2 Staph found in 47% of samples. Multidrug resistant Staph in half of those. From Des Moines Register 4/16/2011

3 The DNA Viruses Chapter 24

4 General Features of Viruses Obligate Intracellular Parasites Very small (ultramicroscopic) Non-cellular Not Alive Protein Coat (capsid) Some have envelopes

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6 Viruses obligate intracellular parasites infect animals, plants, & other microbes, etc. - all forms of life have viruses that infect them All DNA viruses are double-stranded except for parvoviruses, which have ssDNA. All RNA viruses are single-stranded except for dsRNA reoviruses. Viruses are limited to a particular host or cell type. (Host Range)

7 Viruses Viral infections range from very mild and self-limiting to life-threatening. Many viruses are strictly human in origin, others are zoonoses, some transmitted by vectors. Most DNA & a few RNA viruses can become permanent resident of the host cell. Several viruses can cross the placenta & cause developmental problems.

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9 Poxviruses produce eruptive skin pustules called pocks or pox, that leave scars largest & most complex animal viruses have the largest genome of all viruses dsDNA….enveloped examples –Variola – cause of smallpox –Vaccinia – closely related virus used in vaccines –Monkeypox –Cowpox

The stages of lesions in poxvirus infections Figure 24.2

11 Smallpox first disease to be eliminated by vaccination exposure through inhalation or skin contact infection associated with fever, malaise, prostration, & a rash –Variola major – highly virulent, caused toxemia, shock, & intravascular coagulation –Variola minor –less virulent routine vaccination ended in US in 1972 vaccine reintroduced in 2002 (bioterrorism threat)

12 Smallpox

13 Edward Jenner COWPOX People can catch cowpox by direct contact with an infected animal and they then go on to develop pustules, on their hands. These are quite painful and there is a general feeling of being unwell. The incubation period is about 1 week and the illness lasts about 4-6 weeks. There is a full recovery. It had always been noticed in rural communities that dairy maids who caught cowpox would never get smallpox- they were immune. Jenner rubbed cowpox pus into scratches of a rural farmboy (James Phipps) who then got cowpox. Jenner challenged with smallpox, but the boy did not get smallpox Statue of Edward Jenner Showing Jenner transferring pus from the hands of someone infected with cowpox into scratches in skin of a young boy

14 Molluscum contagiosum caused by a poxvirus in endemic areas it is primarily an infection of children transmitted by direct contact & fomites in US, most commonly an STD AIDS patients suffer an atypical form which attacks the skin of the face & forms tumorlike growths treatment: freezing, electric cautery, chemical agents In most people it heals without treatment

15 Herpesviridae Large, enveloped, icosahedral (20-sided polyhedron), dsDNA large family of viruses; 8 infect humans –HSV-1 –HSV-2 –VZV –CMV –EBV –HHV-6 –HHV-7 –HHV-8

16 Herpesviruses

17 Herpesviridae latency & recurrent infections “Herpes is Forever” complications of latency & recurrent infections become more severe with age, cancer chemotherapy, etc Among the most common & serious opportunists among AIDS patients

18 Herpes Simplex viruses HSV-1- lesions on the oropharynx, cold sores, fever blisters –occurs in early childhood HSV-2 lesions on the genitalia –can be spread without visible lesions humans only reservoir treatment: acyclovir, famciclovir, valacyclovir

19 Herpes Simplex Virus-1 Latency in trigeminal nerve ganglion

20 HSV-1 gingivostomatitis

21 HSV-2

22 Varicella-Zoster Virus (VZV) causes chickenpox & shingles transmitted by respiratory droplets & contact primary infection – chickenpox – vesicles virus enters neurons & remains latent later, reactivation of the virus results in shingles with vesicles localized to distinctive areas, dermatomes treatment : acyclovir, famciclovir, interferon live attenuated vaccine (Zostavax)

23 Chickenpox Shingles Early symptoms are acute pain and redness of dermatome followed by rash

VZV Latency and Reactivation

27 Rash usually lasts for a few weeks. In some people nerve pain (postherpetic neuralgia (PHN), which is extremely painful and can last anywhere from 30 days to months or even years after the rash has resolved. Note the vesicular nature of the rash

28 Cytomegalovirus (CMV) produce giant cells transmitted in saliva, respiratory mucus, milk, urine, semen, cervical secretions & feces commonly latent in various tissues most infections are asymptomatic Almost all people have been exposed to CMV by the time they reach adulthood. 3 groups develop a more virulent form of disease: fetuses, newborns, immunodeficient adults Giant cell

