VI.

A.
B.
C.
D.
E.

Viral Diseases
Influenza
Diseases Caused by the Herpes Family
Viral Hepatitis
Human Immunodeficiency Virus
Miscellaneous Viral Diseases

VI. A. Influenza
Properties
Member of the Orthomyxovirus family
Enveloped RNA virus
Two envelope proteins
Hemagglutinin and Neuraminidase

Segmented RNA
8 segments; packaged into helical nucleocapsids

Antigenic variation & genetic exchange lead to

the appearance of new strains; requires use of
different vaccine combinations each year

VI. A. Influenza
Symptoms & Complications of Influenza
Respiratory Tract Symptoms
Fever
Neurological Complications:
Guillain-Barr Syndrome
Reyes Syndrome

VI. B. Diseases Caused by the

Herpes Family
Properties of the Herpes Virus Family
Large, enveloped DNA viruses
Icosahedral capsids
DNA replicates in the nucleus of host cells
Cells may become permanently infected
Host chromosomes may be altered
Herpes infections associated with certain
cancers

VI. B. Diseases Caused by the

Herpes Family
Herpes Simplex
Two major strains

Type I: Oral Herpes

Type II: Genital Herpes

Skin lesions form at site of the infection

Virus travels along sensory neurons to ganglia,
where it remains
During times of stress or weakened immunity,
virus may travel along same neurons to re-infect
the initial skin sites

VI. B. Diseases Caused by the

Herpes Family

Herpes Simplex (cont.)

Other complications
Herpes encephalitis
Congenital herpes
Cervical cancer

Treatment: Acyclovir

VI. B. Diseases Caused by the

Herpes Family
Chicken pox & Shingles
Cause: Varicella-zoster virus
Chicken pox symptoms
Shingles symptoms
Treatment
Chicken pox vaccine
Connection to Reyes syndrome

VI. B. Diseases Caused by the

Herpes Family
Infectious mononucleosis
Cause: Epstein-Barr virus
Infectious mononucleosis
Lymph node swelling; fever; fatigue
Heterophile antibody production
Monospot Test
Other complications
Burkitt's Lymphoma
Chronic Fatigue Syndrome??!?

VI. B. Diseases Caused by the

Herpes Family
Cytomegalovirus
Mild symptoms in otherwise healthy
individuals
Major complications
Miscarriages when contracted during
pregnancy
Severe infections in AIDS patients
Major cause of blindness in AIDS patients

VI. C. Viral Hepatitis

Hepatitis A
Also known as:
Infectious hepatitis
Short-incubation hepatitis

Viral Properties
Picornavirus Family
Small nonenveloped RNA viruses
Family includes common cold (rhinovirus) &
polio viruses

VI. C. Viral Hepatitis

Hepatitis A (cont.)
Transmission:
Virus particles are present in the stool
Fecal-oral route via contaminated food or
water
Saliva contact, sexual contact, and
arthropods also have been implicated

VI. C. Viral Hepatitis

Hepatitis A (cont.)
Symptoms:
Two to four week incubation period
Nausea, vomiting, fever
Abdominal pain
Jaundice in many but not all cases
Duration usually several weeks

VI. C. Viral Hepatitis

Hepatitis A (cont.)
Treatment & Prevention:
Prolonged rest
Hepatitis A Immune Globulin
Hepatitis A vaccine

VI. C. Viral Hepatitis

Hepatitis B
Also known as:
Serum hepatitis
Long-incubation hepatitis

VI. C. Viral Hepatitis

Hepatitis B (cont.)
Viral properties:
Hepadnavirus family
Nucleocapsid consists of DNA surrounded by
hepatitis B core antigen (HBcAg)
The core is surrounded by a lipoprotein envelope
containing the hepatitis B surface antigen (HBsAg)
The virus has also been called the Dane particle
Large amounts of excess HBsAg are found in the
serum & may be detected serologically

VI. C. Viral Hepatitis

Hepatitis B (cont.)
Transmission:
Contact with infected body fluids
Blood, blood products, semen, vaginal secretions
(urine, saliva also implicated)

VI. C. Viral Hepatitis

Hepatitis B (cont.)
Symptoms:
Incubation period: four weeks - six months
Nausea, fever
Dark urine & clay-colored stools
Abdominal tenderness
Jaundice
Duration of symptoms: 3 - 4 months
About 10% of patients remain carriers for several
months

VI. C. Viral Hepatitis

Hepatitis B (cont.)
Treatment & prevention
Hepatitis B Immune Globulin
Hepatitis B vaccination

VI. C. Viral Hepatitis

Non-A non-B (NANB) Hepatitis
Hepatitis C
NANB serum hepatitis
Enveloped virus of the Flavivirus family
Transmission & symptoms similar to B

Delta hepatitis
A small defective RNA virus that requires
coinfection with Hepatitis B to replicate
Co-transmitted with Hepatitis B

VI. C. Viral Hepatitis

Non-A non-B (NANB) Hepatitis (cont.)
Hepatitis E
NANB infectious hepatitis
A small nonenveloped RNA virus of the calcivirus
family
Transmission & symptoms similar to Hepatitis A

VI. D. Human Immunodeficiency

Virus
Viral Properties
A retrovirus
An enveloped RNA virus that replicates through
a DNA intermediate
The DNA intermediate is synthesized by reverse
transcriptase: an enzyme that makes a DNA
molecule using an RNA template
The DNA intermediate is spliced into host
chromosomes, making the infection permanent

VI. D. Human Immunodeficiency

Virus
Viral Properties (cont.)

