Microbiology- Viruses

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Human Parvovirus B19

erythema infectiosum (fifth disease)

Back 1

RT:  respiratory droplet
Symptoms: 
causes a mild disease in children with a "slapped cheek" rash,
rash begins with separate, rose-red raised spots which then converge. 
Spreads with lacy pattern to trunk, buttocks and limbs, may be accompanied by mild fever,
Causes aplastic crisis in those with sickle cell anemia,
Intrauterine infection can cause fetal death,
can infect bone marrow cells
Vaccine:  None


"Slapped Cheek Rash"

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Human Papillomaviruses (HPV)
Disease:  papillomas (skin and genital warts)

Back 2

Route of Transmission:   direct contact, sometimes sexually
Symptoms:
Genital HPV is a common virus that is passed on through genital contact,
most often during vaginal and anal sex.
About 40 types of HPV can infect the genital areas of men and women.
While most HPV types cause no symptoms and go away on their own, some types can cause cervical cancer in women.
These types also have been linked to other less common genital cancers— including cancers of the anus, vagina, and vulva (area around the opening of the vagina).
Other types of HPV can cause warts in the genital areas of men and women, called genital warts. 
Virus infects epithelial cells and multiplies, after 1-2 months, virus stops multiplying and lies dormant in basal epithelium. 
It may reactivate, sexually transmitted warts can cause throat cancer in children infected via the birth canal,
high association with cervical cancer and cancers of the penis, vulva and rectum,
Approximately 20 million people are currently infected with HPV.
At least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives.
By age 50, at least 80 percent of women will have acquired genital HPV infection.
About 6.2 million Americans get a new genital HPV infection each year.
Vaccine: The vaccine, Gardasil®, protects against four HPV types, which together cause 70% of cervical cancers and 90% of genital warts. The Food and Drug Administration (FDA) recently licensed this vaccine for use in girls/women, ages 9-26 years. The vaccine is given through a series of three shots over a six-month period. Skin warts are removed by freezing with liquid nitrogen, Genital warts by laser treatment, Condoms should be used to prevent transmission of genital warts

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Variola (Smallpox Virus)
Disease:  Smallpox

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Disease:  Smallpox
Route of Transmission:  Direct contact, fomites or respiratory route of infection
Symptoms: 

Exposure to the virus is followed by an incubation period during which people do not have any symptoms and may feel fine. This incubation period averages about 12 to 14 days but can range from 7 to 17 days. During this time, people are not contagious


The first symptoms of smallpox include fever, malaise, head and body aches, and sometimes vomiting. The fever is usually high, in the range of 101 to 104 degrees Fahrenheit. At this time, people are usually too sick to carry on their normal activities. This is called the prodrome phase and may last for 2 to 4 days.


Scarring lesions begin on face and hands.

* Smallpox may be contagious during the prodrome phase, but is most infectious during the first 7 to 10 days following rash onset.

Vaccine:  Vaccine has eliminated the disease. The last case of smallpox in the United States was in 1949. The last naturally occurring case in the world was in Somalia in 1977.

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Adenoviruses
Disease:   Common cold, Conjunctivitis, ARD

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Disease:   Common cold, Conjunctivitis, ARD
Route of Transmission:   respiratory droplets and skin contact
Symptoms: 
infects epithelium of respiratory tract, eyes and intestine,
cough, nasal congestion, pneumonia, intestinal illnesses and eye infections,
causes about 5% of viral respiratory illness in U.S.,
Conjunctivitis can be spread by pool water.
Acute respiratory disease (ARD),
first recognized among military recruits during World War II,
can be caused by adenovirus infections during conditions of crowding and stress.
Vaccine: None


Causes 5% of the viral respiratory disease in the U.S.

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Herpes Simplex Virus I (HSVI) or (HHV1) 
Disease:  cold sores

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Route of Transmission:  Transmitted by saliva, vesical fluid, sexual contact and by birth canal
Symptoms: 
Axonal travel to latency sites in sensory ganglia (trigeminal nerve),
can cause herpetic keratitis (corneal infection),
treat with Trifluridine
Vaccine:   No vaccine, Acyclovir used in treatment


Latency in trigeminal ganglion. Causes cold sores. Can also cause genital infections (still not same thing as genital herpes). Warn children with fever blisters to wash hands frequently to prevent eye infections. Anything that jolts the nervous system can trigger a reactivation.

