1
Q
RHABDOVIRUSES RABIES VIRUS
Disease: This virus causes ….
A
rabies, an encephalitis.
2
Q
Rabies virus It has a …… enclosed within a ……. surrounded by a ……
A
single-stranded RNA
bullet-shaped capsid
lipoprotein envelope.
3
Q
Rabies virus has a …. antigenic type.The antigenicity resides in the …….
A
single
envelope glycoprotein spikes
4
Q
Rabies virus attaches to the …. on the cell surface.
A
acetylcholine receptor
5
Q
Rabies virus is transmitted by the ….. that manifests aggressive, biting behavior induced by the ….. The virus is in the …. of the rabid animal. I
A
bite of a rabid animal
viral encephalitis
saliva
6
Q
…. have been the source of most cases of human rabies in the United States.
A
bats
7
Q
…… do not transmit rabies
A
Rodents and rabbits
8
Q
MOT of rabies
A
Rapid animal
Organ transplantation (cornea)(non bite example)
exposure to aerosols of bat secretions containing rabies virus.( non bite example)
9
Q
Pathogenesis of rabies
A
The virus multiplies locally at the bite site, infects the sensory neurons, and moves by axonal transport to the central nervous systemThe virus multiplies in the central nervous system and then travels down the peripheral nerves to the salivary glands and other organs. From the salivary glands, it enters the saliva to be transmitted by the bite. There is no viremic stage. Within the central nervous system, encephalitis develops, with the death of neurons and demyelination. Infected neurons contain an eosinophilic cytoplasmic inclusion called a Negri body, which is important in laboratory diagnosis of rabies. Because so few individuals have survived rabies, there is no information regarding immunity to disease upon being bitten again.
10
Q
The incubation period for rabies is typically ….. but may vary from 1 week to 1 or 2 years, depending on …..
A
2–3 months
size and site of inoculation
11
Q
Initial symptoms of rabies include ……. at the wound site
A
a fever with pain and unusual or unexplained tingling, pricking, or burning sensation (paraesthesia)
12
Q
There are two forms of the rabies disease:
A
furious rabies
Paralytic rabies
13
Q
People with furious rabies exhibit signs of …… Eventually death occurs after a few days due to …..
A
hyperactivity, excitable behaviour, fever, excitation, dilation of the pupils, salivation, anxiety, hydrophobia, spasms of the throat muscles abnormal behavior, hallucinations, insomnia and, sometimes aerophobia (fear of fresh air).
cardio-respiratory arrest.
14
Q
Paralytic rabies accounts for about …….. This form of rabies runs a less dramatic and usually longer course than the ….. Muscles ……… The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.
A
20% of the total number of human cases
furious form
gradually become paralyzed, starting at the site of the bite or scratch. A coma slowly develops, and eventually death occurs.
15
Q
Laboratory Diagnosis
Rapid diagnosis of rabies infection
A
In animal by using either PCR assay, fluorescent antibody to rabies virus, or histologic staining of Negri bodies in the cytoplasm of hippocampal neurons.
Rabies in humans can be diagnosed by PCR assay; by fluorescent antibody
by isolation of the virus from sources such as saliva, spinal fluid, and brain tissue
Negri bodies can be demonstrated in corneal scrapings and in autopsy specimens of the brain.
16
Q
There are two approaches to prevention of rabies in humans:
A
preexposure and postexposure immunization.
17
Q
Preexposure immunization with rabies vaccine should be given to ….
A
individuals in high-risk groups
18
Q
. Preexposure immunization consists of ….. given on days ….
A
three doses
0, 7, and 21 or 28.
19
Q
Postexposure immunization involves the use of both the ……..) plus immediate cleaning of the wound. This is an example of ….
… immunization should also be considered.
A
vaccine and human rabies immune globulin (RIG, obtained from hyperimmunized persons
passive–active immunization.
Tetanus
20
Q
Hospital personnel exposed to a patient with rabies need not be immunized unless a significant exposure has occurred (e.g., a traumatic wound to the health care worker). If the decision is to immunize, both …….
. As much as possible of the RIG is given into the bite site, and the remainder is given intramuscularly.
