characteristics of the genus Staphylococcus?
-On skin and mucous membrane
Non-motile, non-spore forming, Gram(+) cocci in clusters
•Resistant to temperature, osmotic pressure (high salt concentration), drying
-catalase (+)
commensals (many bacteria)
species of Staphylococcus that are pathogenic
•S. aureus
•S. Epidermidis, S.capitis, S.hominis
•S. saprophyticus
most important staphylococcal pathogen? virulence factors?
S. Aureus- most resistant
Withstand salt, Ph, temp, drying, disinfectants
Coagulase :clots plasma, can prevent phagocytosis
•Opportunistic infection
invade the host
•Hyaluronidase -> Destroys host tissues
•Hemolysins -> Lyse RBCs
•Leukocidins -> Destroys WBCs
Staphylococcal infections generally present?
Abscess- pus
Folliculitis- inflammation of hair follicles
-systemic: Endocarditis (heart)
Hidradenitis- inflammation of gland
Furuncle- boil from hair follicle
- systemic Osteomyelitis (bones)
Carbuncle (large)-> Pneumonia (lungs)
Staphylococcus epidermidis and Staphylococcus saprophyticus cause
healthcare associated infections (endocarditis, bacteremia, UTI’s)
UTI’s in sexually active women
local and systemic infections caused by S. aureus
Folliculitis (hair follicle)-> Endocarditis (heart)
Furuncle (boil) -> Osteomyelitis (bones)
Carbuncle (large)-> Pneumonia (lungs)
toxins produced by Staphylococcus and what toxigenic disease
Enterotoxin
•Food intoxication: Enterotoxin is heat resistant, vomit
•Staphylococcal scalded skin syndrome toxin causes SSSS in umbilical/ eye babies and bullious impetigo in all ages
•Toxic shock syndrome: superantergen TSS toxin
fever, shock, low blood pressure, can be fatal
•Toxin is released in high levels when magnesium is not present(low flow)
drugs to combat S. aureus
drainage
resistant to penicillin
–cillins, cephalosporins, sulfa drugs, tetracycline
•Vancomycin, quinupristin “drug of last resort”
MRSA and VRSA?
•MRSA: Methicillin resistant Staphylococcus aureus- use vancomycin
•
•VRSA: Vancomycin resistant Staphylococcus aureus •quinupristin/dalfopristin
characteristics used to differentiate Staphylococci from Streptococci?
Catalase test: Staphylococcus catalase +, strep catalase-
Coagulase test: Staphylococcus aureus coagulase + other Staphylococcus coagulase -
Serological tests: Antibody based tests can identify S. aureus quickly
characteristics of Streptococcus?
•Non-motile, non-spore forming
Gram (+) cocci in long chains.
Facultative anaerobes,
do not survive well outside the host
How are members of the Streptococcus classified
Lancefield groups: type of carbohydrates on cell wall
A- S. pyogenes
B- S. agalactiae
D- Enterococcus facecalis,
H S. sanguinis
S mutans and S. pneumonia none
What diseases are caused by Streptococcus pyogenes group A
Group A (GAS) Streptococcus pyogenes
pyoderma (impetigo)- skin infection
•Streptococcal pharyngitis (Strep throat)
scarlet fever- if erythrogenic toxin=
necrotizing fasciitis (“flesh-eating disease”)- below skin
S. pyogenes pneumonia
Long term complications
•Rheumatic fever: joints and heart. May damaged heart valves
•Glomerulonephritis: Kidney damage.
characteristics of S. pyogenes?
Group A
Gram+ cocci, non motile non spore forming.
Beta hemolysis
sensitive to bacitracin
C-carbohydrate on surface to prevent lysozyme
strep throat, scarlet fever, rheumatic fever, glomerulonephritis
Streptococcal virulence factors?
