DNA/RNA Viruses

(DNA virus) Herpesviruses? (6)

(DNA virus) Herpesviruses? (6)

Herpes Simplex 1-2, Varicella-zoster, Cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus 6.

HSV Type 1 & 2 ROT?

Direct inoculation of muco-cutaneous surfaces

HSV Type 1 & 2 sx?

Oral/genital herpes, herpetic whitlow, encephalitis.

Varicella-zoster virus (VZV) ROT?

Respiratory droplets & direct contact with lesions

Varicella-zoster virus (VZV) causes what dz?

Varicella (chickenpox); but recurrent infection causes zoster (shingles).

VZV vaccine available?

Yes.

Cytomegalovirus (CMV) ROT?

Many:

• Placental

• Saliva

• Sexual

• Blood Transfusions

Cytomegalovirus (CMV) sx?

Mostly asymptomatic, congenital dz and CMV mononucleosis-like syndrome.

Cytomegalovirus (CMV) vulnerable population?

Immunocompromised.

Epstein-Barr Virus (EBV) ROT?

Transmitted via salvia exchange.

Epstein-Barr Virus (EBV) Sx?

Causes mononucleosis (mono):

• Pharyngitis

• Fever

• Lymphadenopathy

• Splenomegaly

Human Herpesvirus 6 ROT?

Saliva

Human Herpesvirus 6 dz?

Roseola (6th dz); high fever then rash

Human Herpesvirus 6 vulnerable population?

Often in young children

(DNA virus) Poxviruses? (2)

Molluscum contagiosum virus (MCV), Mpox

Molluscum contagiosum virus (MCV) ROT?

person-to-person; Close personal contact

Molluscum contagiosum virus (MCV) dz?

molluscum contagiosum:

• umbilicated lesions that appear all at once, starting on face and palms

Mpox ROT?

PtP, vertical, sexual

Mpox sx?

• Similar to smallpox (more mild)

• Rash (vesicle or pustules that are deep-seated, firm or hard, and well-circumscribed) progress to scabs

• Fever, headache, fatigue

Mpox vaccine available?

Yes

Other DNA viruses? (4)

Human papillomavirus (HPV), Parvovirus B19, Hepatitis B, Adenoviruses

Human papillomavirus (HPV) ROT?

Skin-to-skin, sexual contact

Human papillomavirus (HPV) dz?

Warts, Cancer (orpharyngeal, cervical, anal, vulvar, vaginal, and penile)

Human papillomavirus (HPV) vaccine?

Yes.

Parvovirus B19 dz?

Slapped cheek disease aka fifth disease

Parvovirus B19 ROT?

Respiratory route.

Hepatitis B ROT?

blood, sexual contact, vertical

Hepatitis B (HBV) dz causes?

• Acute hepatitis (jaundice/icterus, fever, malaise)

• Fulminant hepatitis (rapid liver failure)

• Chronic hepatitis

• Co-infection possible with Hepatitis C/D

Hepatitis B long-term complications?

Hepatocellular carcinoma, cirrhosis (liver scarring and losing hepatocytes)

Hepatitis B vaccine available?

Yes.

Hepatitis B vulnerable populations?

HIV or Hx of HIV, Hep C people, mulitple sexual partners, needle sharing, blood/tissue donors, infants born to HBV-infected mothers.

Adenovirus ROT?

Aerosol droplet, fecal-oral

Adenovirus sx?

“common cold”, URIs (conjunctivitis, rhinitis, sore throat); enteric version causes diarrhea.

RNA Enteroviruses (2)?

Mostly fecal-oral transmission: Coxsackie A & B virus, poliovirus

Coxsackie A & B dz?

A virus: Hand, foot, mouth disease (HFMD) and herpangia.

B virus: pleurodynia, myocarditis/pericarditis

Poliovirus dz?

Paralytic poliomyelitis

Poliovirus vaccine available?

Yes

Hepatitis RNA viruses? (4)

HP A, C, D, & E.

Hepatitis A & E ROT?

Fecal-oral

Hepatitis A & E sx?

Jaundice, fever, hepatomegaly.

• no chronic carrier state

• no hepatocellular carcinoma

• no cirrhosis

Hepatitis A & E vaccine?

Yes for A, no for E.

Hepatitis D transmission?

Only infected with hepatitis B infection can contract HepD; same ROT as hepB

Hepatitis D vaccine?

Technically yes - use HepB vaccine to protect against HepD.

Hepatitis C ROT?

blood, vertical, less commonly sexually

Hepatitis C concerning populations?