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Herpes Simplex Virus II (HSVII) or (HHVII) 
Disease: Genital Herpes

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Route of Transmission:  vesical fluid, sexual contact and by birth canal
Symptoms: 
Virus infects subcutaneous tissues,
Axonal travel to latency sites in sensory ganglia (sacral ganglia), 
primary infection slight burning sensation,
urination is painful,
vesicles contain virus-laden fluid,
urethral discharge,
neonatal herpes is a real concern,
Many infants infected at birth die or have severe mental retardation,
cesarian sections have been used in the past as a preventative but do not work particularly well.
New studies show use of acyclovir to suppress outbreaks during delivery have a better chance of preventing transfer, 
virus can cross the placenta,
can cause rare herpes encephalitis
Vaccine:  no vaccine but acyclovir can help relieve symptoms, Use of condoms decreases transmission risk


Latency in sacral ganglia, Herpes lesions are painful, Women get larger lesions, Dangerous to newborns, Genital herpes in mouth due to oral sex, anything that jolts the nervous system can trigger a reactivation.

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Varicella Zoster virus(VZV) or (HHV3)
Disease:  chicken pox and shingles

Back 7

Route of Transmission: respiratory aerosol, fomites and direct contact
Symptoms: 
one of the most contagious diseases,
about 150,000 cases annually in U.S., 
localized infection in the skin with fever, malaise,
teardrop-shaped fluid filled vesicles after 3-4 days,
Vesicles itch intensely and yield virus-laden fluid; crust and fall off usually with no scar, 
highly virulent strains can cause fatal encephalitis,
DNA stays latent in neurons,
Herpes Zoster (shingles) may occur many years later,
the first shingles attack may occur as isolated pain,
localized numbness, tingling or burning or shooting pain. 
Mild flu-like symptoms may also occur. 
Lesions ( a blotchy rash) appear 1-14 days later usually in a band on one side of the body or extremities or clustered on one side of the face or scalp. 
The lesions become fluid-filled blisters which slowly crust, scab and heal. 
Once healed, some people experience pain for months longer. 
The pain is called neuropathic pain because of viral damage to nerves. 
In some patients particularly the elderly, the pain becomes chronic. 
This is called post-herpetic neuralgia (PHN) and in some victims the pain is so intense, the slightest touch, contact with clothing or even a breeze may be unbearable.  
Discoloration and scarring of the skin is also possible. 
A person cannot acquire shingles from someone with shingles; however, someone who has never had chicken pox can get it from a shingles patient.
Vaccine:  Acyclovir may be used in treatment, Varicella-zoster immune globulin (VZIG) used in immunocompromised patients exposed to the virus, Reyes syndrome (brain dysfunction due to swelling, coma and death) associated with giving aspirin to reduce fever, transmission is common in schools and day care, Now live, attenuated vaccine.


Latency in dorsal root ganglia along spinal cord, initial lesions are chickenpox, reactivation is shingles, PHN results in a chronic pain syndrome, anything that jolts the nervous system can trigger a reactivation.

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Epstein-Barr virus(EBV) or (HHV4)
Disease:  Encephalitis, Hepatitis, Burkitt's lymphoma, Hodgkin's Disease and Infectious mononucleosis

Back 8

Route of Transmission:  respiratory droplets, saliva, fomites
Symptoms:
Incubation 2-6 weeks,
Usually a pharyngeal infection, virus infects lymph nodes, spleen and other blood rich tissues, 
multiplies in parotid gland,
Enlarged lymph nodes, mild fever, sore throat, swollen spleen, jaundice, ruptured spleen and heart defects can occur,
virus linked to Burkitt's lymphoma (tumor of connective tissues of the jaw),
causes increased B cell proliferation then destruction by T cells.
Diagnosed by high count of atypical lymphocytes,
Latency in B cells,
Reactivation is subclinical
Vaccine: None



Symptoms of mono vary greatly depending on the immune system of the patient.

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Cytomegalovirus (CMV) or (HHV5)
Disease:  Encephalitis, mononucleosis, hepatitis , CMV retinitis, Heart disease?

Back 9

Route of Transmission:  fomites and possibly respiratory droplets, virus is shed in saliva, urine, semen, cervical secretions and breast milk
Symptoms: 
Virus can infect blood cells and blood-rich organs, Usually a pharyngeal infection,
80% of population is infected,
most show fever and malaise but no serious symptoms,
Virus can pass to fetus in pregnant women and damage fetal tissues,
In immunocompromised persons, serious infection of multiple organs including lung, liver, brain, kidney and eye,
CMV retinitis sometimes has a classical appearance of ketchup and cottage cheese (white, clumpy infiltrates and hemorrhages).,
cytomegaly (swollen, enlarged cells) often seen in diagnosis,
latency in macrophages and T cells,
may be linked with the buildup of plaque in arteries leading to heart disease
Vaccine: None


This virus is a hot area of research because if a vaccine can be developed, it might be an anti-plaque vaccine.