•C-carbohydrate on wall,: Protects against lysozyme
•M-protein: Fimbriae. Resists phagocytosis and adhere to host cells
•C5a protease: Inhibits one of the proteins in the complement cascade
•Hemolysins: Streptolysin S (SLS), Streptolysin O (SLO) Attacks kidney, heart, muscle
causes scarlet fever?
•Some strains of S. pyogenes carry a prophage for erythrogenic toxin(pyrogenic) that produce fever and red rash
Where is Group B streptococcal disease found? How is is prevented/treated?
•Streptococcus agalactiae
•β-hemolytic
found in vagina
•Causes wound infections in elderly and diabetic
•Meningitis in newborns when women has •S. agalactiae while birth
•Penicillin is effective treatment
Who is at risk for Streptococcus pneumoniae infection? prevented? What drugs are used to treat Streptococcal infections?
pneumococcus
pairs and short chains, α-hemolytic,
no Lancefield group
thick capsule (phagocytosis difficult)
•Infection: otitis media (middle ear infection) in children
meningitis- all age
pneumonia in older adult/ immune compromised
•Vaccines: Prevnar 13 (13-valent), Pneumovax (23-valent)
•Penicillin or cephtriaxone are effective treatments
major genera of Gram-negative cocci?
Neisseria,
Branhamella,
Moraxella
•Neisseria:
Non-motile, non-spore forming, bean shaped diplococci. Fastidious.
•gram - , fimbriae, catalase
•Two main pathogens
•Neisseria gonorrhoeae
•Neisseria meningitides
Neisseria gonorrhoeae signs/symptom? spread? Treated?
Gonococcus- spread thru sex, birth,
•Pili, Capsules, Protease which inhibits IgA, Lipopolysaccharide
presence of cells within neutrophils = infection
Painful urination
female: may be asymptomic
salpingitis- type of pelvic inflammatory disease (PID) ectopic pregnancy (baby outside uterus)
•Combined drug therapy with ceftriaxone and azithromycin (resistance to penicillin in PPNG strains)
Birth: tetracycline or erythromycin ointment is always applied to the eyes
Neisseria meningitides signs/symptom? spread? Treated?
Neisseria meningitidis-
gram - cocci, diplococci, positive oxidase, ferment maltose not sucrose/lactose
capsule and fimbriae, endotoxin
Meningitis
cerebrospinal meningitis- inflammation of brain/spinal cord
•Fever, stiff neck, photophobia, confusion
Meningococcemia
meningococcal septicemia (bloodstream infection)
•Fever/chills, cold hands and feet, vomiting, dark purple rash (petechiae)
spread thru respiratory secretions
• vaccine
Menactra, Menveo
Bexsero, Trumenba(serotype B for child)
•Treatment: broad spectrum antibiotics ceftriaxone
•Close contacts: prescribed prophylactic antibiotics (rifampin or ceftriaxone)
major endospore forming gram + rod?
Bacillus
Clostridum
gram + rod distinguished from one another?
Endospore formers?
Oblige anaerobe vs aerobic/faculative anaerobe
Regular shape/ staining properties
Acid fast, filamentous branching cell
diseases are caused by each in gram + rod
Bacillus anthracis
Clostridium tetani
Clostridium perfringens
Clostridium botulinum
Clostridioides difficile
Listeria monocytogenes
Corynebacterium diphtheria
Mycobacterium tuberculosis
Mycobacterium leprae
Who is most at risk for anthrax?
