IMPORTANT LISTS OF HELMINTHS

EGGS OF HELMINTHS
Non-bile stained eggs Operculated eggs Don’t float in sat. salt solution
1. N. americanus 1. All trematodes 1.Unfertilized Ascaris eggs
2. E. vermicularis (except Schistosomes) 2.Taenia eggs
3. H. nana 2. D. Latum 3.Hepatic and intestinal fluke eggs
4. A. duodenale

Helminths acquired by skin penetration Auto-infection causing parasites

1. Schistosoma sp. 1. Cryptosporidium parvum
2. S. stercoralis 2. Hymenolepis nana
3. Necator americanus 3. Enterobius vermicularis
4. Anylostoma duodenale 4. Strongyloides stercoralis
5. Non human hookworms 5. Taenia solium
causing Cutaneous larva migrans 6. Capillaria phillipensis

Cutaneous Larva migrans Visceral larva migrans

1. Ancylostoma brasiliensis 1.Toxocara canis
2. Ancylostoma caninum 2.Toxocara cati
3. Bunostomium phlebotomum 3. Angiostrongylus cantonensis
4. Uncinaria stenocephalus 4. Gnathostoma spinigerum

Fish is source of Cat is source of Dog is source of

1. Clonorchis sinensis 1.Toxoplasma gondii 1. E.granulosus
2. Opisthorchis felineus 2.Cryptosporidium parvum 2. E.multilocularis
3. Heterophyes heterophyes 3.Toxocara cati-VLM 3. Toxocaracanis-VLM
4. Metagonimus yokogawii 4. Taenia multiceps
5. Paragonimus westermanii
6. Capillaria phillipensis
7. Diphyllobothrium latum

Raw/ undercooked Pork is the source for- Taenia solium, T.saginata asiatica, Trichinella spiralis,
Toxoplasma gondii, Sarcocystis suihominis

Undercooked beef can transmit- Taenia saginata, Toxoplasma gondii, Sarcocystis hominis

Parasites requiring two IMH- All trematodes except Schistosoma, D. latum (cestode)

Larvae in stool – Strongyloides, Trichinella (rarely)

Adult worms in stool

Ascaris lumbricoides, Ancyclostoma duodenale, Necator americanus
Trichinella spiralis, Enterobius vermicularis-RARE, Taenia spp., D.latum
 VIROLOGY
Largest pathogenic virus-POX
Smallest pathogenic virus-PARVO
Largest genome -POX
Smallest genome-HBV
Obligate intracellular.
All are ultramicroscopic except-poxviruses
Contain DNA or RNA never both
Protein coat surrounding the nucleic acid –Capsid : made of subunits capsomers
Lipid envelope +/- (host cell membrane derived) with virus encoded proteins embedded

DNA VIRUSES- 7 FAMILIES

All have a double stranded DNA as genome except parvoviruses

All replicate in the nucleus except Poxviruses
All have icosahedral symmetry except Poxviruses
Lipid Enveloped-Herpes, Hepadna and Pox
Non-enveloped-Parvovirus, Adenovirus Polyomavirus and Papilomavirus
Transfection of NAKED NUCLEIC ACID IS INFECTIOUS to the host cell in all families except Pox and HBV

RNA VIRUSES

Non-enveloped- Picornavirus, Astroviruses, Reoviruses ,Caliciviruses and Hepeviruses.

Rest are enveloped.
All have a single stranded RNA as genome except REOVIRUSES
All replicate in the cytoplasm except Orthomyxovirus, some Paramyxoviruses and Retroviruses.

HELICAL SYMMETRY SEGMENTED GENOME NEGATIVE STRANDED GENOME

Arenavirus Reovirus Arenavirus
Bunyavirus Orthomyxovirus Bunyavirus
Coronavirus Bunyavirus Paramyxovirus
Paramyxo V Arenavirus Orthomyxovirus
Orthomyxovirus Filovirus
Filovirus Rhabdovirus
Rhabdovirus

DNA VIRUSES
PARVOVIRIDAE includes several species-specific viruses of animals.
B – 19 strain Is a human pathogen - Named so after code number of human serum in which it was discovered.
It belongs to the genus Erythrovirus.
a. Icosahedral, Non enveloped
b. Single stranded DNA virus. Smallest pathogenic virus.
c. Parvovirus B19 binds preferentially to blood group P antigen; hence the tropism of B19 for erythroid
precursor cells particularly pronormoblast and normoblasts.
d. Fails to grow in conventional cell culture lines and no animal model for B19.
e. Only replicates in vitro in erythroid progenitor cells derived from human bone marrow, umbilical cord,
peripheral blood or fetal liver.
f. Infection occurs primarily by the respiratory route. Usually asymptomatic

