99.

ADENOVIRUSES ADENOVIRIDAE
Species Adenovirus Type 1 Adenovirus Type 2 Adenovirus Type 41 (you get the drift) linear double-stranded DNA genome icosahedral capsid (multifaceted protein coat) non-enveloped (naked, not surrounded by a cell membrane) humans (only reservoir, not normal flora - as are all other viruses) direct contact (person-to-person) droplet nuclei (respiratory spray) fecal-oral contaminated fomites (indigestible objects)

Characteristics

Reservoirs Transmission

Diseases

The Common Cold - fever, rhinitis leading to rhinorrhea and pharyngitis leading to sore throat - may complicate by progressing to laryngotracheobronchitis and viral interstitial pneumotitis - primarily occurs in children - caused by Adenovirus infection of the nasopharynx Keratoconjunctivitis - pink eye - keratitis and conjunctivitis leading to conjunctival hyperemia and preauricular lymphadenomegaly - caused by Adenovirus infection of the eye Pharyngoconjunctival Fever - fever, rhinitis, pharyngitis, conjunctival hyperemia and preauricular lymphadenomegaly - caused by simultaneous Adenovirus infection of the pharynx and eye Gastroenteritis - abdominal pain vomiting and watery diarrhea - caused by Adenovirus infection of the GI tract

Treatment

oral fluid and electrolyte replacement (if gastroenteritis)

-1-

100. HERPES SIMPLEX VIRUSES HERPESVIRIDAE

Characteristics linear double-stranded DNA genome icosahedral capsid enveloped (surrounded by a cell membrane originating from the previously infected host cell)

Herpes Simplex Virus 1 (HSV-1, Human Herpesvirus 1)

Reservoirs Transmission Diseases humans (only reservoir) direct contact

Herpes Labialis - cold sore - painful ulcerating encrustating vesicles at the site of initial infection - primarily occurs on the lips and/or the bucca - spontaneously resolves in < 2 weeks - may complicate by reactivation of latent HSV-1 in the trigeminal ganglia ! reoccurrence of the painful ulcerating encrustating vesicles at the site of initial infection - may also complicate by HSV-1 viremia ! meningoencephalitis - caused by HSV-1 infection of the oral cavity Herpetic Keratitis - ulcerating coalescing vesicles on the cornea - may complicate by causing corneal scarring ! blindness - caused by HSV-1 infection of the eye Herpetic Whitlow - painful ulcerating encrustating vesicles on the cuticles of the fingernails - caused by HSV-1 infection of the skin

Treatment

indirect viral DNA polymerase inhibitors

-2-

Herpes Simplex Virus 2 (HSV-2, Human Herpesvirus 2)

Reservoirs Transmission humans (only reservoir) direct contact sexual (sexually transmitted disease, STD, venereal disease) perinatal (mother-to-fetus)

Diseases

Herpes Genitalis - painful ulcerating encrustating vesicles at the site of initial infection - primarily occurs on the external genitalia, periorally (if oral intercourse) or perirectally (if anal intercourse) - spontaneously resolves in < 2 weeks - may complicate by reactivation of latent HSV-2 in the lumbosacral paravertebral ganglia ! reoccurrence the of the painful ulcerating encrustating vesicles at the site of initial infection - may also complicate by HSV-2 viremia ! meningoencephalitis - caused by HSV-2 infection of the skin Herpetic Keratitis - see above Herpetic Whitlow - see above TORCH Syndrome - spontaneous abortion, stillbirth, premature birth, birth defects, viral interstitial pneumonitis, acute viral hepatitis leading to jaundice, hepatosplenomegaly, generalized lymphadenomegaly and neonatal meningoencephalitis leading to mental retardation, seizures, deafness and blindness - caused by intrauterine HSV-2 infection ! HSV-2 viremia

Treatment continued in 101

indirect viral DNA polymerase inhibitors

-3-

101. CYTOMEGALOVIRUS
continuation of 100

Cytomegalovirus (CMV, Human Herpesvirus 5)