A
HDCV and RIG are recommended. Five doses of HDCV are given (on days 0, 3, 7, 14, and 28), but RIG is given only once with the first dose of HDCV (at a different site). HDCV and RIG are given at different sites to prevent neutralization of the virus in the vaccine by the antibody in the RIG
21
Q
Togaviruses
This virus causes …..
A
rubella and congenital rubella syndrome. Congenital rubella syndrome is characterized by congenital malformations.
22
Q
Rubella virus is a member of the …
A
togavirus family.
23
Q
Rubella virus is a member of the …. It is composed of one piece of ….
However, unlike the paramyxoviruses, such as measles and mumps viruses, it has …
A
togavirus family
single-stranded RNA, an icosahedral nucleocapsid, and a lipoprotein envelope.
a positive-strand RNA
24
Q
RUBELLA VIRUS has a .. . antigenic type
A
single
25
RUBELLA VIRUS
The virus is transmitted via ... and from... transplacentally
respiratory droplets
mother to fetus
26
.... is a much more common cause of congenital malformations in the United States than is rubella virus.
cytomegalovirus
27
RUBELLA VIRUS
Initial replication of the virus occurs in the ...
The origin of the rash is unclear; it may be due to ...
similar rashes are caused by other viruses, such as ...
nasopharynx and local lymph nodes.
antigen/antibody–mediated vasculitis.
Coxsackie viruses and echoviruses.
28
Rubella is a milder, shorter disease than ... After an incubation period of...
..... is characteristic.
measles
14 to 21 days
Posterior auricular lymphadenopathy
29
Congenital Rubella Syndrome The significance of rubella virus is not as a cause of mild childhood disease but as...
a teratogen.
30
Congenital Rubella Syndrome
When a nonimmune pregnant woman is infected during the ...., significant congenital malformations can occur as a result of . ...
Rubella can cause congenital rubella syndrome in the newly born. The syndrome (CRS) follows intrauterine infection by ... ,and comprises cardiac, cerebral, ophthalmic and auditory defects. It may also cause ....risk of major defects or organogenesis
is highest for infection in the ..
CRS is the main reason a ... for rubella was developed. Many mothers who contract rubella within the first critical trimester either have a miscarriage or a still born baby. If the baby survives the infection, it can be born with ....
first trimester, especially the first month
maternal viremia and fetal infection
Rubella virus
prematurity, low birth weight, and neonatal thrombocytopenia, anaemia and hepatitis.
first trimester.
vaccine
severe heart disorders (PDA being the most common), blindness, deafness, or other life threatening organ disorders. The skin manifestations are called "blueberry muff
31
Rubella Diagnosis
Rubella virus specific ...
characteristic .. confirms the diagnosis.
IgM antibodies
rash
32
MRR is a combination vaccine that protects against ...
measles, mumps, and rubella.
33
using .... before marriage for girls is the only protective measure. Vaccination should be avoided during ...
living attenuated Rubella (alone)
pregnancy and for 3 months before pregnancy
34
Arenaviruses are ..... viruses that cause chronic infections in rodents and .... in humans through rodent excreta, especially urine.
single-stranded ribonucleic acid (RNA) negative sense
zoonotically acquired disease
35
LASSA FEVER VIRUS
. It causes a ... characterized by multiorgan involvement. The disease begins slowly with ... and progresses to involve the .... A petechial rash and gastrointestinal tract hemorrhage ensue, followed by death from ....
severe, often fatal hemorrhagic fever
fever, headache, vomiting, and diarrhea
lungs, heart, kidneys, and brain.
vascular collapse.
36
The natural host for Lassa fever virus is the .....
small rodent Mastomys,
37
LASSA FEVER VIRUS
...... reduces the mortality rate if given early, and ...... obtained from persons who have recovered from the disease, has been beneficial in some cases. No ..... is available
Ribavirin
hyperimmune serum,
vaccine
38
Lymphocytic choriomeningitis virus is a member of the .......
.The usual picture consists of ....... Spinal fluid shows an increased number of cells, mostly ......
arenavirus family
fever, headache, vomiting, stiff neck, and changes in mental status
lymphocytes, with an elevated protein level and a normal or low sugar level.