Clinical manifestation of Parvovirus infection: ONLY WITH A PRIMARY INFECTION

Erythema Infectiosum/Fifth disease- A mild illness, facial rash with a "Slapped cheek" appearance preceded by
fever and myalgias. Rash spreads on arms, legs and has lacy, reticular, erythematous appearance. Trunk, palm
and soles occ. involved. Rash – maculopapular or morbilliform. Resolves in about a week. Raised IgM
Arthropathy : - M/c manifestation in adults. Symmetrical, peripheral involving wrists, hands most frequently.
Usually resolves in 3 wks; nondestructive, may last many months. Raised IgM
Transient Aplastic Crisis (TAC) : in chronic hemolytic disease, eg : SCA, thalassemias etc. Raised IgM
Chronic anemia in Immunodeficient patients : Unable to eliminate B19 infection due to inadequate production
of IgG antibodies; thus persistence of infection
Fetal and congenital infections :
Primary maternal B19 infections (first half of pregnancy) can be transmitted across the placenta (33%).
5% foetuses- death due to non immune fetal hydrops (severe anemia & CHF). Pregnant women with known
exposure to B19 should have IgM monitored and check for elevated level of  AFP, USG for Hydrops fetalis.
Diagnosis: Fetal infection. PCR for B19 DNA in amniotic fluid / Fetal blood.
Treatment :
Erythema infectiosum - Self immunity; Arthritis and Arthropathy - NSAIDS
Aplastic crisis - Erythrocyte transfusion; Immunodeficient patient - I/V anti Parvovirus IgG
No vaccine currently available.

ADENOVIRIDAE – HOST SPECIFIC

ds linear DNA genome, non-enveloped, icosahedral. Space vehicle shaped (252 capsomers)
Human adenoviruses are divided into six groups (A-F) based on their physical,
chemical and biological properties.
51 distinct antigenic types have been isolated from humans (12, 18, 31- Group A are
oncogenic in new born hamsters).
Have been used as gene vectors (Group C especially serotypes 2 and 5) and Oncolytic
virotherapy
Cultured on only on human cell lines like primary kidney.

Group Principal types Disease

B 3,7,14 Pharyngoconjunctival fever (swimming pool conjunctivitis)
3,7,14,21 Acute respiratory disease in military recruits
3,7 Pneumonia, acute febrile pharyngitis in small children
11, 21 Acute hemorrhagic cystitis
C 1,2,5,6 Acute febrile pharyngitis in small children
1,2,5 Hepatitis in children with liver transplant
D 8,19,37 Epidemic keratoconjunctivitis (ship yard eye)
F 40,41 Infantile gastroenteritis

Laboratory Diagnosis:
Culture: primary human embryonic kidney cells, Hep-2, HeLa; CPE- Rounding and clustering of cells
Antigen detection: Immunofluorescence, ELISA, latex agglutination, electron microscopy
Vaccine - Live attenuated / killed, for prevention of acute respiratory disease, useful for military recruits

PAPILLOMAVIRUSES
• Non-enveloped ds DNA viruses. Circular genome.
• Non-cultivable.
• Over 150 HPV genotypes have been identified by molecular hybridization and are referred to by number
• Circular genome-8000 bp; (divided into 3 regions- a regulatory region, an early region and a late region)
• Early region codes for E1-E7 proteins, 6 nonstructural genes, of which E6 and E7 are associated with
cellular transformation (inactivate tumor suppressor genes p53 and rb).
• The late (L) region codes for 2 structural proteins, L1 and L2, that form the capsid
• Infect only the stratified epithelium of the skin or mucous membranes through micro-abrasion/ other
epithelial trauma that exposes segments of the basement membrane.
 • Infection is ubiquitous and often asymptomatic. Most HPV infections are cleared rapidly by the immune
system. Immunity is type-specific.
• Two types-cutaneous and mucosal, each of which are further divided into low risk and high risk
according to the propensity for malignant progression of the lesions that they cause. Among the
cutaneous HPV types, HPV-5 and HPV-8 are classified as high risk.
Diseases-
• Skin Warts (verrucae), which are noncancerous skin growths.
• Genital or anal warts (condylomata acuminata). Low-risk mucosal HPVs types 6 and 11 account for
about 90% of all cases.
• HPV types 6 and 11 - a rare condition known as recurrent respiratory papillomatosis, in which warts
form on larynx or other areas of the respiratory tract. These recur frequently, may require repetitive
surgery, interfere with breathing, and rarely can progress to cancer.
• Epidermodysplasia verruciformis- AR genodermatosis linked to a gene locus on chromosome 17 with
disseminated cutaneous warts with frequent malignant transformation.
• Persistent infection with "high-risk" mucosal HPV types—may progress to precancerous lesions and
invasive cancer, i.e: 16, 18, (70% of all:16 for SCC and 18 for adenocarcinoma)
• Cancers of the cervix (~100%), vulva 40%, vagina 40%, and anus 90% and penis (40%).
• Oropharyngeal cancers.
Diagnosis-
• Histopathology- Koilocytes indicate the presence of productive HPV infection in exfoliated cells and
biopsy specimens. They are squamous epithelial cells exhibiting perinuclear clearing and increased
density of surrounding cytoplasm.
• Most specific and sensitive is PCR.
FDA approved vaccines for human papillomavirus
• Gardasil-Recombinant L1 proteins of HPV types 16, 18, 6, and 11
• Cervarix-Recombinant L1 proteins of HPV 16 and 18

