastroenteritis, usually in young
children and neonates. Can cause occasional outbreaks.
• Possibly the second most common viral cause of gastroenteritis (7-
15% of all endemic cases).
• Similar disease to rotaviruses
• Adenoviruses replicate well only in cells of epithelial origin
• The presence of most serotypes is not associated with gastrointestinal
disease. However, two serotypes (types 40 and 41) have been
etiologically associated with infantile gastroenteritis and may account
for 5–15% of cases of viral gastroenteritis in young children.
Astrovirus
Astrovirus is ssRNA

Member of Astroviridae family

Naked virus

Icosahedral symmetry
 Astroviruses

• Small RNA viruses, named because of star-shaped surface

morphology, 28 nm in diameter.
• Associated with cases of endemic gastroenteritis, usually in
young children and neonates. Can cause occasional outbreaks.
• Responsible for up to 10% of cases of gastroenteritis.
• Similar disease to rota and adenovirus.
• Diagnosed by electron microscopy only, often very difficult
because of small size.
CALICIVIRUSES
 The particles appear to have cup-shape
on their surface

 In addition to rotaviruses and

adenoviruses, members of the family
Caliciviridae are important agents of
viral gastroenteritis in humans.
 The most significant members are the
noroviruses, the prototype strain being
Norwalk virus.
 Norwalkvirus
 Discovered in Norwalk,ohio 1968
 Family Calciviridae
 +Ss RNA
 Naked virus
 Icosahedral symmetry
 Diagnosis is made by electron
microscopy and by RT-PCR
• Small RNA viruses, with ragged surface, 35 nm in diameter, now classified
as caliciviruses.
• Always associated with epidemic outbreaks of gastroenteritis, adults more
commonly affected than children.
• Associated with consumption of shellfish and other contaminated foods.
Aerosol spread possible as well as faecal-oral spread.
• Also named "winter vomiting disease", with vomiting being the prominent
symptom, diarrhoea usually mild.
• Antibodies acquired later in life, in the US, only 50% of adults are
seropositive by the age of 50.
• Diagnosis is made by electron microscopy and by RT-PCR.