1. Microbiologists aspect of STI’s
By Vicki Parr-Gallant & Jaime Tracey

2. Review Virus Bacteria Above Left-Virus Middle-Cocci Shaped
-Particles of nucleic acid, protene and some lipids
-can only reproduce by infecting living cells
-composed of core DNA or RNA surrounded by capsid
-Capsid binds to receptors on cell and tricks cell to letting it inside
-It then destroys host cell
Two types of infection
1)Litic-Virus enters cell, makes copies of cell, which causes cell to burst
2)Lysogenic-Integrates it’s DNA into DNA of host cell and replicates along with the host cell. Dosen’t kills host cell right away.
Bacteria
Prokaryotes
-unicellular organisms that lack nucleus.
-Typically range from 1-5 micrometers.
-Can be bacilli (rod shaped), cocci (spherical), spirilla (spiral and corkscrew shaped)
-Two kingdoms of prokaryotes.
1st Kingdom—Eubacteria
-Larger of the prokaryotes
-Live in fresh water, saltwater, on land and in human body ie-ecoli
-Usually surrounded by cell wall
-Cell wall contains peptoglandins. Some have a second membrane.
2nd Kingdom--Archaebacteria
-lack nuclei, have cell walls.
-Lack peptoglandin.
-DNA sequences are more like those of Eukaryotes.
-Live in Harsh environments. Some live oxygen free and some live in boiling point water.
**Who can explain the gram stain? Done for the identification of bacteria. Empirical method of differentiating bacterial specis in two large groups-Gram positive and gram negative.
Gram Stain Technique
1.Smear culture on glass slide, heat to fix smear to slide.
2. Add crystal violet stain for 1 min then rinse with water.
3. Add iodine solution for 1 min and rinse with water.
4. Add acetone plus ethyl alcohol rinse with water.
5. Add safranine-which is counter stain for 1 min and rinse with water.
6. Gram positive stain has thick cell wall, no outer membrane and is stained purple. Gram negative cells-thin cell wall, inner and outer membranes and stain pink.
Above Left-Virus
Middle-Cocci Shaped
Above Right-Spirilla
Bottom Right-Bacilli

3. Viral Infections Hepatovirus hepatitis
Herpesviridae-Herpes Simplex Virus
Papillomavirus-warts and genital warts
Human immunodeficiency virus
Acquired immunodeficiency syndrome
Who can name the different types of Hepatitis?
ABCDEFG

4. Hepatovirus hepatitis
Disease Caused-Hepatitis A,B,C,D,E,F,G
Characteristics of Organisms- Virus
Related Disease-Liver Failure, Cancer, Serosis
Symptoms and disease development-Jaundice, Fatigue, Loss of Appetite
Diagnosis- Blood test looking for antibodies and/or antigens

5. Hepatitis Chart Hepatitis Incubation Period Route of Transmission
Onset
Severity
Chronic
Age-Group Affected
Vaccine A
30 days
Fecal, oral, parenteral, sexual
Acute with fever
Mild No
Children and young adults
Yes B
days
Parenteral, sexual
Insidious
Severe
Any C
35-60 days
Parenteral
Mild to severe D
days
Fecal, oral, sexual (parenteral?)
Yes – Hep B vaccine E
15-60 days
Fecal, oral
Acute
Severe in pregnant women G
Unknown

6. Simplexvirus Herpes Simplex Virus
Characteristics of Organisms- Lytic
Related Disease-Eye infections, Infection to infant during birth
Disease development-Initial breakout, lies dormant in nerve cells until next breakout
Diagnosis- Looking at sores, Blood test for antibodies
Incidence- Class exercise
Transmission- Skin to skin contact
Treatment-No cure/Antiviral may help with breakouts
Symptoms HSV1-Coldsores on mouth or genitals
HSV-Blisters on genitals or mouth
*Discuss how transmission occurs via mouth and genitals
*During times of stress or fatigue a breakout may occur
*******What causes immunosuppression?-Illness, colds, drugs, lack of nutrition, stress
*Cesarean sections is sometimes required and antiviral medication is always given during the end of pregnancy is HSV 2 is known.
** Do count in class have every 5th student stand to show prevelance.