Reservoirs Transmission Diseases humans (only reservoir) direct contact perinatal

Infectious Mononucleosis-Like Syndrome - analogous to infectious mononucleosis (see 102) - may complicate by reactivation of latent CMV in the paravertebral ganglia ! viral interstitial pneumonitis, acute viral hepatitis, and retinitis leading to blindness (primarily occurs in immunocompromized) - caused by CMV infection of the nasopharynx ! CMV viremia TORCH Syndrome - see 100

Treatment

indirect viral DNA polymerase inhibitors direct viral DNA polymerase inhibitors

continued in 102

-4-

102. EPSTEIN-BARR VIRUS

continuation of 101

Epstein-Barr Virus (EBV, Human Herpesvirus 4)

Reservoirs Transmission Diseases humans (only reservoir) direct contact

Infectious Mononucleosis - kissing disease - fever, headache, severe pharyngitis, splenomegaly and generalized lymphadenomegaly - spontaneously resolves in < 6 weeks - primarily occurs in children and young adults - caused by EBV infection of the B lymphocytes in the nasopharynx ! dissemination of EBV in virtually every lymphoid organ - may progress to burkitt lymphoma and/or nasopharyngeal carcinoma (see below) Burkitt Lymphoma - malignant neoplasm of B lymphocytes - primarily occurs in children - caused by persistent EBV infection of B lymphocytes Nasopharyngeal Carcinoma - malignant neoplasm of the pharyngeal epithelium - primarily occurs in adults - caused by reactivation of latent EBV ! EBV infection of the pharyngeal epithelial cells

Treatment continued in 103

none in particular

-5-

103. VARICELLA-ZOSTER VIRUS AND HHV-6 (HUMAN HERPESVIRUS-6)

continuation of 102

Varicella-Zoster Virus (VZV, Human Herpesvirus 3)

Reservoirs Transmission humans (only reservoir) direct contact droplet nuclei contaminated fomites

Diseases

Varicella - chickenpox - fever and headache ! erythematous ulcerating encrustating vesicles beginning on the face and trunk and then progressing towards the extremities (as well as mucous membranes) - spontaneously resolves in < 1 week - may complicate by VZV viremia ! viral interstitial pneumonitis and meningoencephalitis (primarily occurs in immunocompromized) - caused by VZV infection of the nasopharynx ! VZV viremia - may progress to zoster (see below) Zoster - shingles - reoccurrence of the erythematous ulcerating encrustating vesicles on 1 or more dermatomes - occurs years after initial infection - caused by reactivation of latent VZV in the paravertebral ganglia

Treatment

indirect viral DNA polymerase inhibitors

-6-

Roseola Virus (Human Herpesvirus 6)

Reservoirs Transmission Diseases humans (only reservoir) direct contact

Roseola Infantum - exanthema subitum - high fever and cervical lympadenomegaly ! erythematous rash on the neck and trunk - spontaneously resolves in < 1 week - may complicate by reactivation of latent Roseola Virus in the paravertebral ganglia ! infectious mononucleosis-like syndrome (see 102), viral interstitial pneumonitis, acute viral hepatitis and meningoencephalitis (primarily occurs in immunocompromized) - primarily occurs in infants - caused by Roseola Virus infection of the nasopharynx ! Roseola Virus viremia indirect viral DNA polymerase inhibitors

Treatment

-7-

104. POXVIRUSES (VARIOLA AND THE ERADICATION OF SMALLPOX) POXVIRIDAE

Characteristics linear double-stranded DNA genome complex capsid (uncharacterizable protein coat) enveloped

Variola Virus
Serotypes Reservoirs Transmission Diseases Variola Major Variola Minor humans (only reservoir, now extinct due to vaccination (!)) direct contact droplet nuclei