39
Hantaviruses are members of the ...... The prototype virus is ..... the cause of .......(KHF)
. KHF is characterized by ......
bunyavirus family
Hantaan virus,
Korean hemorrhagic fever
headache, petechial hemorrhages, shock, and renal failure.
40
Hantaviruses are part of a heterogeneous group of viruses called ....., which stands for “...... Roboviruses are .....
roboviruses
rodent-borne” viruses.
transmitted from rodents directly (without an arthropod vector)
41
Rift Valley Fever (ARBO Virus)
an .......,disease that was first reported in the rift valley of Kenya where ... suffered from fatal hepatic necrosis and abortion
epizootic
sheep
42
Rift Valley Fever (ARBO Virus)
After a brief incubation period of ,.... fever, .... Patients tend to progress to one of three final complications: ...
2-6 days
severe headache, photophobia, and generalized myalgia begins.
mild encephalitis, retinitis, or hemorrhagic fever.
43
Rift Valley Fever
the virus is transmitted by many species of . .... and may also be transmitted by .......
mosquitos
fomites, direct contact and by arthropods.
44
Rift Valley Feve
No ... is available
human vaccine
45
Unconventional slow viruses,
prions
46
Prions are .... containing particles with no ... .. that are highly resistant to inactivation by heat, formaldehyde, and ultraviolet light at doses that ill inactivate viruses
protein
detectable nucleic acid
47
Kuru is a rare and .... that occurred at epidemic levels during the 1950s-60s among the Fore people in the highlands of New Guinea. The disease was the result of ......., in which relatives prepared and consumed the tissues (..........of deceased family members.
fatal brain disorder
the practice of ritualistic cannibalism among the Fore
including brain)
48
Kuru belongs to a class of infectious diseases called ..... also known as ....The hallmark of a TSE disease is ......
Scientists believe that misshapen prion proteins have the ability to change their shape and cause other proteins of the same type to also change shape.
transmissible spongiform encephalopathies (TSEs),
prion diseases.
misshapen protein molecules that clump together and accumulate in brain tissue
49
There were no treatments that could control or cure ...., other than discouraging the practice of cannibalism.
kuru
50
Creutzfeldt-Jakob disease is a ......... Symptoms of Creutzfeldt-Jakob disease (CJD) sometimes resemble those of ....., but Creutzfeldt-Jakob disease usually progresses much more rapidly.
degenerative brain disorder that leads to dementia and, ultimately, death
other dementia-like brain disorders, such as Alzheimer's
51
....) — after eating meat from diseased cattle.
variant CJD (vCJD
52
Initial signs and symptoms of CJD typically include:
Personality changes, Anxiety, Depression, Memory loss, Impaired thinking , Blurred vision, Insomnia, Difficulty speaking, Difficulty swallowing.
53
Creutzfeldt-Jakob disease and its variants belong to a broad group of human and animal diseases known as ......
transmissible spongiform encephalopathies (TSEs).
54
Variant CJD is linked primarily to eating ......
, the medical term for mad cow disease.
beef infected with bovine spongiform encephalopathy (BSE)
55
Filoviridae family of viruses is composed of two specific strains: ....
Marburg and Ebola
56
A filovirus is a virus which is part of the family known as ... .
filoviridae
57
The filovirus is composed of one molecule of ...
single stranded RNA.
58
Filoviruses cause a type of disease called a ....
hemorrhagic fever,
59
the Marburgvirus genus there is just one species, known as ....
Within the Ebolavirus genus there are three species, called ....
Lake Victoria marburgvirus.
Ivory Coast ebolavirus, Reston ebolavirus, and Sudan ebolavirus.
60
The first species of filoviridae to be discovered was ...
Marburg
61
only outbreak which has occurred on a continent other than Africa.
outbreaks of Marburgvirus of Filoviruses
Germany in 1967.
62
Filoviruses are ... viruses
filovirus have been found to infect...