People who work with animal
characteristics of C. tetani
• in soil/GI tract of animals
•Obligate anaerobe
•Produces tetanospasmin (toxin)
•Causes tetanic paralysis(muscle lock)
•prevent Vaccine (tetanus toxoid)
•Treatment
•Human tetanus immune globulin (HTIG)
•antibiotics: metronidazole or penicillin
•Mechanical ventilation/muscle relaxants
characteristics of C. perfringens,
•Gas gangrene (Myonecrosis)infection of soft tissue and food poisonings
•Obligate anaerobe
•Mixed infections
•Treatment
•Cleansing/debridement of wounds
•Clindamycin, antibiotics
•Hyperbaric oxygen treatment
characteristics of C. botulinum
•Spores on soil, water, animal intestine
droopy eyelid, hard to speak
•Descending flaccid paralysis(motor), death from paralysis of respiratory muscles
•Botulinum toxin:
•Prevent release of acetylcholine ( botox)
•food intoxication, Infant botulism (floppy baby syndrome), Wound
Prevention: boiled for 10 minutes
no honey for baby
don't inject
Treatment
antitoxin (anti-botulinum antibodies) mechanical ventilation
characteristics of Clostridioides difficile. location, detected, cause, treatment
C-Diff
normally small amount in intestine
diarrhea, inflamed colon,
ELISA to detect toxins in fecal samples
long term broad antibiotic causes superinfection
Treatment
•Withdrawal of antibiotics
vancomycin or metronidazole
•Fecal microbiota transplantation (eat poop)
divide gram + rods non endospore into regular and irregular.
irregular- stain unevenly
Corynebacterium, mycobacterium, nocardia
Regular
Listeria & eysipelothrix
characteristics of Listeria monocytogenes?Where found? prevent it from infecting humans?
•Listeriosis
•Gram-positive, regular, rods
grows in cold, psychrotroph
•found in dairy, poultry, and processed meat
•immunodeficient patient-affect brain, meningitis
•Pregnant woman (miscarriage, birth defects)
•Prevention/Treatment
•Pasteurization, adequate cooking
•Antibiotic, ampicillin/gentamicin and trimethoprim sulfamethoxazole
How many cases of diphtheria are typically seen in the U.S.? Why?
Corynebacterium diphtheria
0.01 case per million population extremely rare in US thanks to vaccination DTap (no cases since 2014)
•16,000 cases reported worldwide
•Gram-positive, irregular rods
• production of diphtherotoxin, which affects heart and nerves
•Antibiotics to stop infection
•Antitoxin to reverse effects of toxemia
characteristics of acid-fast bacilli? What diseases?
Mycobacterium
•Low infectious dose
resistant to drying and germicides
•Very slow growing
•Cord factor (allows cells to form long aggregates)
•Most species are saprobes, but several pathogens exist
•Mycobacterium tuberculosis
•Mycobacterium leprae
causative agent of Hansen’s disease? signs, if untreated
Mycobacterium leprae (leprosy)
humans and armadillos
predisposing factor: defective T cell, poor health, long term contact with it
years of incubation for disease
•Single lesion paucibacillary (SLPB)-spots
if untreated:
•Paucibacillary (PB) hypopigmented patches, loss sensation
•Multibacillary (MB): • necrosis and disfigurement (sport and death of cell)
•Treatment: long-term antibiotic therapy
what organism is cord factor found?
Mycobacterium tuberculosis
Cord factor is responsible for long strands of cell upon examination and is correlated with increased virulence
stages of tuberculosis?
•Primary TB: tubercles in lung (red areas). mild fever
•Secondary TB: Reactivated primary disease: coughing, fever, bloody sputum, weight loss. 60% mortality if untreated
•Extrapulmonary TB: Spread of cells to other organs, lymph nodes, kidneys, brain. Usually fatal
Mycobacterium leprae treated
long-term antibiotic therapy sane as TB
•Multidrug therapy for 6-9 months
•First line drugs
•Isoniazid
•Rifampin
•Ethambutol
•Pyrazinamide
•Second line drug (Pretomanid) used for MDR-TB and XDR-TB
Mycobacterium tuberculosis treated
•Multidrug therapy for 6-9 months
•First line drugs
•Isoniazid
•Rifampin
•Ethambutol
•Pyrazinamide
•Second line drug (Pretomanid) used for MDR-TB and XDR-TB
Gram-negative pathogens have what virulence factor in common?