29 CMV newborns may exhibit enlarged liver & spleen, jaundice, capillary bleeding, microcephaly, & ocular inflammation, may be fatal –Babies who survive develop neurological sequelae; hearing, visual disturbances & mental retardation perinatal CMV infection – mostly asymptomatic, or pneumonitis, & a mononucleosis-like syndrome AIDS patients – CMV mononucleosis, disseminated CMV, retinitis, transplant patients - pneumonitis, hepatitis, myocarditis, meningoencephalitis

30 Epstein-Barr Virus (EBV) infects lymphoid tissue & salivary glands transmission – direct oral contact & contamination with saliva by mid-life 90-95% of all people are infected. causes mononucleosis – sore throat, high fever, cervical lymphadenopathy Because of great sanitation in U.S. 70% of college-age Americans have never had the infection…so a very vulnerable population for mono Long incubation period (30-50 day incubation) most cases of infection are asymptomatic Burkitt’s lymphoma associated with chronic coinfections with malaria, etc

31 Infectious mononucleosis (EBV) Swollen tonsils and gray-white exudate

32 Burkitt lymphoma B-lymphocyte tumor associated with chronic EBV infection

33 Diagnosis: leukocytosis with large odd lymphoctes

34 Human Herpes Virus 6 (HHV-6) Also known as human T-lymphotropic virus transmitted by close contact with saliva, other secretions very common –95% prevalent causes roseola, an acute febrile disease in babies 2-12 months begins with fever, followed by a faint rash usually self-limited adults may get mono-like symptoms, lymphadenopathy, hepatitis over 70% of Multiple Sclerosis patients show signs of infection (Meaning of this linkage???) can cause encephalitis, cancer

35 Roseola

36 HHV-7 is closely related to HHV-6 causes similar diseases Kaposi’s sarcoma-associated virus or HHV- 8 is linked with common tumor of AIDS patients, also may be involved in multiple myeloma

37 Hepadnaviruses enveloped DNA viruses never been grown in tissue culture unusual genome containing both double & single stranded DNA tropism for liver Hepatitis B virus causes hepatitis & can be a factor in liver cancer

38 Viral hepatitis hepatitis – an inflammatory disease of liver cells that may result from several viruses interferes with liver’s excretion of bile pigments, bilirubin accumulates in blood & tissues causing jaundice, a yellow tinge in skin & eyes caused by 3 principal viruses

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40 Hepatitis B virus multiplies exclusively in the liver, which continuously seeds blood with viruses 10 7 virions/mL blood (a lot) minute amounts of blood can transmit infection sexually transmitted high incidence among homosexuals & drug addicts can become a chronic infection increases risk of liver cancer chronic infection controlled with interferon HBV vaccine –given in 3 doses over 18 months

41 HBV (clinical features)

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43 Adenoviruses nonenveloped, ds DNA 30 types associated with human disease infect lymphoid tissue, respiratory & intestinal epithelia & conjunctiva oncogenic in animals, not in humans spread by respiratory & ocular secretions causes colds, pharyngitis, conjunctivitis, keratoconjunctivitis, acute hemorrhagic cystitis –Adenovirus is only one of many viruses that can cause “the common cold”! vaccine available Adenoviral pinkeye

44 Papovaviruses This term/grouping of viruses is becoming less often used Pa pillomavirus Po lyomavirus Simian va cuolating virus small nonenveloped icosahedra (20-sided polyhedron) with dsDNA

45 Papillomavirus papilloma – benign, squamous epithelial growth, wart or verruca caused by 40 different strains of HPV Common warts (seed warts) – on fingers, etc plantar warts – on soles of feet genital warts – prevalent STD transmissible through direct contact or contaminated fomites, autoinnoculation (self-spread) Incubation – 2 weeks – more than a year

46 Papillomavirus Common wart Plantar wart Genital wart

47 Genital warts most common STD in US over 6 M new cases each year 30 M carriers of one of the 5 types of HPV associated with genital warts CDC estimates sexually active people have a 50% chance of catching HPV during a lifetime strong association with cervical & penile cancer Vaccine available

HPV Vaccine For girls and women 9-26 years of age Three doses –Initial –2 month booster –6 month booster For prevention only…not a treatment

49 Polyomaviruses induce tumors JC & BK viruses (named after patients from which the viruses were first isolated) common throughout the world majority of infections are asymptomatic or mild not much is known BK infection in renal transplants causes complications in urinary function Progressive multifocal leukoencephalopathy (PML) is an uncommon fatal infection by JC

50 Parvoviruses nonenveloped icosahedral virus, ssDNA very small diameter & genome size causes distemper in cats, enteric disease in dogs, fatal cardiac infection in puppies B19 variety causes fifth disease, (erythema infectiosum), rash of childhood –Child may have fever & rash on cheeks –Severe fatal anemia can result if pregnant woman transmits virus to fetus

51 Parvoviruses “slapped face” rash of fifth disease.