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I & I Part II > Enteroviruses and Poliovirus Vaccines > Flashcards

Enteroviruses and Poliovirus Vaccines Flashcards

1
Q

Enteroviruses

A
  • Enterovirus genus of the Picornaviridae family
  • ( + ) ss RNA icosohedral naked
  • worldwide distribution
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2
Q

Enteroviruses Transmission

A
  • Fecal-Oral transmission
  • Infection of the intestinal tract epithelial and lymphoid tissues and shed into feces
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3
Q
A
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4
Q

Enteroviruses are resistant to…

A

…acidic pH (pH 3.0), detergents and many disinfectants, including 70% alcohol.

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5
Q

[] and [] are active against enteroviruses.

A

Formaldehyde and hypochlorite are active against enteroviruses.

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6
Q

Enteroviruses Replication

A
  • Replicate at 37oC
  • Enteroviruses (Picornaviruses) replicate in the cytoplasm by using +RNA replication strategies
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7
Q

Enteroviruses and IRES

A

•Shut off host cell protein synthesis by destroying mRNA capping complex and allowing ribosomes to bind on the internal ribosomal entry site (IRES) located on viral RNA

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8
Q

Enteroviruses cause…

A

…paralytic disease, mild aseptic meningitis, exanthems, myocarditis, pericarditis, nonspecific febrile illness.

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9
Q

Enterovirus Disease - Polio Transmission

A

•fecal-oral route

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10
Q

Enterovirus Disease - Polio Season

A
  • Poliovirus is stable in environment, stomach acid
  • Infections peak late summer in temperate regions, more young people infected but less severity
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11
Q

Enterovirus Disease - Polio Primary Site of Infection

A
  • Virus enters oropharynx and multiplies in mucosa; shed in oral secretions and swallowed
  • Multiply in intestines——>brief viremia; usually asymptomatic; recovery often occurs
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12
Q

Enterovirus Disease - Polio Incubation

A

•Incubation period ranges from 4 - 35 days (usually 7-14 days)

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13
Q

Enterovirus Disease - Polio Pathogenesis

A
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14
Q

Enterovirus Disease - Polio 3 Types

A
  1. Abortive poliomyelitis
  2. Aseptic meningitis
  3. Paralytic poliomyelitis
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15
Q

Enterovirus Disease - Abortive poliomyelitis

A
  • nonspecific febrile illness
  • 2-3 day duration
  • no signs of CNS localization
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16
Q

Enterovirus Disease - Aseptic meningitis

A
  • nonparalytic poliomyelitis
  • stiff neck, back and pain
  • recovery is rapid (within few days)
17
Q

Enterovirus Disease - Paralytic poliomyelitis

A
  • Occurs in less than 2% of infections
  • It is the major possible outcome of infection, often preceded by a period of minor illness, sometimes with 2 or 3 intervening symptoms-free days
  • Signs of meningeal irritation
  • Asymmetric flaccid paralysis with no significant sensory loss is the hallmark
  • variable forms; in most serious forms all four limbs may be completely paralyzed or the brainstem may be attacked followed by paralysis of cranial nerves and muscles of respiration (bulbar polio)
  • temporarily damaged neurons regain their function
  • recovery begins and may continue for 6 months
  • paralysis persisting after this time is permanent
18
Q

Polio Immune Response

A
  • Antibodies appear about day 10, same time as symptoms; neutralizing antibodies protective, block virus binding to host cell and subsequent infection
  • If immune response contains the disease, tissue replication stops but intestinal shedding can continue for weeks even with high antibody titers
  • Cell mediated immunity occurs, but viral proteins are not found on the plasma membranes of infected cells
19
Q

Polio Diagnosis

A
20
Q

Polio Prevention

A
  • Development of tissue culture for viral growth made possible the two polio vaccines in the 1950s
  • Killed vaccines (Salk) stimulates IgG antibodies that can eliminate the virus during viremia
  • Live attenuated vaccine (Sabin) stimulates IgA response, blocks enteral spread, inexpensive, can revert to virulence, few cases every year mostly due to vaccination (1 per 2.4 million doses distributed)
  • Trivalent vaccine (3 major polio serotypes)
21
Q

Common Enteroviral Diseases

A

•Coxsackieviruses (A and B), Echovirus and Enterovirus

22
Q

Common Enteroviral Diseases Incubation

A

•Unapparent infections most common (most people have antibodies), incubation period: 2-14 days

23
Q

Common Enteroviral Diseases Infections

A
  • Aseptic meningitis most common infection
  • Most serious in infants, self limiting (4 to 14 days)
  • Sometimes accompanied by encephalitis, which can lead to permanent neurologic sequelae
  • Enteroviruses cause the majority of nonbacterial CNS infections in the U.S. with severe disease in infants/children and people with weakened immune system than adults
24
Q

Cocksackie A

A
  •  Exanthems (Rubella-like rash), also caused by enterovirus 71  Roseola infantum, or maculopapular exanthems, but may also appear as vesicular or hemangioma-like lesions
  • Hand-foot-and-mouth disease (HFMD), which usually affects children younger than 5 years of age and is characterized by fever
  • Herpangia (vesicles in mouth) blister-like sores in the mouth (herpangina) and a skin rash
  • Conjunctivitis
  • Some group A coxsackieviruses may cause gastro-intestinal syndrome in severely immunocompromised patients
25
Q

Cocksackie B

A
  • Myocarditis and pericarditis, self limiting, but may result in permanent heart damage or be fatal
  • Epidemic myalgia (pleurodynia), patients experience substernal chest pain, and intense upper abdominal or thoracic pain, fever
  • Generalized disease of infants, often lethal (also by Enteroviruses)
  • Evidence linked with pathogenesis of insulindependent diabetes mellitus
  • Associated with acute arthritis, polymyositis, and idiopathic acute nephritis
26
Q

Enterovirus D68

A
  • EV-D68 discovered in 1962 in California
  • Transmitted through respiratory secretions, including saliva, nasal mucus, sputum – direct or indirect
  • Symptoms: Mild symptoms may include fever, runny nose, sneezing, cough, and body and muscle aches.
  • Severe Symptoms: may include wheezing and difficulty breathing.
  • 2014 Epidemic: August to October of 2014 - a total of 1,105 people in 47 states were infected with EV-D68
  • Several cases of acute flaccid paralysis (polio-like condition) with antibodies of EV-D68 detected in CSF on children

I & I Part II (25 decks)

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