Lipopolysaccharide(LPS) which act as endotoxin to produce systemic effect
characteristics of Pseudomonas? Where is it found and who is most at risk?
gram - rod aerobe
on soil, sea water, fresh water
highly versatile
degrade natural substance, food spoil
in homes and hospital
disease caused by Bordetella pertussis? Who is most at risk? How is whooping cough prevented/treated?
•Obligate aerobe
•Cause of Pertussis whooping cough,
endotoxin destroy cell
•Catarrhal stage: Cold-like
•Paroxysmal stage: Severe coughing “whoops”
•
•Adults: mild symptoms
•Infants: highest risk of death
•Acellular vaccine (aP in dTaP)
•Five doses plus a booster at 11-12, not completely effective
•Treatment-Azithromycin or clarithromycin
Characteristics, disease, found? who is at risk? treatment?
Pseudomonas aeruginosa
•Obligate aerobe
•Blue/green pigment
slime layer, enotoxin, endotoxic shock
•soil/water and intestine of health people
hot tub, soap, sponge,
opportunistic: Burn/cystic fibrosis patients
•cause Endocarditis, pneumonia, meningitis
•Healthy patients: rash, UTI, external ear infection
•Susceptibility testing required
•Extensive drug resistance
cephalosporin, aminoglycoside, polymixin
Characteristics, disease, and how infectious occur, Where Legionella found
Legionella pneumophilia
•Obligate aerobe
•Cause of Legionnaires disease
•Fever, cough, may progress to pneumonia
•Opportunistic
•Air conditioning, hot tubs, showerheads, vegetable sprayers + natural sources
•Legionella survive within various protists, and phagocytes within humans
•Prevention: chlorination and elimination of standing water
•Treated: Levofloxaxin broad spectrum antibiotics
•Pontiac fever: Mild, related disease, self limiting
surface antigens on Gram-negative E. coli what diseases? STEC?
H- flagellar antigen
K- capsule and fimbrial antigen
O- somatic or cell wall antigen
•Reservoir in intestines of cattle
•Traveler's diarrhea, Infantile diarrhea can be deadly
•STEC: Shiga toxin producing E. coli
•O157:H7: cause hemorrhagic colitis
•Hemolytic Uremic Syndrome (HUS),Kidney damage
•50%-80% of Urinary Tract Infections (UTIs)
indicator of fecal contamination of food/water\
•Control: clean food, pasteurization
hydration and rest
Bismuth salicylate (pepto bismol)
Pathogenic E. coli infections may be seen in what areas of the body?
Enterohemorrhagic(EHEC) or STEC- damage to kidney
Enterotoxigenic (ETEC)- small intestine
Enteroinvasive(EIEC)- large intestine
Enteropathogenic(EPEC)- infantile diarrhea
Enteroaggregative(EAEC)- intestinal mucosa
Dissusely adgerent(DAEC)- pediatric diarrhea
two major types of Salmonella? difference between the two?
Salmonella enterica Typani cause typhoid fever
Salmonella Paratyphi- paratyphoid disease
Human host
Antibiotic treatment- ciprofloxacin or ceftriaxone
Salmonella bongori- cold blooded animal like lizards
•Nontyphoidal salmonelloses
other Salmonella serotypes
, causing diarrhea. Lasts 2-5 days
•Normal microbiota of cattle, poultry, rodents, reptiles
•Uncooked/unpasteurized milk, meat, eggs present risk
risk factors for contracting Salmonella? prevented/treated?
•Typhoid fever, diarrhea
Washing food, and hands
How is Shigella transmitted? What disease does it cause?
•Shigellosis
invasion of large intestine from five Fs
•Feces, food, fingers, flies, fomites
•Shiga toxin lead to bleeding and heavy mucus
•Bloody, mucus-filled diarrhea
•Damages nerve cells, intestines, kidneys
Treatment: ciprofloxacin or sulfatrimethoprim
Where Yersinia pestis found? What disease does it cause? bacteria transmitted? treated?
