Viro P2

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- Acute viral infection

- Latent infection

- Chronic/ persistent infection

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three characteristic clinical presentations:

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Acute viral infection

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displaying evident signs and symptoms.

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Latent infection

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has no visible signs and symptoms, but the virus is still present in the host cell in a lysogenic state (inserted into the host genome in a resting state) or maintained as a nuclear or cytoplasmic epi-some.

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Chronic or persistent infection

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in which low levels of virus are detectable and the degree of visible signs or symptoms varies

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mucosal site, “viremia”

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After viral infection at a local, often may occur viruses disseminated in peripheral blood

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Secondary viremia

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may occur in a variety of tissues, such as the skin, salivary glands, kidneys, brain, and other central nervous system (CNS) tissues including the meninges.

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herpesvirus group

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remain latent in host tissues with no observable signs or symptoms of disease.

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Retroviruses

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establish a latent state after primary infection. During the latent state, the viral genome is often integrated into the host cell's chromosome and no viral replication occurs.

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● Latent viruses

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can reactivate silently, resulting in viral replication and shedding but no clinical symptoms, or they can reactivate and cause symptomatic, even fatal, disease.

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immune suppression

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Reactivation may accompany _______________, resulting in the recurrence of clinically apparent disease.

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● Pathogenic viruses

● autoimmune pathogenesis

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_____________ stimulate an immune reaction that cross-reacts with antigenically similar components of the host tissues, resulting in impairment to host function. Is called ______________

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Autoimmune pathogenesis

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it occurs well after the acute viral infection has resolved and after antibodies are generated in response to viral antigens; this process takes several weeks to occur.

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Transformation or immortalization

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ultimately resulting in dysregulation or uncontrolled cell proliferation.

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oncogenic viruses

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Viruses with the ability to stimulate uncontrolled growth of host cells are referred to as

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oncoviruses

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oncogenic viruses (also known as _____ ).

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Human papillomaviruses (HSV)

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are oncogenic and are responsible for dysregulation of normal epithelial differentiation leading to cervical cancer.

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- specific disease syndrome

- viral agents suspected

- time of year.

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Specimen selection depends on the

(Code q: SDS - VAS - T)

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Calcium alginate swabs

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interfere with PCR, the recovery of some enveloped viruses, and fluorescent-antibody tests and therefore should not be used.

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centrifugation or filtration.

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Contaminants may be removed by concentrating the sample through what?

this process may also result in removal of virus-infected cells and reduce the recovery of viral agents from the sample.

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nasopharyngeal aspirates

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superior to throat

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nasopharyngeal swabs

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for recovering viruses;

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Throat swabs

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acceptable for the recovery of enteroviruses, adenoviruses, and HSY (EAH)

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nasopharyngeal swab or aspirate

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specimens are preferred for the detection of RSV and influenza and parainfluenza viruses. (RIP)

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Rhinovirus detection

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It requires a nasal specimen.

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Dry sterile swab

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Throat specimens are collected with

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inflamed, vesiculated, or purulent

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Throat specimens are collected with a dry, sterile swab by passing the swab over the ________, ________, _______ areas on the posterior pharynx.

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touched to the tongue, buccal mucosa, teeth, or gums

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The swab should not be:

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Nasopharyngeal Secretion Speciman

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Is collected by inserting a swab with a flexible shaft through the nostril into the nasopharynx or by washing and collecting the secretions by rinsing with a bulb syringe and 3 to 7 mL of buffered saline

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Bronchoscopy

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are excellent specimens for detecting viruses that infect the lower respiratory tract, especially influenza viruses and adenoviruses.

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Stool and rectal swabs

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used to detect rotavirus, enteric adenoviruses

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- do not grow in cell culture

- require PC or electron microscopy for detection

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agents of viral gastroenteritis.

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rectal swab

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inserted 3 to 5 cm into the rectum and rotated against the mucosa to obtain feces.

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stool specimens

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preferable to rectal swabs and should be required for rotavirus and enteric adenovirus testing.