Variola - smallpox - high fever and maculopapular rash beginning on the pharynx, oral cavity, face and extremities and then progressing towards the trunk - > 25% mortality - caused by Variola Virus infection of the nasopharynx ! Variola Virus viremia none in particular

Treatment

Vaccinia Virus
Reservoirs Transmission Diseases humans (only reservoir) parenteral (injectional)

Vaccinia - ulcerating encrustating vesicles at the site of initial infection - may complicate by Vaccinia Virus viremia ! meningoencephalitis (primarily occurs in immunocompromized) - caused by inoculation of Vaccinia Virus into the skin (vaccination against Variola Virus, see above) none in particular

Treatment

-8-

Molluscum Contagiosum Virus (MCV)

Reservoirs Transmission humans animals (primarily primates and marsupials) direct contact sexual zoonotic contaminated fomites

Diseases

Molluscum Contagiosum - multiple medium-sized nodules with central invagination (umbilication) at the site of initial infection - spontaneously resolves in < 2 years - caused MCV infection of the skin none in particular

Treatment

-9-

105. HEPATITIS VIRUSES I (HAV AND HEV) PICORNAVIRIDAE

Characteristics linear positive-sense (does not need a viral RNA-dependent RNA polymerase to replicate) single-stranded RNA genome icosahedral capsid non-enveloped

Hepatitis A Virus (HAV)

Reservoirs Transmission humans animals (primarily primates) direct contact fecal-oral contaminated water contaminated food (primarily seafood)

Diseases

Acute Viral Hepatitis - moderate hepatic damage ! fever, abdominal pain, vomiting, hepatomegaly and jaundice - spontaneously resolves in < 3 months none in particular

Treatment

CALICIVIRIDAE
Characteristics linear positive-sense single-stranded RNA genome icosahedral capsid non-enveloped

Hepatitis E Virus (HEV)

Characteristics Reservoirs Transmission same diseases and treatment as HAV (see above) humans animals (primarily primates, swine and rodents) fecal-oral contaminated water

continued in 106 - 10 -

106. HEPATITIS VIRUSES II (HBV, HDV, HCV AND HGV)

continuation of 105

HEPEDNAVIRIDAE
Characteristics circular double-stranded DNA genome icosahedral capsid enveloped

Hepatitis B Virus (HBV)

Reservoirs Transmission humans (only reservoir) direct contact sexual perinatal parenteral

Diseases

Acute Viral Hepatitis - see 105 - may progress to hyperacute viral hepatitis (see below) Hyperacute Viral Hepatitis - fulminant hepatitis - severe hepatic damage ! hepatic failure leading to generalized edema, ascites, coagulopathies and hepatic encephalopathy - primarily occurs in immunoreactive Chronic Persistent Viral Hepatitis - moderate hepatic cirrhosis ! fever, abdominal pain, vomiting, hepatomegaly and jaundice - primarily occurs in moderately immunocompromized - may progress to chronic aggressive viral hepatitis (see below) Chronic Aggressive Viral Hepatitis - severe hepatic cirrhosis ! hepatic failure (see above) - primarily occurs in severely immunocompromized Chronic Carrier State - no hepatic damage and no hepatic cirrhosis (asymptomatic) Hepatocellular Carcinoma - malignant neoplasm of the hepatocytes

Treatment

indirect viral DNA polymerase inhibitors

- 11 -

DELTAVIRIDAE
Characteristics linear negative-sense (needs a viral RNA-dependent RNA polymerase to replicate) single-stranded RNA genome icosahedral capsid non-enveloped (needs HBV envelope to become infective (!))

Hepatitis D Virus (HDV)

Characteristics Treatment same reservoirs, transmission and diseases as HBV (see above) none in particular

FLAVIVIRIDAE
Characteristics linear positiv-sense single-stranded RNA genome icosahedral capsid enveloped

Hepatitis C Virus (HCV)

Characteristics Treatment same reservoirs, transmission and diseases as HBV (see above) indirect viral DNA polymerase inhibitors (believe it or not (!))