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HHV6
Disease: Exanthem subitum (Roseola infantum)

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Route of Transmission: Probably saliva
Symptoms:
Discovered in 1988,
Infects nearly all humans during the first 3-5 years of life. 
Virus replicates in T and B cells and in the throat and is shed in saliva,
85% of healthy adults have the virus in their saliva for life, 
Causes a maculopapular rash,
two week incubation followed by mild fever for a few days with swollen cervical lymph nodes,
rash appears 1-2 days after fever disappears,
the rash appears to be an immune reaction to the virus and there is no viral invasion of the skin or shedding of virus from infected skin.


Rash appears when the unexplained fever breaks.

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HHV7
Disease: roseola infantum in infants and young children

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Symptoms:
Found in T cells.   
Virus is present for life and is found in 75% of adult saliva samples. 
Like its cousin HHV-6, an HHV-7 primary infection causes roseola infantum in infants and young children, which is an undifferentiated,
febrile illness that typically lasts for 6 days.
Symptoms include a rash on the neck and trunk, as well as mild upper respiratory infection and cervical lymphadenopathy.
Complications include febrile seizures, meningitis and encephalitis, as well as neurological complications (in individuals with active CNS infection). 
HHV-7 is typically acquired prior to age 5, and is thought to affect over 95% of the population.
After primary infection, HHV-7 establishes latency in the host, which predisposes individuals to reactivation during periods of  time when their immune systems are not functioning properly.

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HHV8
Disease: Kaposi's Sarcoma

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Symptoms:
HHV-8, also known as Kaposi's sarcoma associated herpesvirus,
is a gammaherpesvirus found only in humans.
AIDS-related Kaposi's sarcoma (KS) was first discovered in 1981,
and the association with HHV-8 was identified through DNA sequencing in 1994.
HHV-8 has subsequently been identified in all types of KS, including classic, endemic, posttransplant and AIDS-related KS, all of which have identical histological features
Research has shown a possible role for HHV-8 in the development of two rare lymphoproliferative disorders, multicentric Castleman's disease (MCD) and primary effusion lymphoma (PEL).
A primary HHV-8 infection presents as a fever and rash.
The fever typically lasts from 2-14 days, and a maculopapular rash persists for 3-8 days.
When HHV-8 reactivates, it is in the form of Kaposi's sarcoma.
KS was first identified in 1872 by Moriz Kaposi, and has since been characterized into 4 well-documented clinical variants:
Classic KS primarily affects older males of Eastern European and Mediterranean lineage, and typically presents as cutaneous lesions on the lower extremities.
Endemic KS occurs in Africa, and may involve the lymph nodes in addition to typical skin lesions. This variant is often seen in HIV-negative individuals and in children.
Iatrogenic KS occurs in recipients of solid organ transplants who are being treated with immunosuppressive medications.This form of KS occurs more commonly in individuals of Mediterranean descent.
AIDS KS is a very aggressive form that was first identified in the early 1980s in homosexual men who were otherwise healthy. In addition to cutaneous and lymphatic involvement, this variant often spreads to the lungs, GI tract, liver and spleen. When AIDS KS was originally identified, the lifetime incidence was approximately 50% in gay men. Because of antiviral therapy advances in the late 1990s, the incidence has declined markedly.


Usually associated with AIDS patients, purple skin lesions

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Hepadnaviruses
Hepatitis B Virus (HBV)

Disease: Hepatitis

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Route of Transmission:  transfusion and secretion of any body fluids, IV drug use, between mother and fetus, tattooing, earpiercing, acupuncture, between family members, in institutions. Needle-stick injuries, hemodialysis, orally, anal/oral sex
Symptoms: 
goes through an RNA intermediate instead of replicating its DNA directly, similar to HIV, 
60-90 day incubation,
Infectious particle is called Dane particle,
spherical and filamentous particles which are contain unassembled components without nucleic acids but do have HB surface antigen for identification, 
Most cases are asymptomatic,
loss of appetite, fever, joint pains and jaundice, swollen tender liver, clay colored stools and darkening of urine. 
10% of cases become chronic carriers and there is high incidence of liver cancer in carriers possible due to integration of HBV DNA into liver cell chromosomes,
1.25 million Americans are chronic carriers, 
incidence has declined from about 200,000 cases per year in U.S. before the vaccine, to ~60,000 per year now.
 Vaccine:  HBV subunit vaccine is now produced in yeasts, vaccination is needed for anyone exposed to blood in their work, (health care workers, laboratory technicians, dentists, surgeons, nurses, emergency service workers, police, fire fighters, paramedics, military and those living with infected individuals).  interferon treatment is promising,  Prevention: always practice safe sex and never share objects such as needles, razors, toothbrushes, nail files and clippers.  When getting a manicure, tattoo or body piercing, make sure sterile instruments are used.