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diarrheal stool or stool

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Five to ten milliliters. collected in a diaper from young infants is sufficient and preferred for rotavirus and enteric adenovirus detection.

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-CMV

- Rubella

- Adenoviruses

- Measles

- Mumps

- Polyomaviruses

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can be detected in urine. (CODE: CRAMMP!!!)

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processing multiple (two to three) specimens in parallel.

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Viral recovery may be increased by

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clean-catch first-morning urine

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also known as first-void urine

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urine pH and contaminating bacteria

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may interfere with viral replication.

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centrifugation or filtering

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To remove contaminants and neutralizing the pH with a 7.5% solution of sodium bicarbonate.

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7.5% solution of sodium bicarbonate.

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centrifugation or filtering to remove contaminants and neutralizing the pH with a

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- Enteroviruses

- HSV

- VZV

- CMV

- Pox viruses

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can be detected in vesicular lesions of the skin and mucous membranes. (EHVCP ang code!)

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HSV or VZV

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Collection of specimens from cutaneous vesicles for detecting

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Tzanck smear

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may require if PCR testing is unavailable.

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phosphate-buffered saline or viral support media (EMEM)

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added to the viral transport tube. If a tuberculin syringe is used.

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glass microscope slide

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is pressed against the base of the ulcer. The slide is lifted, moved slightly, and pressed again.

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laboratory for fixation and staining.

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The slides are sent to the

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cytocentrifugation of fluid medium or PCR

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Smears can be prepared in the laboratory with

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CSF

Pericardial

Pleural Fluid

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Sterile body fluids that may contain enteroviruses, HSV, VZV, influenza viruses, or CMV.

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Physician

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specimens are collected aseptically by the _____ and sent to the laboratory for processing.

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detect CMV

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Viral culture of blood is used primarily to

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CMV Viremia

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is associated with peripheral blood leukocytes.

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Heparinized

citrated

EDTA

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What anticoagulated blood is acceptable for CMV detection.

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EDTA

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should be used for samples collected for nucleic acid testing

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PCR Amplification

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EDTA should be used for samples collected for nucleic acid testing, because other anticoagulants may interfere with the enzyme functions required for

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Serum

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may be used for serologic tests and nucleic acid assays.

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sterile tube with anticoagulant.

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Bone marrow for virus detection should be added to

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Aspiration

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Bone Marrow specimens are collected by

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parvovirus B19

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Except for ______ , most viruses are detected more readily from sites other than bone marrow.

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lungs (CMV, influenza virus, adenovirus, sin nombre virus),

brain (HSV),

gastrointestinal tract (CMV).

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Tissue specimens are especially useful for detecting viruses that commonly infect the

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Surgical procedures

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Tissue specimens are collected during

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formalin fixed and paraffin-embedded tissue

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may be used after the removal of the paraffin (deparaffinization) and extraction.

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HSV and human papillomavirus (HPV).

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Genital specimens often are required for the detection of

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Genital swabs

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should be used for ulcerations and placed in appropriate viral transport media.

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Swab/brush

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Cervical specimens may be collected using

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● Acute specimens

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should be collected as soon as possible after the appearance of symptoms.

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Serum for Antibody Testing

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Acute and convalescent serum specimens may be needed to detect antibodies to specific viruses.

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Convalescent specimen

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collected in a minimum of 2 to 3 weeks after the acute specimen.

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3 - 5 mL of serum collected by venipuncture

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Serum for antibody testing appropriate specimen is

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4°C

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Storage up to 5 days, specimens are held at

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-20°C, preferably -70°C.

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Storage for ≥ 6 days should be at

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diluted or emulsified in viral transport medium.

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Specimens for freezing should first be

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Swab

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Many types of specimens for the detection of viruses can be collected with

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Cotton tips and Wooden shafts

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Swabs that are NOT ACCEPTABLE

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viral serologic testing

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Blood for _______ should be transported to the laboratory in a sterile collection tube.

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Serum

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stored for hours or days at 4°C or for weeks or months at -20°C or lower before testing.