Host cells for HIV: CD4+ cells

Helper T (T-4) lymphocytes
Macrophages
Damage to the helper T cell population cripples
the immune system of the host

VI. D. Human Immunodeficiency

Virus
Transmission
Contact with infected body fluids
Blood, blood products, semen, vaginal
secretions, breast milk

VI. D. Human Immunodeficiency

Virus
What is the difference between HIV & AIDS?
HIV: the Human Immunodeficiency Virus
The cause of AIDS
Also known as: HTLV-III and LAV
Two known types: HIV-1 and HIV-2
AIDS: Acquired Immune Deficiency Syndrome
Catastrophic immune system failure caused by HIV
infection
Symptoms & cases are usually defined by the CDC
case surveillance definition

VI. D. Human Immunodeficiency

Virus
CDC Case Surveillance Definition for AIDS
Based on:
Clinical Symptoms: Categories A, B, C
Helper T-4 lymphocyte count:
Categories 1, 2, 3
Category A
Asymptomatic HIV infection
Persistent Generalized L ymphadenopathy
Acute HIV infection

VI. D. Human Immunodeficiency

Virus
CDC Case Surveillance Definition for AIDS (cont.)
Category B
Symptomatic HIV infection with constitutive
illness & certain opportunistic infections
Often an early indication that AIDS is developing
*Category C
Symptomatic HIV infection with opportunistic
infections listed in the CDC surveillance case
definition

VI. D. Human Immunodeficiency

Virus

CDC Case Surveillance Definition for AIDS (cont.)

Category 1
T-4 count greater than 400 per microliter of blood
Category 2
T-4 count between 400 and 200 per microliter of
blood
*Category 3
T-4 count less than 200 per microliter of blood

VI. D. Human Immunodeficiency

Virus
CDC Case Surveillance Definition for AIDS
(cont.)
*These categories (C and 3) meet the CDC
surveillance definition to be included among the
AIDS cases
Many HIV-infected individuals show no
symptoms, yet are capable of transmitting the
virus

VI. D. Human Immunodeficiency

Virus

Symptoms & Secondary Infections Associated with

AIDS
Acute Infection
Fever, lymph node swelling, aches, fatigue, flulike or mono-like symptoms
Persistent Generalized Lymphadenopathy
Lymph node swelling for greater than 6 months in
two or more body areas (excluding the groin)
Often an early manifestation that AIDS has
developed

VI. D. Human Immunodeficiency

Virus
Symptoms & Secondary Infections Associated
with AIDS (cont.)
Constitutive Illness
Weight loss, persistent fever, diarrhea
Cancers
Kaposis sarcoma
Certain lymphomas

VI. D. Human Immunodeficiency

Virus
Symptoms & Secondary Infections Associated
with AIDS (cont.)
Bacterial Secondary Infections
Mycobacterium
Listeria
Salmonella
Mycoplasma
many others

VI. D. Human Immunodeficiency

Virus
Symptoms & Secondary Infections Associated
with AIDS (cont.)
Fungal Secondary Infections
Candida and others
Protozoan Secondary Infections
Toxoplasma gondii
Cryptosporidium
Pneumocystis carinii

VI. D. Human Immunodeficiency

Virus
Symptoms & Secondary Infections Associated
with AIDS (cont.)
Viral Secondary Infections
Herpes simplex
Cytomegalovirus
Many others

Treatments
Inhibitors of DNA replication
Protease Inhibitors

VI. E. Miscellaneous Viral

Diseases
Miscellaneous Pneumotrophic Viruses
Rhinovirus
Adenovirus
Respiratory Syncytial Virus

VI. E. Miscellaneous Viral

Diseases
Miscellaneous Dermotrophic Viruses

Measles (Rubeola)
Rubella
Mumps
Fifth disease
Papilloma (HPV)

VI. E. Miscellaneous Viral

Diseases
Miscellaneous Viscerotrophic Viruses
Enterovirus (Coxsackie & Echo Viruses)
Rotavirus
Norwalk Virus

VI. E. Miscellaneous Viral

Diseases
Miscellaneous Neurotrophic Viruses

Poliomyelitis
Rabies
Arbovirus
Arenavirus (lymphocytic choriomeningitis)

VI. E. Miscellaneous Viral

Diseases
Prion Diseases

Bovine Spongiform Encephalopathy

Scrapie
Creutzfelt-Jakob Syndrome
Kuru