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Diarrhea Viruses

Viral Gastroenteritis
• Viruses probably cause up to 3/4 of all
infective diarrhoeas.
• The second most common viral illness after
upper respiratory tract infection.
• In developing countries, a major killer of
undernourished infants.
• Rotaviruses cause of half a million deaths
per year.
• Only some gut-associated viruses cause
gastroenteritis.
Gastroenteritis Viruses

• Rotaviruses
• Adenoviruses
• Astroviruses
• Calciviruses
Rotaviruses

• Naked ds RNA viruses, 80 nm in diameter.


• 50-80% of all cases of viral gastroenteritis.
• Responsible for occasional outbreaks.
• Severe symptoms in neonates and young children.
And elderly
• Symptomatic infections again common in people
over 60.
• Up to 30% mortality rate in malnourished children,
responsible for up to half a million deaths per year.
Rotavirus
Rotavirus Pathogenesis

• Outbreaks occur primarily in winter months in


temperate zones and year around in the tropics
• Spread by oral-fecal route
• I.P. 2-3 days
• Rotaviruses replicate in the epithelial cells in the tips
of the microvilli of the small intestine
• The microvilli are stunted and absorption is reduced
Global Distribution of
Rotavirus Gastroenteritis
Enteric Adenoviruses

•Naked DNA viruses, 75 nm in


diameter.

•Types 40 and 41are associated


with gastroenteritis.
Enteric Adenoviruses
• Cause occasional outbreaks in young children and
neonates.

• Possibly the second most common viral cause of


gastroenteritis (7-15% of all endemic cases).

• Similar disease to rotaviruses

• Most people have antibodies against enteric


adenoviruses by the age of 3.

• Diagnosed by electron microscopy or by the


detection of adenovirus antigens in faeces by
ELISA or other assays.
Astroviruses

• 30 nm in diametr
• Seen in stools from young
children up to 7 Y
• 7 serotypes
• Shed in large quantities in
feces
• Are minimally pathogenic
Caliciviruses

• 27-38 nm
• Five groups
• Norwalk-like viruses
• Sapporo viruses
• Hepatitis E virus
• Marine calcivirus
• Rabbit haemorrhagic disease
• Relatively common cause of
gastroenteritis in Southeast
Asia
• Outbreaks can be endemic or
epidemic and a peak in winter
Diagnosis of Calicivirus Infection

• Specific diagnosis of calicivirus infection usually is


not possible.

• In epidemics, save stool and emesis specimens for


evaluation

• Enzyme immunoassays for serum antibody and


stool antigen

• PCR
Norwalk-like Viruses
Norwalk-like Viruses

• Small RNA viruses, 35 nm in diameter.

• Associated with epidemic outbreaks of gastroenteritis in adults

• Due to consumption of shellfish and other contaminated foods.

• Aerosol spread possible as well as faecal-oral spread.

• Also named "winter vomiting disease", with vomiting being the


prominent symptom, diarrhoea usually mild.

• Antibodies acquired later in life, in the US, only 50% of adults


are seropositive by the age of 50.

• Diagnosis is made by electron microscopy and by PCR.


Treatment & Prevention

• Rehydration
• Patient Education
• Vaccination: in developmental stages
• Rotavirus vaccine is available ( under trial,
approved in Latin America)