10% of patients become chronic carriers, similar to HIV in that it uses reverse transcriptase to replicate, no other viruses, except the retroviruses, do this.

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Hepatitis F Virus (HFV)
Disease: Hepatitis

Back 14

Route of Transmission: blood transmission
Symptoms:
causes 10%? of hepatitis cases,
may be a mutation of HBV
Vaccine: None

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Picornaviruses
Poliovirus
Disease: Poliomyelitis (Polio)

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Route of Transmission:  fecal/oral route of transmission
Symptoms: 
Most cases (10% clinical cases) are flu-like (headache, sore throat, fever, nausea), gastrointestinal distress,
only 1% are paralytic, stable in food and water,
1-3 day incubation,
infects throat, small intestine and motor nerve cells in upper spinal cord causing paralysis and death from respiratory failure,
3 serotypes,
Less than 10 cases per year in U.S.
The last cases of indigenously acquired polio in the United States occurred in 1979.

Vaccine:  Salk vaccine 1954 was inactivated (killed ) viruses of all 3 types (trivalent) called IPV, 90% effective, injection, requires a booster: Sabin 1963 attenuated oral vaccine (OPV). Attenuated viruses shed in feces are hazardous to immunocompromised.  To eliminate the risk of vaccine-associated paralytic poliomyelitis, OPV is no longer recommended for routine immunization in the United States as of January 1, 2000. OPV is no longer available in this country, although it continues to be used in the majority of countries and for global polio eradication activities.


Small percentage actually paralytic. Fecal oral transmission. Be sure you know the difference between the two vaccines.

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Rhinovirus
Disease: Common Cold

Back 16

Route of Transmission:   respiratory droplets and possibly nasal secretions and hand to hand contact
Symptoms: 
Incubation 3-5 days,
Virus infects upper respiratory tract tissues
Vaccine: None


Yet another virus causing rhinitis (the common cold). Note there is a common cold causing virus in every category of viruses. Also note there are over 200 know cold causing viruses. Curing one, does not cure the others. A vaccine for one, does not work for the others. Will we ever have a cure for "the common cold"? Will we ever have a cure for "cancer"?

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Hepatitis A Virus (HAV)
Disease: Hepatitis

Back 17

Route of Transmission: Fecal/oral route, between family members, in institutions, IV drug use, transfusions, orally, anal/oral sex, sexually suspected.
Symptoms: 
infects epithelial lining of intestinal tract, spreads to liver, kidneys and spleen,
2-4 wk incubation,
most of viruses are shed prior to symptoms,
survive several days on surfaces,
harbored in oysters,
many cases are subclinical,
symptoms are anorexia, malaise, nausea, diarrhea, abdominal discomfort, fever, chills, jaundice, dark colored urine, clay colored stool,
no chronic form,
Over 150,000 cases in U.S. per year.
Adults will have signs and symptoms more often than children.
Once you have had hepatitis A you cannot get it again.
Vaccine:  Passive antibody may be given, there is an inactivated virus vaccine which was licensed by the FDA in February 1995, vaccine recommended for day care workers, anyone coming in contact with an infected person, travel to locations with poor sanitation, or living in an area of a recent outbreak.

Associated with contaminated foods, especially in schools and large cafeterias. Something else for you to think about at Oyster Bake.

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Hepatitis D Virus (HDV)
Disease: Hepatitis

Back 18

Route of Transmission: Probably same as HBV and HCV
Symptoms: 
occurs as a coinfection with HBV (get both at the same time from the same source) or as superinfection (you have HBV first and get HBV later from a different source), requires the envelope of HBV to be infectious. 
Infected persons have high rate of liver damage
Vaccine: None, but HBV prevention will prevent HDV infection

The only way you can get HDV is if you have HBV.

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Rubivirus
Disease:   Rubella or German Measles

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Route of Transmission:  respiratory route
Symptoms: 
Pale pink rash, light fever,
short duration,
serious in congenital cases,
Usually occur during first trimester with infections of eyes, ears and heart,
possibly congenital deformity and/or stillbirth,
About 1500 cases annually in U.S.,
50 congenital
Vaccine:  MMR vaccine (Measles, Mumps and Rubella),  vaccines developed in 1969 and 1979


Rash below the colar bone. Lasts three days, Mild. Never vaccinate a pregnant womon with the MMR.