•Bubonic plague: enlarged lumph bubos (swollen lymph nodes)
•Black death: darkening of skin
•Pneumonic plague: Localized to lungs
•Found and Spread through bite of infected fleas, handling infected animals
•Prevention: quarantine/kill animal hosts
•Treatment with broad antibiotics: streptomycin, gentamicin, doxycycline and ciprofloxacin
Spirochetes include what pathogenic genera?
Treponema
Leptospira
Borrelia
causative agent of Syphilis?
Treponema pallidum
•Sexually Transmitted Disease (STD or STI)
•Fastidious. Doesn’t survive long outside the body
differences between primary, secondary and tertiary syphilis? control?
•Primary syphilis: Hard chancre at point of contact (genitals, mouth)
•Secondary syphilis: Spread of bacterium. (don’t treat primary becomes secondary) Fever headache, sore throat “Nickel and Dime” rash on the palms and soles
•Tertiary syphilis: Occurs after long (20 year) latent period. Damage to multiple organs untreated
•Gummas: Tumors
•Neurosyphilis: Blindness, convulsions, mental deterioration
•Argyll-Robertson pupil (pupil not round)
Penicillin G for all stages
characteristics of Leptospira? acquired? Where would you be most likely to acquire the disease?
Leptospira interrogans
•Zoonosis, found in many animals
•Bacteria are shed in the urine of infected animals(cuts, usually in streams)
•Disease is concentrated in tropics, most U.S. cases found in Hawaii
•Flu-like disease, progresses to include hallucinations
•Serological detection
•Early treatment with doxycycline is effective
characteristics of Borrelia?
•Human infection is transmitted by ticks or lice
•Two major species
•Borrelia hermsii: Relapsing fever (antigen mutation ensure relapse)
•Borrelia burgdorferi: Lyme disease
•Relapsing fever occurs because the spirochete changes its surface antigens, so antibodies only protect for a short time
•Treatment is doxycycline
•Prevention relies on avoiding ticks and lice
diseases caused by members of the genus Borrelia?
•Borrelia hermsii: Relapsing fever (antigen mutation ensure relapse)
•Borrelia burgdorferi: Lyme disease
causative agent of Lyme disease? characteristics? controlled? spread?
•Borrelia burgdorferi:
•Lyme disease, spread by ticks, endemic to NE U.S.
•70% of cases display bullseye rash
•Without treatment, disease progresses to neurologic, cardiac and arthritic symptoms
•Detection relies on serological testing (ELISA)
•Early treatment with doxycycline,
prevention: avoid ticks and outdoors
diseases caused by bacteria in the genus Vibrio? Where would you contract these diseases, and who is most at risk for serious complications?
Vibrio cholerae
dirty water
•death via secretory diarrhea due to cholera toxin
•Treatment: replacement of electrolytes (Gatorade) and antibiotics
•Prevention: water purification and proper sewage disposal
•Vaccine: limited protection for ~2 years
•Rare in the U.S.
Vibrio parahaemolyticus
•Salt tolerant microbes, severe gastroenteritis
•consumption of squid, mackerel, tuna, oysters etc.
•Prevention: proper refrigeration/cooking of seafood
Vibrio vulnificus
• more severe
• lethal in individuals with diabetes/liver disease
•enter wounds and cause disease
•Prevention : cook/storage of seafood. no brackish water with cuts
Salty water
characteristics of Campylobacter?
curved, spiral bacilli in S shape, gull winged pair. spinning motility
characteristics of Campylobacter jejuni
•Cause Campylobacter gastroenteritis(stomach ache)
•Common resident of birds and mammals (raw chicken)
•CJT: Enterotoxin that stimulates secretory diarrhea
•75 deaths, mostly compromised patients
•Treatment :replacement of electrolytes
What disease is caused by Helicobacter pylori?
•Cause of stomach and duodenal ulcers
•Favors a low pH environment
•Treatment centers on antibiotic therapy plus acid inhibitors
major characteristics of Rickettsia?