Hepatitis G Virus (HGV)

Characteristics Diseases Treatment same reservoirs and transmission as HBV (see above) none directly associated none in particular

- 12 -

107. INFLUENZA VIRUS A, B AND C ORTHOMYXOVIRIDAE

Characteristics linear segmented (8 segments) negative-sense single-stranded RNA genome helical capsid (spirally-shaped protein coat) enveloped

Influenza Virus
Serotypes Influenza Virus Type A Influenza Virus Type B Influenza Virus Type C humans animals (primarily birds, only Influenza Virus Type A) direct contact droplet nuclei zoonotic (only Influenza Virus Type A)

Reservoirs Transmission

Diseases

Influenza - the flu - high fever, headache, myalgias, rhinitis leading to rhinorrhea, pharyngitis leading to sore throat, and non-productive cough - may complicate by progressing to laryngotracheobronchitis and viral interstitial pneumonitis (primarily occurs in elderly and immunocompromized) - caused by Influenza Virus infection of the nasopharynx viral uncoating and assembly inhibitors viral exit inhibitors

Treatment

- 13 -

108. MUMPS VIRUS PARAMYXOVIRIDAE

Characteristics linear negative-sense single-stranded RNA genome helical capsid enveloped

Mumps Virus
Reservoirs Transmission Diseases humans (only reservoir) direct contact droplet nuclei

Mumps - fever, headache and parotitis leading to painful swollen jaws - may complicate by progressing to meningoencephalitis (primarily occurs in children) - may also complicate by progressing to orchidoepididymitis and/or oophoritis (primarily occurs in teenagers and adults) - primarily occurs in children - caused by Mumps Virus infection of the nasopharynx ! Mumps Virus viremia none in particular

Treatment continued in 109

- 14 -

109. MEASLES VIRUS

continuation of 108

Rubeola Virus (Measles Virus)

Reservoirs Transmission Diseases humans (only reservoir) direct contact droplet nuclei

Rubeola - measles - high fever, rhinitis, pharyngitis, conjunctivitis, non-productive cough and generalized lymphadenomegaly ! medium-sized erythematous rash with bluish-white centers on the bucca and tongue (kopliks spots) ! erythematous maculopapular rash beginning on the face and then progressing descendingly to the feet - spontaneously resolves in < 2 weeks - may complicate by causing viral interstitial pneumonitis, infective myocarditis and meningoencephalitis - primarily occurs in children - caused by Rubeola Virus infection of the nasopharynx ! Rubeola Virus viremia - may progress to subacute sclerosing panencephalitis (see below) Subacute Sclerosing Panencephalitis - SSPE - stupor and myclonic spasms in awaken state (spasms normally occurring in healthy as they fall asleep you know what Im talking about) ! deafness, blindness and seizures ! coma - > 25% mortality - occurs years after initial infection - caused by reactivation of latent Rubeola Virus

Treatment

none in particular

- 15 -

110. RUBELLA VIRUS TOGAVIRIDAE

Characteristics linear positive-sense single-stranded RNA genome icosahedral capsid enveloped

Rubella Virus
Reservoirs Transmission Diseases humans (only reservoir) direct contact droplet nuclei

Rubella - german measles - low-grade fever, rhinitis, pharyngitis, conjunctivitis and painful postauricular and suboccipital lymphadenomegaly ! small erythematous rash on the soft palate (forchheimers spots) ! erythematous maculopapular rash beginning on the face and then progressing descendingly to the feet - spontaneously resolves in < 1 week - may complicate by progressing to infective arthritis - analogous to rubeola (see 109) - primarily occurs in children - caused by Rubella Virus infection of the nasopharynx ! Rubella Virus viremia TORCH Syndrome - see 100

Treatment

none in particular

- 16 -

111. ROTAVIRUSES REOVIRIDAE

Characteristics linear segmented (11 segments) double-stranded RNA genome icosahedral capsid non-enveloped