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Hepatitis C Virus (HCV) 
Disease: Hepatitis

Back 20

Route of Transmission:   blood transfusion, IV drug use, Sexually, needle-stick injuries, hemodialysis, mother to child, body piercing/tattooing, also suspected are oral, anal/oral sex and family member transmission
Symptoms:
Incubation 2-4 months, 
most infections subclinical or mild,
85% of cases become chronic carriers,
20% develop severe liver damage,
150,000 new cases each year. 
3.5 million Americans currently are chronic carriers.
Vaccine: None, interferon treatment somewhat successful, Prevention: always practice safe sex and never share objects such as needles, razors, toothbrushes, nail files and clippers.  When getting a manicure, tattoo or body piercing, make sure sterile instruments are used.


85% become chronic carriers, no vaccine.

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Hepatitis E Virus (HEV) 
Disease: Hepatitis

Back 21

Route of Transmission:  fecal/oral
Symptoms: 
clinically similar to HAV and exists in contaminated water,
May be responsible for 50% of sporadic hepatitis cases in developing countries,
Incubation 6-8 weeks,
for some reason high mortality rate in pregnant women (20%) in the third trimester with disseminated intravascular coagulation. 
Vaccine: None, antibodies may be helpful


  
fecal/oral, mainly seen in developing countries. Dangerous in pregnant women, similar to HAV otherwise.

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Hepatitis G Virus (HGV)
Disease: Hepatitis

Back 22

Route of Transmission: Blood transfer and possible other routes
Symptoms: 
newly discovered,
0.3% acute viral hepatitis.
About 900 - 2000 mostly asymptomatic cases of infection per year (U.S.A., U.K.).
90 - 100% persons with HGV infection has chronic infection.
may first appear as mild infection which subsides,
followed by years of cumulative liver damage,
Probably develops carriers,
found in complex research assays to contaminate 2% of today's blood donors which is more than carry HBV or HCV. 
There is currently no rapid blood test used by blood banks. 
20% of patients with HCV will also have HGV
Vaccine: none

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Arboviruses

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Includes yellow fever virus, dengue fever virus and west nile virus.
Arbo stands for arthropod borne which means these viruses are transmitted by insect. In this case all by the mosquito.

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Yellow Fever Virus
Disease: Yellow Fever

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Route of Transmission:   Aedes mosquito
Symptoms:
Jungle yellow fever is mainly a disease of monkeys. It is spread from infected mosquitoes to monkeys in the tropical rain forest. People get jungle yellow fever when they are bitten by mosquitoes that have been infected by monkeys. rare and occurs mainly in persons who work in tropical rain forests.
Urban yellow fever is a disease of humans. It is spread by mosquitoes that have been infected by other people. Aedes aegypti is the type of mosquito that usually carries yellow fever from human to human. mosquitoes have adapted to living among humans in cities, towns, and villages. They breed in discarded tires, flower pots, oil drums, and water storage containers close to human dwellings. Urban yellow fever is the cause of most yellow fever outbreaks and epidemics.  Incubation period 3-6 days, Virus infects lymph nodes, then viremia, then necrotic lesion in liver, bone marrow, spleen and other organs, Symptoms included Anorexia, malaise, bloody vomitus, jaundice, waves of high fever, bleeding gums, delirium and high mortality
Vaccine:  Vaccine yields long term immunity



High fevers and mortality. Bleeding gums, black vomit.

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Disease: Dengue Fever (Breakbone Fever) and Dengue Hemorrhagic Fever, respectively
Route of Transmission: Aedes Mosquito

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Symptoms: 
A pandemic of dengue began in Southeast Asia after World War II and has spread around the globe since then. 
The Ae. aegypti eradication program, which was officially discontinued in the United States in 1970, gradually weakened elsewhere, and the mosquito began to rainfest countries from which it had been eradicated.
As a result, the geographic distribution of Ae. aegypti in 2002 was much wider than that before the eradication program,
2-15 day incubation,
Virus infects lymph nodes, then viremia,
necrotic lesions in bone marrow, spleen and other organs then appear,
Symptoms include fluctuating fever, sharp pain in muscles and joints,
possible skin rash with desquamation,
possible shock syndrome upon recurrent infections,
Considered a tropical disease, however the mosquito which transmits the disease has now migrated to the U.S. and it has been predicted that we are overdue for an outbreak
Vaccine:  No vaccine just supportive care and bed rest for 1-2 weeks.