7. Papillomavirus Disease Caused-Warts and Genital Warts
Related Disease-Cervical Cancer, Anal & Penile Cancer, Head & Neck Cancer
Symptoms and disease development-Warts, Abnormal Pap Smear
Diagnosis-Physical Exam, Pap Smear, Biopsy
Incidence-Class exercise
Transmission-Skin to skin contact
Treatment-Removal of visible lesions or prescribe cream, No cure for virus itself
Prevention-Gardasil & Cervarix – Protect against 4 of 20 strains found. Suspected 200 strains.
-have class count out in 1,2,3,4 and have 123 stand up…..they all have HPV
Men and Women can take gardasil
Age for gardasil??-9-26
Why is immunization important to women?

8. Human Immunodeficiency Virus
Disease Caused- Acquired Immunodeficiency Syndrome
Related Disease-Fungal disease, Bacterial Diseases, Protozoal Diseases, Viral, Malignancies
Diagnosis-Blood test
Incidence-On the rise
Transmission-Intercourse, Injection Drug uses, Blood to Blood contact, Mother to fetus, Via Breast Milk
Treatment-HIV Cocktail to slow disease progression
Prognosis-No Cure
Fungal-Candida—Yeast
Bacterial-TB, Bacterial Pneumonia
Protozoal-Toxoplasmosis
Viral-Herpes
Malignancies-Karposi sarcoma (this was known as “gay cancer” prior to HIV/AIDS gay men who frequented bath houses in San Fransisco were all developing Karposi sarcoma—this prompted the center for communicable disease to start running tests which lead to the discovery of AIDS)-The band played on
*Between HIV increased by 14%
**Total of 60,160 from

9. HIV Trajectory
HIV attacks CD4+ cells (also some macrophages and all T-
helper cells).
Causes death of T-helper cells, via apoptosis, and cell lysis.
**Does anyone know the definition of apoptosis? A type of cell death in which the cell uses specialized cell machinery to kill itself, in other words cell suicide.
CD8 T-cells (cytotoxic) will also kill infected CD4 T-cells.
Flu like acute symptoms as initial HIV spike occurs.
Has long latent phase (~10 years).
AIDS occurs when CD4+ count < 200 cells/mm3

10. Attache to T-cell lymphocytes and macrophages (large glycoproteins)
HIV virion:
Attache to T-cell lymphocytes and macrophages (large glycoproteins)
Fuse with host cell (small gp glycoprotein) and viral capsid enters cell
 Uncoats (break-down of capsid) in the host cell cytoplasm
When uncoated, ‘Reverse transcriptase’ is produced results in dsDNA being formed by the ssRNA of the Virus
dsDNA – Provirus; enters host nucleus and is inserted (integrated) into a human
chromosome under the action of viral ‘Integrase’
Once integrated, provirus is part of host cell – for ever!
Integrated HIV provirus can replicate and be transcribed using host cell systems
May remain dormant (Latent) [hours, months, years] or become activated   
Role of other cells in skin, mucosa, smooth muscle, dendritic cells as “antigen presenting” cells and B cell lymphocytes which carry virus to lymphoid tissue]
Assembly: Provirus transcribes mRNA – translation into viral proteins
(e.g. capsomeres, Gp 120 and Gp 41 glycoproteins, reverse
transcriptase, integrase. and protease)
Two molecules of genomic ssRNA incorporated into new virion
Release of virion from cell membrane – process of “budding”
Does not become virulent until capsid is assembled and protease becomes active
AIDS: First reported in USA (1981)