... are the natural hosts of filoviruses.
zoonotic
monkeys and swine,
bats
63
Ebola virus is named for the .... that was the site of an outbreak of .... The disease begins with ..... Later, bleeding into the gastrointestinal tract occurs, followed by ..... The hemorrhages are caused by severe thrombocytopenia. The mortality rate associated with this virus approaches 100%. Most cases arise by secondary transmission from contact ....
river in Zaire
hemorrhagic fever in 1976
fever, headache, vomiting, and diarrhea
shock and disseminated intravascular coagulation
with the patient’s blood or secretions (e.g., in hospital staff).
64
high mortality rate of Ebola virus is attributed to several viral virulence factors: ....
resulting in ....., and two other proteins inhibit .... Lymphocytes are killed
Its glycoprotein kills endothelial cells,
hemorrhage
the induction and action of interferon.
65
Ebola
No antiviral therapy is available. Treatment with ..... has had variable results. Prevention centers on limiting secondary spread by proper handling of patient’s secretions and blood. There is no ....
immune serum globulins containing antibody to Ebola virus
vaccine
66
Initial symptoms of filovirus infection include ...
severe headache, aching muscles, fatigue, sore throat, dizziness, nausea, and joint or muscle pain.
67
Why are the Marburg and Ebola viruses considered effective bioweapons?
They can be aerosolized,
produced in large industrial quantities and spread from person-to-person. In addition, they have a high fatality rate, a low infectious dose,
no known effective vaccine or treatment,
68
Virulence Factors: What Makes Filoviruses Deadly?
The virulence factors unknown in filoviruses
filoviruses infect the cells of the immune system, which fights infections, the liver, which produces the coagulation proteins in the blood, and the adrenal gland, which has a role in controlling blood pressure. The resulting hemorrhagic fever causes three major problems: 1) Blood clots form in the circulatory system and can cause multi-organ failure. 2) Blood vessels weaken and become permeable, causing bleeding (hemorrhaging) and swelling (edema). 3) The immune system is altered.
69
Arbovirus is an acronym for ....primarily ....
arthropod-borne virus
mosquitoes and ticks.
70
term ROBO refers to the fact that these viruses are ...
rodent-borne
71
Two roboviruses cause a respiratory distress syndrome that is often fatal:
Sin Nombre virus (a hantavirus) and Whitewater Arroyo virus (an arenavirus).
72
Most arboviruses are classified in three families, namely, ....
togaviruses, flaviviruses, and bunyaviruses.
73
Togaviruses are characterized by an .....
icosahedral nucleocapsid surrounded by an envelope and a single-stranded, positive-polarity RNA genome.
74
Togaviruses are divided into two families, .. .
alphaviruses and rubiviruses
75
Flaviviruses have ...
have an icosahedral nucleocapsid surrounded by an envelope and a single-stranded, positive-polarity RNA genome
76
Bunyaviruses have a .....
consisting of ..
helical nucleocapsid surrounded by an envelope and a genome
three segments of negative-polarity RNA
77
The life cycle of the arboviruses is based on the ability of these viruses to multiply in both the ....
vertebrate host and the bloodsucking vector.
78
An obligatory length of time, called the . ....., must pass before the virus has replicated sufficiently for the saliva of the vector to contain enough virus to transmit an infectious dose.
extrinsic incubation period
79
Clinical Findings & Epidemiology The diseases caused by arbovirusesone of three categories: ... (1)
encephalitis; (2) hemorrhagic fever; or (3) fever with myalgias, arthralgias, and nonhemorrhagic rash.
80
ARBOVIRUSES THAT CAUSE DISEASE IN THE UNITED STATES
.....
Eastern Equine Encephalitis Virus, Western Equine Encephalitis Virus
California Encephalitis Virus, Colorado Tick Fever Virus, West Nile Virus
Epidemiology of Important Arbovirus Diseases in the United States
81
IMPORTANT ARBOVIRUSES THAT PRIMARILY CAUSE DISEASE OUTSIDE THE UNITED STATES...
Yellow fever virus
Dengue fever
82
Flavivirus is a genus of viruses in the family ... This genus includes the ...
Flaviviridae
West Nile virus, dengue virus and yellow fever.
83
Flaviviruses share several common aspects: common size (40-65 nm), symmetry (.....