•Tiny parasitic bacteria
•Part of life cycle takes place in arthropod vectors (lice, fleas, ticks)
•Major diseases are typhus and spotted fever
disease Rickettsia prowazekii? transmitted?
•Epidemic typhus
•Carried by lice (associated with overcrowded living conditions)
•Flulike, rash, mortality up to 60% in older patients
•Treatment: antibiotics doxycycline or chloramphenicol , along with anti- louse soap/shampoo
insecticides of living spaces
disease Rickettsia typhi? transmitted?
•Endemic typhus, worse than prowazekii
•Carried by fleas
•workers in rat infested sites
•Flu-like, rash, milder symptoms than R. prowazekii
•Treatment: antibiotics doxycycline or chloramphenicol
disease Rickettsia rickettsia? transmitted?
•Cause of Rocky Mountain Spotted Fever
• Eastern US Transmitted by ticks thru dog then to human
•Flulike + red spotted rash, cardiovascular and CNS involvement
•Detected via ELISA or PCR
•Treatment: doxycycline
avoidance of tick bites
structure of viruses
•Outer protein coat, inner nucleic acid
•RNA or DNA, not both
•Some viruses possess envelope and spikes
•Envelope derived from host cell membrane
•Spikes aid in attaching to host cells
•Host range/tissue tropism
type of nucleic acid is found in the genome of viruses. Do they have all the genes they need for infection and metabolism?
RNA or DNA, not both need a host for metabolism
How is viral infection typically diagnosed?
Symptoms! (virus attack specific host range, lung)
•Serological detection of envelope, viral spikes, or production of antibodies against a virus
•Polymerase chain reaction of viral DNA/RNA
risk of contracting smallpox?
Poxvirus
fever, malaise, prostration and rash
variola major: toxemia shock and intravascular coagulation
characteristics of herpes simplex I and II? differ? treated?
HSV-1
•Herpes keratitis (ocular herpes): spreads to the eye via fingers or the ophthalmic branch of the trigeminal nerve
Herpetic whitlows: Health care workers
HSV-2 Genital lesions
•Neonatal herpes: during birth
•Split between HSV-1 and HSV-2
can be deadly for baby
•Acyclovir limits viral shedding during third trimester
C-section
diseases caused by varicella-zoster virus
Chickenpox when reactivated (x-rays, drugs, surgery…) shingles
relationship between Chickenpox & shingles
•Cause of chickenpox in children (rash spread across face and trunk)
•Shingles appears as a single limited rash (dermatome)
•Post-shingles neuralgia can cause months-long pain
•Patients with shingles can infect others with chickenpox
•Both diseases are diagnosed based on symptoms
•Vaccine protects against chickenpox
•Vaccine after age 50 protects against shingles
•Acyclovir may lessen symptoms
Which DNA viruses are enveloped?
Poxviruses
Herpesviruses
Hepadnaviruses
Which DNA viruses are unenveloped?
Adenoviruses
Polyomaviruses
Papillomaviruses
Parvoviruses
largest and most complex viruses?
Poxvirus
characteristics of Epstein Barr
Epstein-Barr Virus (a herpes virus)
•Infectious mononucleosis
•Found in lymphoid tissue and salivary glands
•“kissing disease”
•Sore throat, swollen tonsils, fever, malaise
• Burkitts lymphoma: B-cell cancer that swells the cheek
•Immunocompromised patients
•Diagnosed via abnormal white blood cells, PCR
•Treatment: relief of symptoms
Ganciclovir may be used to help airway
characteristics of Hepatitis B viruses?
Hepatitis B (a hepadnavirus) DNA virus
•bilirubin causes jaundice
•Fever, rash
•Spread via blood, sexual contact, needles
•Chronically carried (long term)
•Risk of cirrhosis liver cancer
•Detection via serological testing
• vaccine for under 18
•Treatment for severe infection: interferon and Hepatitis B immune globulin (HBIG)
What do papillomaviruses causes? Which strains are most important? vaccines available?