Severity of symptoms depends on whether you get breakbone fever or the hemorrhagic version.

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West Nile Virus
Disease:  WNV

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Route of Transmission: Mosquito
Symptoms:
People who contract WNV usually experience only mild symptoms-fever, headache, body aches, skin rash, and swollen lymph glands.
If WNV enters the brain, however, it can cause life- threatening encephalitis (inflammation of the brain) or meningitis (inflammation of the lining of the brain and spinal cord).
Most cases of disease occur in elderly people and those with impaired immune systems.
Most human cases are mild or asymptomatic. 
Greatest risk to horses and birds in the crow and jay family.
Vaccine: none

Almost always mild in humans.

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Coronavirus
Disease:   Acute coryza (Common cold)

Back 27

Route of Transmission:   indirect contact (fomite)
Symptoms: 
nasal and sinus congestion, runny nose, sore throat, coughing,
recovery time one to two weeks,
usually no fever,
sinusitis, laryngitis and otitis media esp. in children are complications,
most common in children and elderly
Vaccine: None


One of the many common cold causing viruses.

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Disease: Sudden Acute Respiratory Syndrome (SARS)

Back 28

Route of Transmission: Close person to person contact
Symptoms: Common cold like symptoms.  Elderly and immunocompromised most at risk.  Only 8 cases diagnosed in the U.S.
Vaccine: None

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Rabies virus
Disease: Rabies

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Route of Transmission: Lick or bite
Symptoms: 
Fatal encephalitis with progressive CNS involvement,
multiplies in skeletal muscle and connective tissue,
then travels to CNS, 
Incubation 6 days to 1 yr,
Immune system can't reach virus in CNS,
Symptoms:  abnormal sensations at bite location, agitated behavior, hallucination, muscle spasms, stupor. 
Eventually salivation, aggressive behavior, hydrophobia (water and drafts cause mouth and pharynx to spasm), paralysis and coma,  
Two forms, furious and paralytic (dumb) rabies,
Diagnosed by serology or fluorescent antibodies against brain tissue and presence of Negri bodies,
Usually less than 10 cases in U.S. per year.
Vaccine:  Human diploid cell vaccine (inactivated virus), 5-6 injection, IM, 28 day period along with passive antibody, Field trials on subunit vaccine in Vaccinia virus.

abnormal sensations at bite location, agitated behavior, hallucination, muscle spasms

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Disease: Ebola Hemorrhagic Fever

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Route of Transmission: Blood or fluid transfer, depending on the strain
Symptoms:
Four Ebola viruses (Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Reston. 
Only Ebola-Reston is airborne and only causes disease in primates.
In humans, the incubation period for Ebola HF ranges from 2 to 21 days.
The onset of illness is abrupt and is characterized by fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain.
A rash, red eyes, hiccups and internal and external bleeding may be seen in some patients.
Patients develop fever, hemorrhage, rash and intravascular coagulation. 
When clotting factors are used up, the blood continually streams from every orifice. 
Virus multiplies in connective tissue and dissolves the tissue promoting hemorrhage,
Researchers do not understand why some people are able to recover from Ebola HF and others are not.
However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.
Vaccine: None

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Paramyxovirus
Disease:  Mumps

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Route of Transmission:  saliva, respiratory route and urine.
Symptoms: 
Infects respiratory epithelium,
then general viremia,
infects multiple organs including Parotid glands, swelling, blocks ducts of gland causing saliva accumulation and swollen facial tissues,  
Meningitis occurs in 1 out of 10 children with mumps and can lead to deafness and other damage. 
Orchitis in post puberty males,
over 4,000 cases in U.S. annually
Vaccine:  MMR, mumps, measles, and rubella vaccine, attenuated live vaccine


Swelling of the jaws

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Morbillivirus
Disease:  Rubeola (measles)

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Route of Transmission: Respiratory route
Symptoms: 
Measles symptoms generally appear in two stages.
In the first stage, the individual may have a runny nose, cough and slight fever.
The eyes may become reddened and sensitive to light, while the fever consistently rises each day.
The second stage begins on the third to seventh day, and consists of a temperature of 103° to 105°. and a red, itchy rash lasting four to seven days.
The rash usually begins on the face and then spreads over the entire body.
Koplik spots (little white spots) may also appear on the gums and inside of cheeks.  
Incubation 9-12 days,
Pneumonia occurs in up to 6 percent of reported cases and accounts for 60 percent of deaths attributed to measles.
Encephalitis (inflammation of the brain) may also occur.
Other complications include middle ear infection and convulsions.
It can lead to ear infection, seizures (jerking and staring), brain damage, and death.
Vaccine 95% effective if given prior to symptoms, 
Can cause fatal encephalitis in children,
Most cases today occur in infants too young to vaccinate and in inner city children who receive no vaccinations.
Approximately 10,000 U.S. cases annually
Vaccine:         MMR - live attenuated vaccine


