SCoPE Viruses

Adenovirus family

Adenoviridae

Adenovirus morphology

dsDNA, linear DNA, naked icosahedral capsid, replicates in nucleus

Adenovirus transmission

droplets, feces, eyes

Adenovirus virulence factors

infect epithelium of respiratory tract and eyes, spread to lymphoid tissues. viral protein blocks interferon and Tc cells

Adenovirus clinical

conjunctivitis (pink eye), upper respiratory tract (rhinitis, sore throat, cough), pneumonia, gastroenteritis with watery diarrhea, hepatitis, hemorrhagic cystitis, myocarditis

Adenovirus Lab ID

PCR

Adenovirus treatment and prevention

live oral vaccines for military; disease is usually self-limited

Epstein-Barr Virus (EBV) family

Herpesviridae

EBV morphology

enveloped, dsDNA, linear, icosahedral capsid

EBV transmission

saliva (kissing), blood/sexual contact, organ transplant

EBV virulence factors

Infects B cells via CD21; latent infection with viral proteins that promote B-cell proliferation

EBV clinical

Infectious mononucleosis, oral hairy leukoplakia in patients with HIV/AIDS, Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, CNS lymphomas in patients with HIV/AIDS, lymphoproliferative disease in transplant patients

EBV Lab ID

heterophile antibody (Monospot); EBV-specific antibodies (VCA IgM/IgG, EBNA); PCR in selected immunocompromised patients

EBV treatment and prevention

supportive care for mononucleosis; treat associated malignancy according to cancer-specific therapy

EBV misc

Atypical lymphocytes (activated cytotoxic T-cells) and posterior cervical lymphadenopathy. Amoxicillin/ampicillin can trigger maculopapular rash

Coronaviruses morphology

ssRNA, ⊕ sense, linear, envelope, helical capsid

Coronaviruses transmission

respiratory droplets

Coronaviruses virulence factors

SARS-CoV/SARS-CoV-2 bind ACE2 receptor; MERS-CoV binds DPP4 receptor

Coronaviruses clinical

common cold, SARS, SARS-CoV-2 (COVID-19) with severe pneumonia, MERS

Coronaviruses Lab ID

PCR, rapid antigen testing

Coronaviruses treatment and prevention

supportive care; antivirals (e.g., remdesivir, nirmatrelvir/ritonavir, molnupiravir) and vaccines available for SARS-CoV-2; dexamethasone, baricitinib, tocilizumab for severe COVID-19

Coronaviruses misc

SARS-CoV-2 caused the COVID-19 pandemic; spike protein mediates receptor binding and is the target of most vaccines

Orthomyxoviridae viruses

Influenza A (human and animal), B (human only), C (humans and animals)

Orthomyxoviridae morphology

ssRNA, ⊝ sense, linear, multisegmented, enveloped, helical capsid, replicates in the nucleus

Orthomyxoviridae transmission

respiratory droplets

Orthomyxoviridae virulence factors

Hemagglutinin glycoprotein binds sialic acid receptors on respiratory epithelial cells and RBCs, leading to fusion and adsorption. Neuraminidase cleaves sialic acid residues, allowing virus hemagglutinin to release from host cell receptors and move from sialic group to sialic group, and allows virus to move through mucus (rich in sialic acid). Neuraminidase cleaves sialic acid residues attaching new virions to host membrane, allowing them to spread.

Orthomyxoviridae clinical

influenza, URI, viral pneumonia, Reyes syndrome in children who use aspirin; secondary bacterial pneumonias with staph and strep

Orthomyxoviridae Lab ID

rapid antigen test, PCR

Orthomyxoviridae treatment and prevention

oseltamivir, zanamivir, are neuraminidase inhibitors; baloxavir is endonuclease inhibitor; amantadine and rimantidine, annual inactivated or live attenuated vaccine

Orthomyxoviridae misc

Antigenic drift (small mutations in HA and NA) result in common flu epidemics. Antigenic shift (major changes in HA and NA on influenza A, including acquisition from animals); leads to pandemics

Paramyxoviridae viruses

Measles (rubeola), parainfluenza virus, rhinovirus

Measles morphology

ssRNA, ⊝ sense, linear, enveloped, helical capsid

Measles transmission

respiratory droplets

Measles virulence factors

Hemagglutinin glycoprotein, F-protein, immunosuppression via infection of lymphocytes

Measles clinical

high fever, cough, rhinitis, conjunctivitis, Koplik spots, descending maculopapular rash; complications include pneumonia, acute encephalitis, eye damage, myocarditis, subacute sclerosing panencephalitis and giant cell pneumonia in immunosuppressed patients; fetal death during early pregnancy

Measles Lab ID

serology (IgM), PCR

Measles treatment and prevention

supportive care; MMR vaccine for prevention; vitamin A in developing countries

Pneumoviridae viruses

Human metapneumovirus, rhinovirus

Human metapneumovirus morphology

ssRNA, ⊝ sense, linear, enveloped, helical capsid

Human metapneumovirus transmission

respiratory droplets

Human metapneumovirus virulence factors

F-protein causes syncytia formation, similar to RSV; integrin alpha-V-beta receptor allows infection of respiratory tract epithelial cells

Human metapneumovirus clinical

bronchiolitis, pneumonia, upper respiratory infection, especially in young children and elderly

Human metapneumovirus Lab ID

PCR

Human metapneumovirus treatment and prevention

supportive care

Human metapneumovirus misc

Clinically similar to RSV; identified relatively recently

Parainfluenza morphology

ssRNA, ⊝ sense, linear, enveloped, helical capsid

Parainfluenza transmission

respiratory droplets

Parainfluenza virulence factors

Glycoproteins with HA and NA activity, F-protein causes syncytia formation

Parainfluenza clinical

croup (barking cough, inspiratory stridor due to swelling and narrowing of larynx), otitis media, bronchiolitis, pneumonia

Parainfluenza Lab ID

PCR

Parainfluenza treatment and prevention

supportive care; nebulized epinephrine and corticosteroids for croup

Parainfluenza misc

Most common cause of croup in children

Rhinovirus morphology

ssRNA, ⊕ sense, linear, naked, icosahedral capsid

Rhinovirus transmission

respiratory droplets, fomites

Rhinovirus virulence factors

binds ICAM-1 receptor on respiratory epithelium; acid-labile (does not survive the GI tract)

Rhinovirus clinical

common cold

Rhinovirus Lab ID

clinical diagnosis, PCR

Rhinovirus treatment and prevention

supportive care

Rhinovirus misc

Most common cause of the common cold; >100 serotypes

HIV morphology

Enveloped ssRNA, retrovirus

RSV morphology

ssRNA, ⊝ sense, linear, enveloped, helical capsid

RSV transmission

respiratory droplets, fomites

RSV virulence factors

fusion (F) protein causes respiratory epithelial cells to form multinucleated giant cells (syncytia), No HA or NA glycoproteins

RSV clinical

bronchiolitis, especially in babies and young children, URI, viral pneumonia in elderly adults, complications include otitis media

RSV Lab ID

rapid antigen test, PCR

RSV treatment and prevention

supportive care; palivizumab (monoclonal antibody) for high-risk infant prophylaxis; RSV vaccines available for older adults and maternal immunization; ribavirin

RSV misc

Most common cause of bronchiolitis and pneumonia in infants <1 year old