Nonenveloped and single stranded
•Cause of warts, genital wart
•Spread via contact with warts or, less often, fomites
strains HPV 16 and 18
•70% of metastatic tumors (cervix and penis)
•Gardasil 9 Vaccine protects against the nine strains most strongly linked to cancer
•Recommended for children 11-18 (prior to sexual activity)
What viruses are enveloped segmented single-stranded RNA viruses?
Orthomyxoviruses -influenze
Bunyaviruses- hantavirus pulmonary syndrome
Arenavirus- Lassa fever
What is meant by the terms antigenic drift and antigenic shift?
•Antigenic drift
•Nonsegmented genomes change slowly over time via mutation
•Immunological memory offers protection
•Antigenic shift
•Segmented genomes may join within a single cell creating a unique virus
•Leads to rapid change in virus
•No immunological memory
purpose of the surface spikes on influenza virus?
Orthomyxovirus: Influenza
•Two types of surface spikes
•Hemagglutinin: Allow virus to bind to respiratory receptors (18 types)
•Neuraminidase: Breaks down mucus, assists budding of new viruses from host cell.
•Flu viruses named for their combination of H and N spikes
How many people die of the flu each year in the U.S.?
50,000 deaths/year. Mostly old, young
What types of vaccines/treatments are available for influenza?
•Injectable vaccine: Inactivated virus
•Inhaled vaccine: Live virus
•High dose vaccines are available for older patients
•Treatment:
•Relenza, Tamiflu, Rapivab : Block viral budding and release
•Xofluva: Blocks viral RNA synthesis
What diseases are caused by hantavirus
hantavirus
•Hantavirus pulmonary syndrome
•Severe pulmonary (lung) disease
•Carried by deer mice feces (Yosemite)
•Southwest U.S.
What diseases are caused by paramyxovirus?
parainfluenza and
•Mumps: Swollen parotid glands, flulike symptoms
•Spread respiratory secretions
•Diagnosed: symptoms/serological testing
•Prevention through vaccination (MMR)
•Few thousand cases per year in small outbreaks
complications associated with measles?
Morbillivirus: Measles (Rubeola)
•Severe, flulike symptoms
•Extremely contagious
•Identified by skin rash, Koplik's spots in mouth
•Complications
•Subacute sclerosing panencephalitis (SSPE): Occurs 7-10 years later, ends in coma and death
•Deafness, neurological deficits
•Pneumonia
•Immune amnesia: Memory T and B cell for diseases other than measles are lost. Leaves patients vulnerable
•Prevention relies on vaccination (MMR)
•Treatment is based on alleviating symptoms
enveloped non-segmented RNA viruses?
Paramyxoviruses- Measles, mumps
Rhabdoviruses- rabies
Filoviruses- Ebola fever
Corona virus- SARS, MERS
Togavirus- Rubella
Flavivruses- Dengue fever, Zika virus
disease caused by rhabdovirus and characteristics? How is the disease treated/prevented?
Rhabdovirus: Rabies lyssavirus
•Slowly progressing, neurologic, zoonotic disease
•1-3 human cases/year, 40,000 people/year receive post-exposure prophylaxis (U.S.)
•Neurological symptoms
•Furious phase: seizure, twitching, hydrophobia
•Dumb phase: paralyzed, disoriented, coma, death
•Untreated disease is 100% fatal
• bite of unprovoked mammal
•Treatment: passive immunization with human rabies immune globulin (HRIG) on day 1 and vaccination on days 1, 3, 7, and 14.
•Negri bodies in brain tissue may be seen upon autopsy
•Wild animals may be vaccinated to reduce vectors
two major filoviruses
Ebola and Marburg Virus
treatment/prevention Ebola
Contact with infected animal/fluid of infected person
•Ebola treatment with monoclonal antibodies (Inmazeb) approved October 2020
supportive care
treatment/prevention Marburg Virus
•Marburg virus has no treatment or preventative beyond supportive care
diseases caused by each of the three major coronaviruses?
