Enteroviruses
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Enteroviruses
New Emerging DiseaseApril 2010
Huthayfa Mujahed
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Outline
• Introduction• Virus Properties• Clinical Aspects• Pathogenesis• Vaccines & Treatment• Epidemiology
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Introduction
• Most common human pathogens.• Distribution world wild.• Usually cause mild fever.• Rarely progress to severe and fatal disease.
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Properties
1. Classification :Family : Picornaviridae
Genus : Enterovirus10 species
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Properties
2. Morphology :• Small 30 nm.• Icosahedral.• Non-enveloped.• 60 protomers forms the
capsid
- Variant VP = Different Ag serotypes.
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Properties
3. Genome :• +ssRNA• 7500 b
(De Palma, et. al 2008 )
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Properties
4. ReplicationEndocytosis Cytoplasm Cell lysis
(Zoll, et. al 2009)
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Clinical Aspects
• Symptoms :• Often NO symptoms.• Rash, Fever, Muscle aches, Common clod, flu-like.
• Transmission :• Saliva, Blister fluid, stool, nasal mucus, and any thing
contaminated with the virus.
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Pathogenesis
The University of Texas Medical Branch at Galveston, Pathogenesis of enterovirus infections 1996.
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Pathogenesis
• Aseptic Meningitis– Less severe than bacterial meningitis.– Rarely fatal in people with normal immune
systems.– Symptoms last from 7 to 10 days.– Completely recover within 2 weeks.
– H. Enterovirus B species
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Pathogenesis
• Hand Foot and Mouth Disease– causes fever, sores in the
mouth, and a rash with blisters.
– children <10 yr.– recover in 7–10 days.
– Coxsackievirus A16
When pretty baby gets HFMD
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Lab Diagnosis
• RT-PCR.• Recently Flow Cytometry .
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Vaccines
– No vaccine, Good hygiene.
Treatment
– No specific anti-viral agent.
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Epidemiology
Centers for Disease Control and Prevention :Aseptic meningitis in Baltimore-USA during June 1 – September 30, 1998–2001.
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Epidemiology
Centers for Disease Control and Prevention : Reported aseptic meningitis cases in Cuba, January through September 2000
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Epidemiology
Centers for Disease Control and Prevention : Monthly distribution of aseptic meningitis incidence in Cuba 2000.
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Epidemiology
Centers for Disease Control and Prevention : Total cases of HFMD and herpangina in Taiwan, March 19 to August 29, 1998.
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Epidemiology
Centers for Disease Control and Prevention : Number of hospitalizations and severe cases of hand, foot, and mouth disease and herpangina in Taiwan, June-August, 1998
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Epidemiology
Centers for Disease Control and Prevention : Clinical features of HFMD in children admitted to hospital in southern Vietnam during 2005.
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Epidemiology
March,2010 more than 77,000 cases of HFMD and 40 deaths were reported in China by CDC.
Centers for Disease Control and Prevention : Monthly distribution of 387 cases of HFMD associated with isolation of either (CVA16) (214 cases) or (HEV71) (173 cases), southern Vietnam, 2005.
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References• Cordey. Samuel, Gerlach. Daniel, Junier. Thomas, Zdobnov. Evgeny M, Kaiser. Laurent, and
Tapparel. Caroline. 2008. The cis-acting replecation elements define human enterovirus and rhinovirus species. RNA, 14:1568-1578.
• De Palma. Armando M, Vliegen. Inge, De Clercq. Erik, Neyts. Johan. 2008. Selective inhibitors of Picornavirus replication. Medicinal Reasearch Reviews, 28:823-884.
• Lin. Mong-Cheng, Chan. Yu-Jiun, Chen. Chun-Jen, Tang. Ren-Bin, and Wu. Keh-Gong. 2008. Epidemiology and diagnostic methodology for enterovirus infection, including cerebrospinal fluid analysis. Microbio Immunol & infect, 41:450-455.
• She. Rosemary C, Preobrazhensky. Sergey N, Taggar Edward W, Petti Cathy A, and Bahler Devid W. 2009. Flow cytometric detection and serotyping of enterovirus for the clinical laboratory. Jviromet, 162:245-250.
• Zoll. Jan, Heus. Hans A, Kuppeveld. Frank J.M Van, and Melchers. Willem J.M. 2009. The structure-function relationship of the enterovirus 3’-UTR. Viruses, 139:209-216.
• Centers for Disease Control and Prevention./www.cdc..gov/
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Be a virus, see the world
When pretty baby gets HFMD…