VIRUSURILOR
1. Concepte de baza
2. Structura virusurilor
3. Reproducerea virala
4. Agenti infectiosi mai mici decat virusurile
5. Termeni cheie
6. Concluzii
Concepte de baza
STRUCTURA VIRUSURILOR
1.
2.
3.
4.
Capsida si anvelopa
Capsida = invelis proteic care protejeaza genomul viral
- pot fi poliedrice sau deosebit de complexe
- sunt formate din numeroase capsomere
Anvelopa = structura de tip membranar, care acopera la unele specii,
capsida
- rol esential in infectie
- este derivata din membrana celulei gazda infectate anterior si
contine si proteine de origine virala
5.
Proprietatile Plante
ARN 2.5-28 kb
virusurilor in ARN 0.3-28 kb
ADN niciodata
ADN 3-10 kb
functie de
unele au anvelopa
cele cu anvelopa nu au si capsida
gazdele
lor
cpmplexitatea genomului - redusa
complexitate redusa a genomului
Fungi
Procariote
ARN 5-8 kb
ADN 10-200 kb
unele au anvelopa
complexitate variabila
morfologie diversa
unele au genom divizat
Animale
ARN 5-30 kb
ADN: 5-350 kb
majoritatea au anvelopa
complexitate variabila
morfologie diversa
unele au genomul divizat
Eucariote inferioare
ARN 5-10 kb
ADN 180-1200 kb
anvelopa interna
complexitate variabila
morfologie diversa
nu sunt cunoscute ca avand
genom divizat
ARN viral
Subunitati proteice
ale anvelopei
18-nm diametru,
250-nm lungime
Anvelopa lipidica;
proteinele virale
care proemina
prin anvelopa
80-nm diametru
ADN
invelis proteic
gat
ARN viral
placa bazala
fibrele cozii
Revers transcriptaza
Capsida proteica
100-120 nm diametru
65-nm diametru
capul, 225-nm
lungime totala
5 etape
Finalizat cu liza
celulei gazda
atasarea
penetrarea
replicarea
asamblarea
eliberarea
Ciclul litic
Virusuri virulente
Ciclul lizogenic
ADN-ul viral se
integreaza in
cromosomul
bacterian (devine
profag)
Virusuri temperate
Clase de
virusuri care
infecteaza
celulele
animale
Smallpox
varsatul de vant
Measles- rujeola
Viroizi
Mici fragmente de ARN
Provoaca boli la plante
Termeni cheie
Provirus
Capsida
Retrovirus
Anvelopa virala
Revers-transcriptaza
Bacteriofag (fag)
Viroid
Ciclu litic
Prion
Virus virulent
Ciclu lizogen
Virus temperat
Profag
HIV (human immunodeficiency virus)
AIDS (acquired immunodificiency
syndrome)
CONCLUZII
VIRUSURILE
ARN
VIRUSURILE ARN
Replicarea are loc pe
seama formarii initial a
unei structuri
intermediare, dublucatenare forma
replicativa
Enzima cheie este o ARN
polimeraza ARN
dependenta, de origine
virala, dar sunt necesari si
factori de transcriptie pe
care ii pune la dispozitie
gazda
Virusurile ARNdc
Decapsidarea activeaza
enzime care vor produce
ARNm prin transcriptia
genomului viral
Sunt sintetizate catene
pozitive, care vor fi preimpachetate
Ulterior sunt sintetizate
si catenele negative
ARNdc viral nu este
lasat liber in citoplasma,
pentru a nu fi distrus de
ARN-azele celulare
GENERALITATI
Febrele hemoragice
Definitie: sindrom sistemic deosebit de sever
Afectarea sistemului vascular
Alterarea capacitatii de autoreglare a organismului
Hemoragii generalizate
FILOVIRUSURILE
Filovirusuri
Virusul Marburg
Provoaca febra hemoragica africana, numita si boala
maimutelor verzi sau febra Marburg
Prima epidemie Marburg Germania, 1967
Personalul de laborator s-a infectat de la maimute
Epidemie simultana in Hamburg, Germania si Belgrad,
Iugoslavia (Serbia)
32 cazuri umane
31 infectie primara si 1 caz de transmitere secundara
23% mortalitate
Virusul Ebola
Este numele unui rau din
Republica Congo (fost Zair)
Prima epidemie Zair 1967
318 cazuri umane
88% mortalitate
Boala s-a raspandit foarte repede la personalul din spital
EPIDEMII
Marburg
Epidemii europene
1967
Hamburg si Marburg, Germania si Belgrad, Iugoslavia
Epidemii africane
1975
Johannesburg, Africa de Sud
3 decese
1980
Vestul Kenyei
2 decese
1987
1 deces Kenya
1999-2000
Durba, Republica Congo
Lucratori la o exploatare de aur
Anul
Ebola subtip
Tara
Numrul de
cazuri
umane
Mortalitate
Condiii
1976
Ebola-Zaire
Zaire [Democratic
Republic of
the Congo]
318
88%
Occurred in
Yambuku and
surrounding
area. Disease
was spread
by close
personal
contact and
by use of
contaminated
needles and
syringes in
hospitals/clini
cs. This
outbreak was
the first
recognition of
the disease.