Rotavirus
Reservoirs Transmission humans (only reservoir) direct contact fecal-oral contaminated water contaminated food contaminated fomites

Diseases

Gastroenteritis - most common cause of gastroenteritis - abdominal pain, vomiting and severe watery diarrhea (> 20 liter per day) - may complicate by leading to hypovolemia ! hypovolemic shock ! death - may also complicate by Rotavirus viremia ! meningoencephalitis - primarily occurs in children - caused by Rotavirus infection of the GI tract oral fluid and electrolyte replacement

Treatment

- 17 -

112. NORWALK VIRUS AND OTHER VIRUSES OF HUMAN GASTROENTERITIS CALICIVIRIDAE

Characteristics see 105

Norwalk Virus
Characteristics Diseases same reservoirs, transmission and treatment as Rotavirus (see 111)

Gastroenteritis - see 99 - primarily occurs in teenagers and adults - caused by Norwalk Virus infection of the GI tract

- 18 -

113. POLIOVIRUSES PICORNAVIRIDAE

Characteristics see 105

Poliovirus
Reservoirs Transmission humans (only reservoir) direct contact droplet nuclei fecal-oral

Diseases

Inapparent Poliomyleitis - low-grade fever, headache and pharyngitis - spontaneously resolves in < 1 week - primarily occurs in children - caused by Poliovirus infection of the nasopharynx - may progress to non-paralytic poliomyelitis and/or paralytic poliomyelitis (see below) Non-Paralytic Poliomyleitis - meningitis leading to high fever, vomiting and nuchal rigidity - spontaneously resolves in < 1 week - primarily occurs in children - caused by Poliovirus viremia ! Poliovirus infection of the meninges Paralytic Poliomyleitis - asymmetric flaccid paralysis ! muscular atrophy and loss of myotatic reflexes (stretch reflexes) - may complicate by flaccid paralysis of the respiratory muscles ! death - primarily occurs in teenagers and adults - caused by Poliovirus infection of the peripheral motor neurons

Treatment continued in 114

none in particular

- 19 -

114. COXSACKIE AND ECHO VIRUSES

continuation of 113

Coxsackie A Virus (CAV)

Reservoirs Transmission humans (only reservoir) direct contact droplet nuclei fecal-oral

Diseases

The Common Cold - see 99 - may complicate by CAV viremia ! meningoencephalitis - caused by CAV infection of the nasopharynx - may progress to herpangina (see below) Herpangina - high fever and painful ulcerating erythematous vesicles on the pharynx - caused by progression of the common cold (see above) - may progress to hand-foot-and-mouth disease (see below) Hand-Foot-and-Mouth Disease - high fever and painful ulcerating erythematous vesicles on the bucca and tongue as well as on the palms and soles - caused by progression of herpangina (see above)

Treatment

none in particular

- 20 -

Coxsackie B Virus (CBV)

Reservoirs Transmission humans (only reservoir) direct contact droplet nuclei fecal-oral

Diseases

The Common Cold - see above - may complicate by CBV viremia ! meningoencephalitis, infective myocarditis and acute pericarditis - caused by CBV infection of the nasopharynx - may progress to pleurodynia (see below) Pleurodynia - bornholm disease - high fever, headache and intercostal striated muscle necrosis leading to severe pain during inspiration (pleuritic pain) - caused by progression of the common cold (see above)

Treatment

none in particular

Echovirus
Reservoirs Transmission humans (only reservoir) direct contact droplet nuclei fecal-oral

Diseases

The Common Cold - see above - may complicate by Echovirus viremia ! meningoencephalitis, infective myocarditis and acute pericarditis - caused by Echovirus infection of the nasopharynx Keratoconjunctivitis - see 99 - caused by Echovirus infection of the eye Gastroenteritis - see 99 - primarily occurs in infants - caused by Echovirus infection of the GI tract

Treatment

none in particular

- 21 -

115. RABIES RHABDOVIRIDAE

Characteristics linear negative-sense single-stranded RNA genome helical capsid enveloped