Most of these viruses are transmitted by the ...
enveloped, icosahedral nucleocapsid), nucleic acid (positive-sense, single-stranded RNA.
bite from an infected arthropod (mosquito or tick).
84
YELLOW FEVER
The virus is transmitted to humans by the .....
bite of an infected female aedes aegypti mosquito.
85
There is no specific .... for yellow fever
treatment
86
YELLOW FEVER
The severe form is characterized by ....
high fever, jaundice, bleeding, and eventually shock and failure of multiple organs.
87
YELLOW FEVER
Care should be taken to avoid certain medications, such as .... which may increase the risk of bleeding.
aspirin or other nonsteroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen),
88
The jungle (sylvatic) cycle involves transmission of the virus ...
between nonhuman primates (e.g., monkeys
89
The urban cycle involves transmission of the virus ....
between humans and urban mosquitoes, primarily Aedes aegypti.
90
... vaccine is a live-virus vaccine
Yellow fever
91
Zika virus is a member of . ... with ...., it is a mosquito-borne illness
mosquito also responsible for the transmission of ...... and chikungunya viruses
flavivirus
SS RNA virus
dengue
92
two known species responsible for Zika transmission are the ...
Aedes albopictus, known as the Asian Tiger mosquito, and the Aedes aegypti species.
93
The Zika virus was first identified in ...
The first human case, however, was detected in ....
monkeys
Nigeria in 1954
94
possible link between maternal Zika virus infection and ....
infant microcephaly
95
Zika virus has been confirmed to be present in two.... samples of microcephalic babies.
amniotic fluid
96
there have been no known transmissions of the Zika virus from mother to infant during .
breastfeeding
97
Microcephaly is a
neurological condition where an infant's head circumference is significantly smaller than the average size for infants of the same age. Microcephaly can lead to developmental delays in movement and speech among other complications.
98
Complications of microcephaly include:
Dwarfism or short stature
Facial distortion
Mental retardation
Hyperactivity
Seizures.
99
...direct treatment for microcephaly
No
100
Transmission of Zika virus
Through mosquito bites
From mother to child
Through sex
Through blood transfusion
101
What types of testing for Zika virus are available to test pregnant women?
Reverse-transcriptase PCR (RT-PCR)
102
There is no specific.... for Zika virus.
Do not take until.... dengue can be ruled out to reduce the risk of bleeding.
medicine or vaccine
aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS)
103
Since there is currently no vaccine to protect against the disease,avoiding ..... to preventing transmission of Zika virus.
mosquito bites is vital
104
When choosing an insect repellent, the CDC recommend using products which contain .... that contain ..... can also provide long-lasting protection.
DEET, picaridin, and IR335. Some products
oil of lemon eucalyptus and para-methane-diol
105
If somebody is infected with the Zika virus, it is important to avoid being .... during the first week of infection; the virus can be passed by humans to mosquitos via blood, increasing the risk of spread to others.
bitten by mosquitos
106
Picornaviruses are small .....
Picornaviruses replicate in the ..... of cells
. do not have an envelope.
nonenveloped viruses composed of an icosahedral nucleocapsid and a single-stranded RNA genome. The genome RNA has positive polarity
cytoplasm
107
The picornavirus family includes two groups of medical importance: the .........
Among the major enteroviruses are .....
Enteroviruses infect primarily the enteric tract, whereas rhinoviruses are found in the nose and throat (rhino = nose)
enteroviruses and the rhinoviruses.
poliovirus, Coxsackie viruses, echoviruses, and hepatitis A virus.
108
.... are stable under acid conditions
.... are acid-labile.
Enteroviruses
rhinoviruses
109
Enteroviruses have several subgroups: ...serotypes of polioviruses, ... serotypes of group A coxsackieviruses, ... serotypes of group B coxsackieviruses, and at least ... serotypes of echoviruses. (ECHO virus is a based on the acronym enteric cytopathic human orphan virus) enteroviruses types 68 to 71, Enteroviruses 72 (hepatitis A viruse)
3
23
6
31
110
Poliovirus
Disease: This virus causes .....
poliomyelitis
111
Poliovirus is transmitted by the ...
fecal–oral route
112
poliovirus preferentially replicates in the motor neurons located in the ..... Death of these cells results in ....
anterior horn of the spinal cord
paralysis of the muscles innervated by those neurons.