Rash starts at hairline and continues to spread over body, patients are very sick, Koplik spots are hallmark

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Respiratory Syncytial Virus 
Disease: RSV

Back 33

Route of Transmission: Respiratory route
Symptoms:
Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and pneumonia among infants and children under 1 year of age.
Illness begins most frequently with fever, runny nose, cough, and sometimes wheezing.
During their first RSV infection, between 25% and 40% of infants and young children have signs or symptoms of bronchiolitis or pneumonia, and 0.5% to 2% require hospitalization.
Most children recover from illness in 8 to 15 days.
The majority of children hospitalized for RSV infection are under 6 months of age.,
transmitted by respiratory route,
4-5 day incubation,
virus infects respiratory epithelium,
Symptoms include respiratory distress with bronchiole infection and pneumonia,
Acute fever, cough, rhinitis, nasal congestion. 
Often croup like symptoms in children, mild disease in adults,
G (large glycoprotein spike) binds virus to host,
F (fusion protein) fuses viral envelope and cytoplasmic membrane of host cell,
Also causes fusion of cytoplasmic membranes of infected cells. 
Results in syncytia or multinucleated masses of fused cells.
Vaccine: None,  aerosol Ribavirin is given.  Cases are always isolated. New injectable vaccine, RespiGam, has been approved by the USDA

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Disease: Influenzae
Route of Transmission:  respiratory route and hand to hand contact

Back 34

Symptoms: 
headaches, chills, abrupt fever, muscle aches, nasal discharge, sore throat, pneumonia, 
dangerous in elderly,
Infects humans, pigs, geese, horses,
N (neuraminidase) and H (hemagglutinin) proteins are present in envelope,
no such thing as stomach flu,
major changes called antigenic shifts,
minor changes by antigenic drift
Vaccine: Flu vaccine are based on the best guess and the earliest cases, Amantadine (antiviral) somewhat useful for Influenzae B not A.  The drug GG167 developed in 1992 interferes with the virus' ability to replicate and spread to new respiratory cells and can be given as a nasal spray or tablet.  GS4104 is given in pill form and promises the same action.
Tamiflu (oseltamivir) is for treating influenza A and B virus infections in adults and children 1 year and older.
Relenza (zanamivir) is for treating influenza A and B virus infections in children 7 years and older and adults who have an uncomplicated flu infection and who have had symptoms for no more than 2 days.

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Hantavirus
Disease: Hantavirus Pulmonary Syndrome

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Route of Transmission: Respiratory Particles shed by mice, Not spread person to person
Symptoms: 
Hantavirus pulmonary syndrome (HPS) is a deadly disease from rodents.
Humans can contract the disease when they come into contact with infected rodents or their urine and droppings.
HPS was first recognized in 1993 and has since been identified throughout the United States.
Although rare, HPS is potentially deadly.
Rodent control in and around the home remains the primary strategy for preventing hantavirus infection. 
Patients with HPS typically present in a very nonspecific way with a relatively short febrile prodrome lasting 3-5 days.
In addition to fever and myalgias, early symptoms include headache, chills, dizziness, non-productive cough, nausea, vomiting, and other gastrointestinal symptoms.
Malaise, diarrhea, and lightheadedness are reported by approximately half of all patients, with less frequent reports of arthralgias, back pain, and abdominal pain.
Patients may report shortness of breath, (respiratory rate usually 26 - 30 times per minute).
Typical findings on initial presentation include fever, tachypnea and tachycardia.
The physical examination is usually otherwise normal.
Within 24 hours of initial evaluation, most patients develop some degree of hypotension and progressive evidence of pulmonary edema and hypoxia, usually requiring mechanical ventilation.
The patients with fatal infections appear to have severe myocardial depression which can progress to sinus bradycardia with subsequent electromechanical dissociation, ventricular tachycardia or fibrillation.
Causes lungs to fill with fluid in 33% of patients,
infects cells beneath the lung epithelium,
35% mortality rate
Vaccine: None

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Reoviruses
Disease: Common cold

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Route of Transmission: respiratory route
Symptoms:  Respiratory tract infection, like common cold and infantile gastroenteritis.
Vaccine: No vaccine

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Rotavirus
Disease:  Diarrhea