Rabies Virus
Reservoirs Transmission Diseases humans animals (primarily dogs, cats and bats) direct contact zoonotic

Furious Rabies - fever, headache and neuralgia at the site of initial infection ! encephalitis leading to delirium, psychosis and bursts of furious rage, and severe pharyngeal spasms upon drinking (hydrophobia) leading to foaming of the mouth ! symmetric flaccid paralysis and seizures ! coma and respiratory center dysfunction - > 90% mortality rate (within 2 weeks (!)) - most common - caused by Rabies Virus infection of wounds ! retrograde migration of Rabies Virus through sensory neurons into the CNS Apathetic Rabies - fever, headache and neuralgia at the site of initial infection ! encephalitis leading to insomnia, stupor and apathy ! symmetric flaccid paralysis and seizures ! coma and respiratory center dysfunction - > 90% mortality rate (within 2 weeks (!)) - caused by Rabies Virus infection of wounds ! retrograde migration of Rabies Virus along sensory neurons into the CNS

Treatment

none in particular

- 22 -

116. SLOW VIRUS INFECTIONS AND PRION DISEASE PRIONS

Characteristics proteinaceous infectious particles not viruses consists solely of protein (prion protein, PrP) humans animals (primarily cattle) zoonotic contaminated food contaminated fomites inherited (!)

Reservoirs Transmission

Diseases

Variant Creutzfeldt-Jakob Disease - vCJD - (bovine spongiform encephalopathy, BSE, mad cow disease, in cattle) - cerebral and cerebellar granulovacoular degeneration ! chronic progressive encephalopathy leading to insomnia, stupor, apathy, myclonic spasms in awaken state (see 109), and finally coma - 100% mortality (in less than 2 years (!)) - caused by Prion viremia ! Prion accumulation in the CNS none in particular

Treatment

- 23 -

117. TUMOR VIRUSES HERPESVIRIDAE

Characteristics see 100

Kaposi Sarcoma Herpesvirus (KSHV, Human Herpesvirus 8)

Reservoirs Transmission humans (only reservoir) direct contact sexual perinatal

Diseases

Kaposi Sarcoma - malignant neoplasm of vascular smooth muscle - caused by KSHV viremia ! KSHV infection of vascular smooth muscle cells none in particular

Treatment

- 24 -

PAPOVAVIRIDAE
Characteristics circular double-stranded DNA genome icosahedral capsid non-enveloped

Human Papilloma Virus (HPV)

Reservoirs Transmission humans (only reservoir) direct contact sexual perinatal contaminated fomites

Diseases

Common Cutaneous Warts - verrucae vulgaris - painless superficial medium-sized rough hyperkeratinized nodules at the site of initial infection - primarily occurs on the hands and fingers (as well as on the feet) - caused by HPV infection of the skin - may progress to deep palmo-plantar warts (see below) Deep Palmo-Plantar Warts - myrmecias - painful deep medium-sized rough hyperkeratinized pigmented nodules at the site of initial infection - primarily occurs on the feet and toes (as well as on the hands) - caused by progression of common cutaneous warts (see above) ! HPV invasion of the dermis Anogenital Warts - condyloma acuminata - multiple small papules coalescing to form a large cauliflower-like lesion at the site of initial infection - primarily occurs on the external genitalia or perirectally (if anal intercourse) - caused by HPV infection of the skin Cervical Intraepithelial Neoplasia - CIN - benign neoplasm of the cervix - caused by HPV infection of the cervix - may progress to cervical carcinoma (see below) Cervical Carcinoma - malignant neoplasm of the cervix - caused by progression of cervical intraepithelial neoplasia (see above)

- 25 -

Treatment

topical liquid nitrogen (if common cutaneous warts, deep palmoplantar warts and/or anogenital warts)

RETROVIRIDAE
Characteristics linear diploid (2 exact copies) positive-sense single-stranded RNA genome complex capsid enveloped