113
The range of responses to poliovirus infection includes (
1) inapparent, asymptomatic infection; (2) abortive poliomyelitis; (3) nonparalytic poliomyelitis; and (4) paralytic poliomyelitis.
114
most common clinical form poliovirus infection is ....
abortive poliomyelitis, which is a mild, febrile illness characterized by headache, sore throat, nausea, and vomiting. Most patients recover spontaneously
115
n paralytic poliomyelitis, ... is the predominant
the term meningomyeloencephalitis is often used.
flaccid paralysis
116
Poliomyelitis can be prevented by both the ...
Both vaccines induce ....
killed vaccine (Salk vaccine, inactivated polio vaccine, IPV) and the live, attenuated vaccine (Sabin vaccine, oral polio vaccine, OPV).
humoral antibodies,
117
Coxsackie viruses cause a variety of diseases. Group A viruses cause, for example, ...
whereas group B viruses cause ... Both types cause nonspecific ..... Coxsackie viruses and echoviruses together cause approximately 90% of cases of ....
herpangina, acute hemorrhagic conjunctivitis, and hand-foot-and-mouth disease,
pleurodynia, myocarditis, and pericarditis.
upper respiratory tract disease (common cold), febrile rashes, and aseptic meningitis
viral (aseptic) meningitis.
118
Coxsackie viruses are transmitted primarily by ...., but respiratory aerosols also play a role
Humans are the only natural hosts.
the fecal–oral route
119
Group A viruses have a predilection for ...
whereas group B viruses cause disease in...
Both group A and B viruses can affect the ...
skin and mucous membranes,
various organs such as the heart, pleura, pancreas, and liver.
meninges and the motor neurons (anterior horn cells) to cause paralysis.
120
Pleurodyniapain due to an infection of the
intercostal muscles (myositis), not of the pleura.
121
Echoviruses
The prefix ECHO is an acronym for...
enteric cytopathic human orphan.
122
These viruses are the main cause of the common cold.
Rhinoviruses
123
Coronaviruses are a.... and can infect man and animals
positive-sense SS RNA genome, nonsegmented, They are enveloped viruses with a helical nucleocapsid
124
Coronaviruses are named for the.... on their surface. There are four main sub-groupings of coronaviruses, known as ...
crown-like spikes
alpha, beta, gamma, and delta.
125
Common human coronaviruses
Other human coronaviruses
229E (alpha coronavirus)
NL63 (alpha coronavirus)
OC43 (beta coronavirus)
HKU1 (beta coronavirus)
MERS-CoV (the beta coronavirus that causes Middle East Respiratory Syndrome, or MERS)
SARS-CoV (the beta coronavirus that causes severe acute respiratory syndrome, or SARS)
COVID - 2019
126
Coronaviruses are transmitted by the ..
respiratory aerosol.
127
... originated in China in November 2002
SARS
128
...appears to be the natural reservoir for CoV-SARS-1, with the civet cat serving as an intermediate host.
The horseshoe bat
129
In 2012–2013, a new human coronavirus caused an outbreak of serious, often fatal pneumonia in Saudi Arabia and other countries in the region. The disease is called ...., and the virus is called ... Its closest relative is a bat coronavirus, and bats are thought to be the reservoir. Person-to-person transmission is low. Another name for the virus is ...
Middle East respiratory syndrome (MERS)
MERS coronavirus (MERS-CoV).
human coronavirus-EMC (HCoV-EMC)(
130
The corona virus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection caused by
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2
131
Pathogenesis & Immunity Coronavirus infection
is typically limited to the mucosal cells of the respiratory tract. Pneumonia caused by SARS coronavirus is characterized by diffuse edema resulting in hypoxia. The binding of the virus to angiotensin-converting enzyme-2 (ACE-2) on the surface of respiratory tract epithelium may contribute to the dysregulation of fluid balance that causes the edema in the alveolar space. MERSCoV binds to CD-26 on the respiratory mucosa, not to ACE-2.
132
. . are the best specimens for detecting common human coronaviruses.
Nose and throat swabs
Microbiologie
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