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Route of Transmission:  Fecal/Oral
Symptoms: 
Rotavirus is the most common cause of severe diarrhea among children,
resulting in the hospitalization of approximately 55,000 children each year in the United States and the death of over 600,000 children annually worldwide.
The incubation period for rotavirus disease is approximately 2 days.
The disease is characterized by vomiting and watery diarrhea for 3 - 8 days, and fever and abdominal pain occur frequently.
Immunity after infection is incomplete, but repeat infections tend to be less severe than the original infection.
A rotavirus has a characteristic wheel-like appearance when viewed by electron microscopy (the name rotavirus is derived from the Latin rota, meaning "wheel").
Rotaviruses are nonenveloped, double-shelled viruses. The genome is composed of 11 segments of double-stranded RNA, which code for six structural and five nonstructural proteins.
The virus is stable in the environment.
Vaccine:  In a report issued February 3rd, 2006, the U.S. Food and Drug Administration approved a live, oral vaccine (RotaTeq™) for use in children.



The leading cause of diarrhea in young children in the U.S.

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Human Immunodeficiency Virus (HIV)
Disease: Acquired Immunodeficiency Syndrome (AIDS)

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Route of Transmission: Sexually, IV drug use, Tissue transplant, blood transfusion


The stages of cellular infection are as follows:
1. HIV attaches to receptors on a host cell and release HIV RNA into the cytoplasm. 
2.  An enzyme called reverse transcriptase converts the SS viral RNA into DS viral DNA which travels to the nucleus. 
3.  The enzyme called integrase splices the viral DNA into the host cells DNA. 
4.  The infected cell produces more viral RNA which in turn can be translated to form large viral proteins. 
5.  A protease enzyme cuts the viral proteins into functional protein shorter in length. 
6.  New viral proteins and RNA come together to form new viral particles. 
7.  New HIV particles bud from the surface of the infected cell and infect new cells.
 
HIV Replication Animation 
 
An HIV positive individual undergoes and intense battle from the time of infection until development of disease in which the immune system is counteracting the destruction of T cells by increasing new T cells at a higher rate.  The battle to keep up is eventually lost and then the disease symptoms begin. 
HIV disease: fatigue, mild fever, sore muscles, occasional diarrhea, swollen lymph nodes, T cell count drops to 800/cc. 
AIDS Related Complex:  exaggerated symptoms of HIV disease, persistent fatigue, swollen lymph nodes, diarrhea, weight loss, night sweats, candidiasis, T cell count drops to 400/cc, psychological stress and fear. 
AIDS:  T cell count reaches 25/cc, constant swollen nodes, nausea, intense fatigue, vomiting, headaches, heavy night sweats, brain disease with dementia and disorientation, wasting with cholera like diarrhea and severe weight loss, opportunistic diseases. 
HIV antibodies determined by ELISA followed by Western blot and gene probes for definite identification, AZT and nucleotide analogs can be given to interfere with DNA synthesis by reverse transcriptase but these drugs also poison the body, Soluble CD4 can be given to prevent HIV attachment to T cells, Predicted to be 20 million cases in work by year 2000.
Vaccine:         None

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Tobacco mosaic virus, filterable agents, obligate intracellular parasites, capsid, envelope, host range, virions, capsomeres, nonenveloped, glycoprotein spikes, attachment, penetration, hemagglutination, superinfection, naked virus, helical, polyhedral, icosahedral, bacteriophage, plaque, plaque forming units, cell culture, primary cell lines, transformed cells, cancer, cytopathic effects, diploid cell lines, packaging, tail fibers, phage lysozyme, eclipse period, maturation, lysis, burst time, burst size, lytic cycle, lysogeny, lysogenic, temperate, prophage, excision, toxin, specialized transduction, endocytosis, fusion, uncoating, papovaviruses, papillomas, polyomas, picornaviruses, sense or + stranded, antisense or - stranded, RNA dependent RNA polymerase, rhabdoviruses, reoviruses, retroviruses, reverse transcriptase, provirus, cancer, tumor, budding, inclusion bodies, Negri bodies, polykaryocytes, hormones, interferon, malignant, benign, oncogenes, proto-oncogenes, transduction, transformation, contact inhibition, point mutations, Burkitt's lymphoma, gene amplification, Herpesviruses, Epstein Barr virus, Hodgkin's disease, genital herpes, latency, fever blisters, Varicella zoster virus, shingles, chicken pox, retroviruses, slow viral infection, subacute sclerosing panencephalitis, unconventional agents, scrapie, prion,  Creutzfeldt-Jakob disease, Kuru

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