•2002 SARS (severe acute respiratory syndrome)
•2012 MERS (Middle East Respiratory Syndrome, MERS-CoV)
•2019 Novel coronavirus (SARS-CoV-2)
•SARS-CoV-2 spreads mostly via respiratory droplets
•Droplets don’t stay airborne long
How does COVID-19 cause death?
SARS-CoV-2 binds to angiotensin-converting enzyme 2 (ACE2), on cell membrane of lungs, vascular epithelium, kidneys, other tissues
•SARS-CoV-2 can induce hyper-immune response in some people (severe disease)
•Cytokine release syndrome: Systemic inflammation driven by T cells (mostly IL-6)
•Organ failure: kidney, heart, liver
•Inflammation of the vasculature allows blood and fluid to fill the lungs leading to acute respiratory distress syndrome (ARDS)
•~70% of deaths due to ARDS
•~30% of deaths due to multi-organ failure
COVID prevented/treated?
Treatment
•Maintenance of oxygen levels
•Treatment of bacterial and fungal infections
•Dexamethasone: Steroid. Reduces immune response
•Remdesivir: Inhibits viral RNA polymerase
•Paxlovid: Inhibits protease needed for replication
•Molnupiravir: Cause multiple mutations in the viral RNA
•Paxlovid and Molnupiravir can both be taken after symptoms occur and can shorten course of disease.
•Monoclonal antibody therapy
•Bamlanivimab: Binds to viral spikes, prevents entry of virus into cells.
Prevention
•Moderna and Pfizer vaccines are mRNAs that invade muscle and epithelial cells (like a virus) and produces viral spike proteins
•Proteins elicit an immune response
two types of coronavirus testing and how do they differ?
•Nucleic acid amplification tests (NAATS)
•PCR (polymerase chain reaction), others
•Used to intensify coronavirus RNA
•Do you have the virus in your body?
•Nasal swab
•Accurate even without symptoms
•
•Serological testing
•Do you have antibodies against the virus?
•IgM: new infection
•IgG: old infection
•Most accurate after symptoms have begun
disease caused by rubrivirus? Who? prevented?
Togavirus
Rubella (German measles)
•spread through respiratory and college dorm
•Teratogenic when pregnant women are infected (congenital rubella syndrome)
•Eliminated from U.S. in 2004, still prevalent worldwide
•Prevented through vaccination (MMR)
hepatitis C contracted? How is it treated?
Flavivirus
• blood contact, needles (not generally sexual)
• increased risk of liver cancer
•Diagnosed by detecting antibodies to the virus
•Treatment: Harvoni, a combination of two drugs, taken for 12 weeks
•93%-99% cure rate
arboviruses? What diseases? controlled?
(Arthropod born)
•Fever, rash, flu-like symptoms, hemorrhagic fever(bleed from eyes), maybe meningitis
•West Nile Virus, Colorado tick fever, Yellow fever, Various encephalitides
•Sentinel animals track spread
•Aedes aegypti mosquito-borne viruses
•Chikungunya
•Dengue: breakbone fever
•Zika: Birth defects: microcephaly
•Sexual transmission
•Control
•Yellow fever: Vaccine
mosquito control
What qualifies a virus as a retrovirus?
•Backward (retro) flow of genetic info RNA ->DNA
•Reverse transcriptase produce DNA from RNA genome
•Viral DNA integrates into host cell genome
•Three retroviruses infect humans
•Human T cell Leukemia virus I and II (HTLV-1, HTLV-2)
•Human Immunodeficiency Virus (HIV)
GP-120 and GP41 in HIV?
•HIV has two envelope proteins (spikes) that allow binding to CD4 host cells
•GP-120
•GP-41