Human T-Lymphotrophic Virus 1 (HTLV-1)

Reservoirs Transmission humans (only reservoir) sexual perinatal parenteral

Diseases

Tropical Spastic Paraparesis - HTLV-1 associated myelopathy - skeletal muscle spasms and generalized striated muscle asthenia (including external urethral and external rectal sphincters) leading to incontinence - caused by HTLV-1 viremia ! HTLV-1 infection of the CNS Acute T-Lymphocytic Leukemia - malignant neoploasm of T lymphocytes - caused by HTLV-1 viremia ! HTLV-1 infection of T lymphocytes

Treatment

none in particular

- 26 -

118. ARBOVIRUSES (YELLOW FEVER VIRUS AND TICK-BORNE ENCEPHALITIS VIRUSES) FLAVIVIRIDAE
Characteristics see 106

Yellow Fever Virus (YFV)

Reservoirs Transmission Diseases humans animals (primarily primates and marsupials) zoonotic vectorial (mosquitoes)

Yellow Fever - fever, headache and myalgias (primarily of the lower back) ! toxic acute tubular necrosis leading to intrarenal acute renal failure and uremia, and acute viral hepatitis leading to jaundice and coagulopathies - > 40% mortality - caused by YFV viremia none in particular

Treatment

TOGAVIRIDAE
Characteristics see 110

Western Equine Encephalitis Virus (WEEV)

Reservoirs Transmission Diseases humans animals (primarily horses, rodents and birds) vectorial (mosquitoes)

Western Equine Encephalitis - WEE - meningitis leading to high fever, vomiting and nuchal rigidity, and encephalitis leading to delirium, stupor and seizures ! coma - < 10% mortality - caused by WEEV viremia

- 27 -

Treatment

none in particular

Eeastern Equine Encephalitis Virus (EEEV)

Characteristics Diseases same reservoirs, transmission and treatment as WEEV (see above)

Eastern Equine Encephalitis - EEE - analogous to WEE (see above) - > 60% mortality - caused by EEEV viremia

Venezuelian Equine Encephalitis Virus (VEEV)

Characteristics Reservoirs Diseases same transmission and treatment as WEEV (see above) humans animals (primarily horses)

Venezuelan Equine Encephalitis - VEE - analogous to WEE (see above) - < 20% mortality - caused by VEEV viremia

BUNYAVIRIDAE
Characteristics linear segmented (3 segments) negative-sense single-stranded RNA genome helical capsid enveloped

California Encephalitis Virus (CEV)

Characteristics Reservoirs Diseases same transmission and treatment as WEEV (see above) humans animals (primarily rodents)

California Encephalitis - analogous to WEE (see above) - < 1% mortality - caused by CEV viremia - 28 -

119. ROBOVIRUSES (HANTAAN VIRUS, MARBURG AND EBOLA VIRUSES, LASSA AND LCM VIRUSES) BUNYAVIRIDAE
Characteristics see 118

Hantavirus (Hantaan Virus)

Reservoirs Transmission humans animals (primarily rodents) direct contact zoonotic aerosolized

Diseases

Hantavirus Pulmonary Syndrome - HPS - fever, headache and myalgias (primarily of the lower back) ! alveolar capillary endothelial damage leading to adult respiratory distress syndrome (ARDS) - > 80% mortality (in < 1 week (!)) - caused by Hantavirus viremia (primarily of the pulmonary circulation) Hantavirus Hemorrhagic Fever with Renal Syndrome - HFRS - fever, headache and myalgias (primarily of the lower back) ! disseminated capillary endothelial damage leading to hemorrhages in the skin and mucous membranes, and toxic acute tubular necrosis leading to intrarenal acute renal failure and uremia - < 10% mortality - caused by Hantavirus viremia (primarily of the systemic circulation)

Treatment

indirect viral DNA polymerase inhibitors (believe it or not (!))