1976
Ebola-Sudan
Sudan
284
53%
Occurred in
Nzara, Maridi
and the
surrounding
area. Disease
was spread
mainly
through close
personal
contact
within
hospitals.
Many medical
care
personnel
were
infected.
1979
Ebola-Sudan
Sudan
34
65%
Occurred in Nzara.
Recurrent outbreak
at the same site as
the 1976 Sudan
epidemic.
1989
Ebola-Reston
USA
0%
Ebola-Reston virus
was introduced into
quarantine facilities
in Virginia, Texas,
and Pennsylvania by
monkeys imported
from the Philippines.
Four humans
developed antibodies
to Ebola-Reston virus
but did not become
ill.
1990
Ebola-Reston
USA
0%
Ebola-Reston virus
was introduced once
again into quarantine
facilities in Virginia,
and Texas by
monkeys imported
from the Philippines.
Four humans
developed antibodies
but did not get sick.
1992
Ebola-Reston
Italy
0%
Ebola-Reston virus
was introduced into
quarantine facilities
in Sienna by
monkeys imported
from the same export
facility in the
Philippines that was
involved in the
episodes in the
1994
Ebola-Zaire
Gabon
49
59%
Occurred in
Mkouka and
other gold-mining
camps deep in the
rain forest.
Initially thought to
be yellow fever;
identified as Ebola
hemorrhagic fever
in 1995.
1994
Ebola-Ivory Coast
Ivory Coast
0%
Scientist became
ill after
conducting an
autopsy on a wild
chimpanzee in the
Tai Forest. The
patient was
treated in
Switzerland.
1995
Ebola-Zaire
Democratic
Republic of
the Congo
(formerly Zaire)
315
81%
Occurred in
Kikwit and
surrounding area.
Traced to index
case-patient who
worked in forest
adjoining the city.
Epidemic spread
through families
and hospitals.
1996
Ebola-Zaire
Gabon
31
68%
Occurred in
Mayibout area. A
chimpanzee found
dead in the forest
was eaten by
people hunting for
food. Nineteen
people who were
1996
Ebola-Zaire
Gabon
60
75%
Occurred in
Boou area with
transport of
patients to
Libreville. Index
case-patient was
a hunter who
lived in a forest
camp. Disease
was spread by
close contact
with infected
persons. A dead
chimpanzee
found in the
forest at the
time was
determined to
be infected.
1996
Ebola-Zaire
South Africa
50%
A medical
professional
traveled from
Gabon to
Johannesburg,
South Africa,
after having
treated Ebola
virus-infected
patients and
thus having
been exposed to
the virus. He
was
hospitalized,
and a nurse who
took care of him
became infected
and died.
1996
Ebola-Reston
Philippines
0%
Ebola-Reston
virus was
identified in a
monkey export
facility in the
Philippines. No
human
infections were
identified.
20002001
EbolaSudan
Uganda
425
53%
Occurred in
Gulu, Masindi,
and Mbarara
districts of
Uganda. The
three most
important risks
associated with
Ebola virus
infection were
attending
funerals of
Ebola
hemorrhagic
fever casepatients, having
contact with
case-patients in
one's family, and
providing
medical care to
Ebola casepatients without
using adequate
personal
protective
measures.
20012002
Ebola-Zaire
122
79%
Outbreak
occurred over
TRANSMITERE
Virusul Ebola
Nu este cunoscuta starea de purtator (specia
rezervor necunoscuta)
Specialistii o considera de origine animala
Exista si teorii privind provenienta vegetala
Transmiterea inter-uman se face prin contact cu
fluidele contaminate.