12. Bacterial Infections Chlamydia trachomatis-Chlamydia
Treponema Pallidum-Syphilis
Neisseria Gonorrhoeae-Gonorrhea

13. Chlamydia trachomatis
Disease Caused-Chlamydia
Characteristics of Organisms-Gram Negative
Related Disease-Urethritis, Proctitis, Infertilitiy, PID
Symptoms and disease development- Asymptomatic, Onset of symptoms may take months. Discharge, Pain with urination, abdominal paid.
Diagnosis- Cervical swab, Swab or urethra. Urine tests are now avaialable.
Incidence-Fredericton has the highest rate in all of Canada
Transmission-Vaginal, Anal or Oral Sex/Mother to Infant transmission
Treatment-Antibiotics
Prognosis-Curable with no damaging effects if caught early.
**What kind of cell wall will it have? A. Gram-negative bacteria, therefore its cell wall components retain the counter-stain saffarin and appear pink under a light microscope
C. trachomatis is an obligate intracellular pathogen (i.e. the bacterium lives within human cells) and can cause numerous disease states in both men and women.[1] Both sexes can display urethritis, proctitis (rectal disease and bleeding), trachoma, and infertility.
**Most reported STI in Canada
-Chlamydia is the most widespread of sexually transmitted diseases.
-In 2004 alone there were cases
2/3 of all reported cases were between 15-24
-BUT, this is only an estimate because chlamydia is difficult to detect and often goes without notice.
-All sexually active people, regardless of their sexual preference, can get the disease.
-Chlamydia is very common in the sexually active teenage population. About 45% of sexually active teenagers are exposed to the disease
What happens in men?
50% will show no symptoms.
Chlamydia causes something called NON-SPECIFIC URETHRITIS (if you really want to impress someone, call it NSU for short).
If you get this, you will see or feel:
discharge from the penis
the testes swelling up (which if not treated can lead to infertility-can't have kids anymore)
pain when you urinate
What happens in women?
75% of the women can't even tell or feel that they have the infection.
If they do feel something, it happens within 3 weeks after getting the infection.
If women do feel something, it is usually:
a yellow vaginal discharge
pain during urination
may have lower abdominal pain that doesn't go away
pain during sexual intercourse
spotting between periods
may also have nausea and fever
It can also lead to cervicitis (inflammation of the cervix)
about 5-13% of the women in the U.S. who get Chlamydia get cervicitis
It can also cause salpingitis (inflammation of the fallopian tubes)

14. Treponema Pallidum Disease Caused-Syphilis
Characteristics of Organisms- Bacteria Infection, Helical Coil, Posses Flagella, Reproduces by asexual transverse fission
Related Disease-Dementia, Paralysis, Numbness, Blindness, Cardiovascular disease
Symptoms and disease development-
Diagnosis-Diagnosis is made by dark-field microscopy of genital ulcers in primary syphilis and by serology in all stages (blood test)
Incidence-3.5/100,000 (highest in BC due to sex trade workers)
Transmission-Direct contact with Syphilis sore, occurs during vaginal, anal or oral sex
Treatment-Antibiotics (IM injection of penicillin)
Prognosis-Can be cured if caught early, can be re infected
Over the last five years, the most significant change in the rate of reported infectious syphilis has been seen in men aged 20 to 24 (a 3.8-fold increase). However, the rate is increasing in all age groups in males.
If untreated, the infection progresses through five stages: primary, secondary, early latent (asymptomatic syphilis <= 1 year), late latent (asymptomatic syphilis > 1 year) and tertiary syphilis. Tertiary syphilis involves the cardiovascular, neurological and musculoskeletal systems. Infection during pregnancy can lead to miscarriage, stillbirth, premature birth and congenital infection. Infectious syphilis refers to the primary, secondary and early latent stages.
Estimated 2-5 fold increase risk of inquiring HIV if syphilis infection present
Transverse Fission –divides across its width into two distinct organisms

15. Neisseria Gonorrhoeae
Disease Caused-Gonorrhea
Characteristics of Organisms-Gram-negative cocci , intrecellular and typically appear in pairs
Related Disease-Conjunctivitis, pharyngitis, proctitis, urethritis, prostatis, orchitis
Symptoms and disease development- Women-PID, Cervical infection/irritation, Urinary freq., Discharge, Spotting. Men-pain with urination, discharge
Diagnosis- Urine screening, Sample of discharge, High White Blood Cell Count
Incidence-28.9/100000
Transmission-Sexual Intercourse/Mother to Baby
Treatment-Antibiotics
Prognosis-95-99% Cure Rate, May lead to sterility
**Discuss suffex and ending of each word
IE-Conjunc-Eye, itis –Infection
Proctitis-Anus
Cunjunctivitis-aka pink eye
Pharyngitis-throat
orchitis –testies
*Second most reported STI in Canada
Symptoms are also related disease