- 29 -

FILOVIRIDAE
Characteristics linear negative-sense single-stranded RNA genome helical capsid enveloped

Marburg Virus
Reservoirs Transmission Diseases humans animals (primarily primates) direct contact zoonotic

Marburg Hemorrhagic Fever - fever headache and myalgias (primarily of the lower back) ! disseminated capillary endothelial damage leading to hemorrhages in the skin, mucous membranes as well as other organs ! multiple organ failure - > 25% mortality - caused by Marburg Virus viremia none in particular

Treatment

Ebola Virus
Characteristics Diseases same reservoirs, transmission and treatment as Marburg Virus (see above)

Ebola Hemorrhagic Fever - analogous to marburg hemorrhagic fever (see above) - > 90% mortality (!) - caused by Ebola Virus viremia

- 30 -

ARENAVIRIDAE
Characteristics linear segmented (2 segments) negative-sense single-stranded RNA genome helical capsid enveloped

Lassa Virus
Reservoirs Transmission humans animals (primarily rodents) direct contact zoonotic aerosolized contaminated food contaminated fomites

Diseases

Lassa Fever - analogous to marburg hemorrhagic fever (see above) - < 1% mortality - caused by Lassa Virus viremia indirect viral DNA polymerase inhibitors (believe it or not (!))

Treatment

Lymphocytic Choriomeningitis Virus (LCMV)

Reservoirs Transmission humans animals (primarily primates, rodents, swine and dogs) direct contact zoonotic aerosolized contaminated food contaminated fomites

Diseases

Lymphocytic Choriomeningitis - LCM - fever, headache and myalgias ! meningoencephalitis (see 119) - < 1% mortality - caused by LCMV viremia none in particular

Treatment

- 31 -

120. HUMAN PARVOVIRUS B19 PARVOVIRIDAE

Characteristics linear single-stranded DNA genome icosahedral capsid non-enveloped

Human Parvovirus B19

Reservoirs Transmission humans direct contact perinatal parenteral

Diseases

Erythema Infectiosum - slapped-cheek disease - erythematous rashes of the cheeks as well as on the trunk and extremities - may complicate by infection of the bone marrow ! aplastic anemia ! transient aplastic crisis (primarily occurs in infants, immunocompromized or if already anemic) - spontaneously resolves in < 1 week - primarily occurs in children - caused by Human Parvovirus B19 viremia none in particular

Treatment

- 32 -

121. VIROLOGY AND LABORATORY DIAGNOSIS OF AIDS 122. EPIDEMIOLOGY AND SPREAD OF AIDS RETROVIRIDAE
Characteristics see 117

Human Immunodeficiency Virus (HIV)

Reservoirs Transmission humans (only reservoir) direct contact sexual perinatal parenteral

Diseases

Acquired Immunodeficiency Syndrome - AIDS - infectious mononucleosis-like syndrome (see 102) ! immunodeficiency leading to a torrent of opportunistic bacterial, viral, fungal protozoal and helmithic superinfections, as well as a torrent of malignant neoplasms - may complicate by HIV infection of both the central and peripheral nervous system ! encephalopathies, myelopathies and peripheral neuropathies (AIDS dementia complex) - 100% mortality (eventually (!)) - caused by HIV viremia ! HIV dissemination in virtually every lymphoid organ ! HIV infection of helper T lymphocytes indirect viral reverse transcriptase inhibitors direct viral reverse transcriptase inhibitors viral protease inhibitors

Treatment

- 33 -

123. CONGENITAL VIRAL INFECTIONS (RUBELLA AND CMV, DIAGNOSIS AND PREVENTION) 124. IMMUNOSUPPRESSIVE CONDITIONS, TRANSPLANTATION AND VIRAL INFECTIONS, PREVENTION 125. NOSOCOMIAL VIRAL INFECTIONS, EXAMPLES FOR TRANSMISSION OF RESPIRATORY, ENTERIC AND BLOODBORNE VIRUSES

- 34 -