Ebola-Reston
A aparut n USA (Reston, Virginia)
La maimutele verzi africane folosite ca animale de laborator
Patru cercettori s-au dovedit a avea anticorpi
Virusul Marburg
Transmiterea de la animalul gazd este neelucidata
De la om la om probabil prin schimb de fluide corporale
SPECIA REZERVOR
Necunoscuta
Poate fi:
O specie foarte rara
O specie care obinuit nu intr n contact cu gazda
clinica
Dac are loc contactul, virusul nu se transmite cu
usurinta
Ipoteze
liliecii
plantele
Structura:
Pleiomorfica: filamente lungi, uneori ramificate,
cu forma cifrei 6, a literei U sau circulare
Fiecare virion contine o molecula de ARN
monocatenara, negativa
INCUBATIE SI PERIOADA PN
LA DECES
Ebola: 2 21 zile
Marburg: 3 9 zile
Decesul se produce in general dupa 7 16 zile
In cazul imbolnavirii cu Ebola moartea survine
de regula la dou zile dupa aparitia
simptomelor
MORFOLOGIE SI
STRUCTURA
Virioni filamentosi
Variabilitate foarte mare a lungimii
Marburg - 860 nm
Ebola - 1200 nm
Diametru uniform de 80 nm
Compusi din:
Nucleocapsida
Matrix
Anvelopa cu spiculi glicoproteici cu lungimea
maxima de 10 nm
GENOMUL
PATRUNDEREA VIRUSULUI SI
REPLICAREA VIRALA
Spiculii din anvelopa virala sunt recunoscuti si se leaga
la nivelul unor receptori de suprafata apartinand
celulelor gazda
Virusul patrunde prin endocitoza
Are loc eliberarea nucleocapsidei in citoplasma
Incepe transcriptia
ARN-ul viral ARNm poliadenilat, monocistronic
Incepe translatia si producerea de proteine virale, initial
nucleoproteine
Extruzia noilor particule virale
Celula gazd este distrusa: vacuolizare, distrugerea
mitocondriilor si a altor organite
PATOGENEZA IN INFECTIA
EBOLA
1. Inhibarea activitatii neutrofilelor
2. Regiuni specifice din glicoproteine induc efecte
citotoxice specifice in celulele endoteliale
- eliberarea rapida de agenti vasoactivi din
celulele infectate
- pierderea formei celulei (devin sferice) i
desprinderea din matrixul extracelular
- permeabilitatea membranar creste foarte
mult
POSIBILITATI DE SUPRAVIETUIRE
IN INFECTIA EBOLA
1996 doua epidemii majore in Gabon, in
care au existat si supravieuitori
Compararea raspunsurilor imunitare:
supravietuitorii
- raspuns IgG la proteinele de anvelopa
- activarea limfocitelor T citotoxice
decedati
- raspuns IgG negativ
- nivele aproape nedetectabile de IgM
STADIUL TARDIV:
Splina si ficatul se maresc datorita excesului de
sange
Hemoragii la nivelul tractului gastrointestinal,
pleurei, pericardului si spatiului peritoneal, precum si
in rinichi, cu depunerea de fibrina
Modificarea parametrilor de coagulare
Leucopenie profunda
DIAGNOSTICUL DIFERENTIAL
EBOLA
Febra foarte mare
Eruptii
maculopapulare
Prurit
Sangerare
MARBURG
Mialgie
Bradicardie
Descuamare
Pierderea apetitului
ELISA
TRANSMITEREA
Contact direct cu sangele, secretiile, sperma unei
persoane infectate
Transmiterea prin sperma continua circa 80 zile
dupa revenirea clinica
Manipularea persoanelor sau maimutelor bolnave
sau decedate
Personalul medical este frecvent infectat
Neonatal
Picaturi de saliva sau aerosoli responsabile de
raspandire in cazul formei Reston
TERAPIA CURENTA
Terapie de suport a functiilor vitale
Transfuzii
Ribavirin (analog nucleosidic sintetic), eficient in
tratarea febrei Lassa si a unor infectii cu
Arenavirusuri, nu este deloc eficienta in infectia
Ebola
PROFILAXIA
Studiile au aratat ca:
Imunoglobulinele hiperactive protejeaza babuinii
infectati experimental daca sunt administrate in
acelasi timp cu virusul, dar tratamentul este inutil
daca se intarzie trei zile de la infectare.
Tratamentul este util in cazul infectiilor
accidentale.
SARCINA IN INFECTIA CU
FILOVIRUSURI
Maladia se manifesta mai grav la gravide, cu
complicatii serioase de natura hemoragica si
neurologica
Mortalitatea este de 95.5% la gravide versus
77% la persoanele neinsarcinate infectate
Avortul spontan este frecvent
Toti copii nascuti sunt infectati si nu
supravietuiesc
POTENTIALE VACCINURI
Compania biotehnologica olandeza Crucell, in
colaborare cu US National Institute of Allergy
and Infectious Diseases (NIAID) lucreaza la
producerea primului vaccin anti-Ebola
Noul vaccin utilizeaza ADN care codifica pentru trei
glicoproteine si o nucleoproteina a virusului Ebola
(Nature 408, 605; 2000). Este primul vaccin care a
indus imunitate pentru Ebola la maimute
IN STUDIU
Gasirea gazdei purtatoare
Necesitatea de a cunoaste mai mult
despre transmisie
De la animal la om
Din hrana
Problema aerosolizarii
Daca este posibil sa se transmita prin aerosoli
UTILIZAREA FILOVIRUSURILOR
CA ARME BIOLOGICE
Ebola in particular
Rata mortalitatii foarte mare
Ingoranta in randurile marelui public
Lipsa de pregatire in domeniu a personalului
medical
EBOLAPOX
PREVENIREA EPIDEMIILOR
Spitalizarea si izolarea
pacientilor
Instituirea carantinei
Utilizarea echipamentului de
protectie
Dezinfectarea chimica si termica
a aparaturii si instrumentarului
Incinerarea materialelor folosite