Zoonotic Viruses

Front 1

Japanese Encephalitis

Back 1

Flavavirus

Front 2

Culex mosquitoes, flight range 20km

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Japanese Encephalitis

Front 3

Most infections are subclinical, otherse get encephalitis, "sleeping sickness", neck pain, drowsiness

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Japanese encephalitis

Front 4

Antibodies to this virus can actually enhance an infection via Fc receptors on macrophages

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Flavivirus

Front 5

This virus, found in asia, involves birds and pigs, a long distance mosquito, and has an effective vaccine available

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Japanese Encephalitis

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Yellow Fever

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Flavavirus

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2 Flavors of Yellow Fever

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Jungle - cycle between primates and forest mosquitoes

Urban - transmitted between humans by Aedes mosquito

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What happens in yellow fever?

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Flulike syndrome, hepatitis, hemorrhage, shock. NO encephalitis. Can also get bradycardia (Fayet's Sign).

50% get fatal form with hemorrhagia, oliguria, hypotension

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What is a strange symptom of yellow fever?

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Decreased pulse with high fever

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What is there to treat yellow fever?

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Nothing. There is a vaccine, live attenuated, 17D for people traveling to endemic areas.

Front 11

Dengue

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Flavavirus

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What are the 3 forms of Dengue?

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Dengue Fever
Dengue Hemorrhagic Fever
Shock Syndrome - occurs when you are exposed to both type I and type II dengue.

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Aedes Mosquito, 4 serotypes, 3 forms

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Dengue, a flavivirus

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What is there for a vaccine for dengue?

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No current vaccine, one is being tested in thailand. Must be careful with added problem of Shock Syndrome

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What are the symptoms of dengue?

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High fever, lymphadenopathy, myalgia, bone and joint pain, headache, maculopapular rash. Also known as Breakbone fever.

Front 16

West Nile Virus

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Flavavirus

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Fever, headache, fatigue, body ache, skin rash on trunk, lymphadenopathy, 1% get encephalitis

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West Nile Virus

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Spread by birds thru a mosquito vector

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West Nile Virus

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This flavavirus is diagnosed by serology and IgM for recent infection. Man and horse are accidental hosts.

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West Nile virus

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Colorado Tick Fever

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Orbovirus, DS RNA segmented, a reovirus

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Found in the western united states, this arbovirus normally has a tick-rodent cycle and can pass the virus to its offspring transovarianly

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Colorado tick fever, orbovirus, DS RNA segmented

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Lassa Fever

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Arenavirus, ssRNA, negative, enveloped.

Front 23

This disease has 2 pieces of antisense ss RNA, an envelope with protruding spikes

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Lassa Fever, Arenavirus

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What is the pathology of Lassa Fever?

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fever, malaise, myalgia, sore throat, PATCHY ULCERATIVE PHARYNGEAL LESIONS

Can develop myocarditis, pneumonia, encephalitis, hemorrhagic manifestations, shock

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Where do you find lassa fever?

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West Africa like liberia, sierra leone, nigeria.

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Mastomys Rat is where the infection comes from

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Lassa Fever, an arenavirus

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This Arenavirus is a type IV pathogen that has a 25% Mortality rate, more if you're pregnant.

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Lassa Fever.

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How do you treat Lassa Fever?

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Ribavirin

Sometimes hyperimmune serum has a dramatic effect.

Can do post exposure prophylaxis

No vaccine

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How do you diagnose Lassa Fever?

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Don't CULTURE! Detect viral antigen by EIA, which can happen even before you can detect IgM.

Front 30

Junin Virus and Macupo virus come from these two areas, respectively

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Junin = Argentina
Macupo = Bolivia

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Junin and Macupo Hemorrhagic Fever

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Arenavirus with similar presentation to Lassa Fever

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This disease is an arenavirus with calomys musculinis and calomys callosus vectors. There is no record of human to human spread.

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Junin and Macupo Hemorrhagic Fever

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How do you treat Junin and Macupo hemorrhagic fever?

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Hyperimmune serum and ribavarin

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This virus is enveloped, ssRNA negative, and consists of 3 RNA segments, L, M, and S

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Hantavirus, part of Bunyaviridae

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Name the five subtypes of hantavirus

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1. Porogian, Hantaan - China, Russia, Europe. Classic, severe.
2. Seoul - moderate, worldwide
3. Puumala - Scandinavia, UK, France, Russia, mild - nephropathic
4. Sin Nombe - US, Canada, Mexico - carried by deer mice, causes pulmonary syndrome

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What does hantavirus cause?

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Hemorrhagic fever with renal syndrome (HFRS)

Pulmonary syndrome - damage to capillaries, vasodilation, congestion, hemorrhage

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What are the five distinct phases of Hantvirus?

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1. Febrile
2. Hypotensive
3. Oliguric
4. Diuretic
5. Convalescent

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Sin Nombre causes this type of disease

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Hantavirus Pulmonary Syndrome - damage to lung capillaries and not kidney, get some cardiac complications

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Unlike all the other viruses in Bunyaviridae, this one has no arthropod vector

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Hantavirus

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How is hantavirus transmitted?

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Between mice by agressive behavior

To humans thru inhalation of secondary aerosols, particularly urine, mucous membrane contanct, skin breeches. This is uncommon in US because it's not shed in urine, more feces.

It is spread easily person -> person

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How do you diagnose hantavirus?

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Chest X-ray for pulmonary edema

Direct antigen detection (better than serology, 4x increase in IgM)

RT-PCR for HPS

Viral isolation from urine if early in disease.

Sin Nombre has never been isolated in patients

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How do you treat Hantavirus?

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Supportive care

Ribavarin if early

No vaccine

Rodent control

Front 43

This member of filoviridae causes severe hemorrhagic fever, internal and external bleeding, and extremely high mortality

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Ebola and Marburg

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How is ebola transmitted?

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Thru blood, often due to burial rituals. It is not airborne.

Marburg may be transmitted by African Green Monkeys, must kill infected animals.

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This disease requires level 4 isolation, can sometimes only be diagnosed by animal inoculation, and requires quarantine.

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Ebola, a filoviridae. Can also diagnose due to large eosinophilic cytoplasmic inclusion bodies, ELISA, PCR.

Front 46

In dengue, if you're infected with more than one strain you get this unpleasant side effect

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Enhanced infection, because antibodies to flavavirus can enhance infection via Fc receptors on macrophages

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What is St. Louis encephalitis?

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Caused by flavavirus, it is similar to WEE and has a mosquito vector and a bird host. Seen throughout the US.