IV drug users, incarcerated populations

Hepatitis C dz?

Acute and chronic hepatitis, can be asymptomatic.

RNA Flaviviruses (4)?

West nile, dengue, yellow fever, zika viruses

West Nile Virus ROT?

Bite of infected mosquito

West Nile Virus dz?

Leading mosquito-borne disease, causes west nile:

• encephalitis

• meningitis

Zika virus ROT?

infected mosquito bite, sexual, and vertical

Zika virus dz?

Zika disease:

• fever

• rash

• conjunctivitis

• congenital microcephaly

Dengue virus ROT?

Transmitted via bite of infected mosquito

Dengue virus dz?

Dengue:

• eye/muscle/bone/joint pain

• fever

• HA

• Nausea/Vomitting

• rash

Yellow fever virus ROT?

Bite of infected mosquito, found in Africa and South America.

Yellow fever virus dz?

Yellow fever: jaundice & fever, can cause organ failure

Yellow fever virus vaccine available?

Yes.

RNA Paramyxoviruses (4)?

Parainfluenza, Respiratory syncytial virus (RSV), mumps and measles.

Parainfluenca virus ROT?

droplet, direct contact, fomites

Parainfluenca virus sx?

• URI in adults

• Lower respiratory tract infections (pneumonia) in kids, elderly, immunocompromised

• Croup (larygotracheobronchitis) in kids

Respiratory syncytial virus (RSV) ROT?

Droplets

Respiratory syncytial virus (RSV) Sx?

URI symptoms, unless its an infant or elderly, can cause bronchiolitis and pneumonia.

Respiratory syncytial virus (RSV) vaccine available?

Yes.

Mumps ROT?

Droplets and saliva

Mumps Sx?

URI, regional lymph nodes, hematogenous spread to infect organs (esp parotid glands), and testes.

• Causes orchitis & parotitis

Mumps vaccine available?

Yes.

Measles virus ROT?

Nasopharyngeal secretions or direct contact.

Measles sx?

• “Three Cs” Cough, coryza (runny nose), conjunctivitis

• Koplik spots** (distinguishes virus)

• Maculopapular rash spreads from head to trunk to lower extremities

Other RNA respiratory viruses? (3)

Influenza, rhinovirus, coronavirus

Influenza vaccine available?

Yes

Influenza dz?

Causes the flu:

• HA, fever, chills, malaise, myalgia, URI

Influenza types?

A, B, C, & D

Rhinovirus ROT?

Aerosol droplets, hand-to-nose/eyes/mouth contact

Rhinovirus dx?

URI, common cold

Coronavirus ROT?

Aerosol droplet, hand-to-nose/eye/mouth contact.

Coronaviruses sx?

Common strains: mild URI

Three strains cause severe sx: SARS-CoV; MERS-CoV, SARS-COV2*

RNA Diarrhea viruses? (3)

Norovirus, rotavirus, ebola virus

Norovirus ROT?

Fecal-oral; either through person-to-person contact, or indirectly via contaminated food or water.

• Fomites, aerosols of vomitus.

Norovirus dz?

Acute gastroenteritis: V/D.. leading cause of food-borne illness in the US.

Rotavirus ROT?

Fecal-oral transmission

Rotavirus sx?

Severe diarrhea, fever, abd. pain

Rotavirus vulnerable populations?

Infants and young children, concern for dehydration.

Rotavirus vaccine?

Yes.

Ebola virus ROT?

Person-to-person contact.

Ebola virus dz?

Ebola virus: diarrhea, vomitting, hemorrhagic fever.

Ebola virus vaccine available?

Yes.

Other RNA viruses? (3)

Rubella, rabies, hantavirus.

Rubella virus ROT?

direct or droplet contact from nasopharyngeal secretions

Rubella vaccine availalbe

Yes.

Rubella viruses sx?

Rash, fever, lymphadenopathy.

• Usually erythematous, discrete maculopapular exanthem beginning on the face and spreads downwards.

• congenital rubella syndrome

Rabies virus ROT?

Zoonotic, animal reservoir (CNS of warm-blooded animals) via bite of rabid animals.

Rabies sx/dz?

Acute/fatal encephalitis. Death due to respiratory system dysfunction.

Rabies vaccine available?

Yes.

Hantavirus ROT?

transmitted via wild rodent via aerosols of rodent poop, usually due to poor ventilation or during cleaning

Hantavirus sx/dz?

Americas: causes Hantavirus Pulmonary Syndrome - with pulmonary edema

Europe/Asia: hemorrhagic fever w/ renal syndrome - followed by acute renal failure