RNA VIRUSES- compiled by Dr Shivika J Sethi

RHABDOVIRIDAE
Two genera-Vesiculovirus: infections in animals and LYSSAVIRUS: RABIES VIRUS
Bullet shaped, 75x180nm, single stranded linear, non-segmented negative-sense RNA, enveloped

Rabies virus –one antigenic type

Man acquires infection by the bite of the rabid dog or other animals
Rarely infection can occur following licks on abraded skin and intact mucosa
Bite of the animal results in deposition of rabies virus infected saliva in the muscle→ virus replicates
locally→ infects peripheral nerves→ within the nerve fibres it travels along the axon towards the CNS
(speed of 3mm hour)→ in CNS it multiplies and produces encephalitis→ virus then spreads outwards along
the nerve trunks to various parts of the body including salivary glands→ shed in saliva
Man is not highly susceptible, the incidence of human rabies after bites by known rabid dogs is about 15%
Clinical features
i. Incubation period: 1-2 months, shorter in children and persons bitten on the face or head
ii. Malaise, headache, fever, paraesthesia at the site of bite followed by anxiety, hyperactivity,
aggression, convulsions, hydrophobia. Finally, patient develops coma and death.
iii. Disease once developed is always fatal in about 4-14 days
iv. Virus is secreted in saliva, urine and other secretions
Laboratory diagnosis
i. Demonstration of Negri bodies (intracytoplasmic, round, oval, eosinophilic with basophilic inner
granules) by Seller’s stain. Max. in pyramidal cells of Ammon’s horn, Purkinje cells of hippocampus,
brain stem, cerebellum
ii. Demonstration of antigen by direct immunofluorescence-very sensitive
Antemortem: salivary, corneal smears, skin biopsy from nape of the neck
Postmortem: impression smears of cut surface of salivary glands, hippocampus, brain stem,
cerebellum
iii. Detection of genomic RNA or viral mRNA: PCR, DNA probes
Compiled by Dr Shivika J Sethi
Rabies vaccines for POST EXPOSURE PROPHYLAXIS
i. Neural vaccines- Associated with serious risk of neural complications.
a) Pasteur vaccine, Fermi vaccine, Semple vaccine, Beta-propiolactone vaccine
b) Suckling/infant mouse brain vaccine
ii. Non-neural vaccine
a) Duck egg vaccine-Flurry strain and Kelev strain
b) Cell culture vaccine-used now
First generation: Human diploid cell vaccine (HDCV)
Second generation: Purified chick embryo cell vaccine, Purified vero cell vaccine

FAMILY-REOVIRIDAE

Non-enveloped, icosahedral capsid 60-80nm in diameter.

• Ds DNA viruses with segmented genome-10-12
• Genus-Rotavirus -11 segments
• Genus-Coltivirus-12 segments
Colorado tick fever- common arboviral infection in the US; Vector-tick (mainly Dermacentor)
• Reservoir-porcupines, squirrels;
• IP-3-5 days; Fever, chills, headache, lethargy, myalgia
• Meningitis, encephalitis in pediatric population
• Diagnosis-RT-PCR on blood and CSF

• Rotavirus- appearance of wheel because the outer capsid is attached by short spokes to the inner
capsid and core
• The 11 segments of genome encode six structural proteins (VP1 to VP4, VP6, and VP7) and six
nonstructural proteins (NSP1 to NSP6).
• Divided into seven serogroups (A-G). Serogroup A, B, and C cause diarrheas in humans; ). Serogroup
A is the most important clinically, as they cause gastroenteritis of children
• Group A rotaviruses are classified into G and P serotypes.
• Pathogenesis-destruction of villous epithelial cells due to replication of the virus, inhibit
disaccharidase, produce an enterotoxin (NSP-4) which inhibits glucose-coupled sodium transport.
• Diagnosis- Cultivation-difficult
• Antigen detection in feces-LA/PHA/ELISA. Commercial antigenic assays primarily detect the VP2 and
VP6 proteins of group A rotaviruses
• RT-PCR
• Rotarix (Glaxo) a monovalent oral, LAV, derived from the human 89-12 strain which belongs to
G1P[8] type.
• RotaTeq (Merck) is a multivalent oral live reasssortant virus vaccine

FAMILY- ORTHOMYXOVIRIDAE
• Helical, 80-120 nm, Enveloped with glycoproteins H and N embedded.
• Single stranded RNA, negative sense, segmented genome (influenza virus- A,B: 8, C: 7 segments)
• Segmentation of genome leads to increased chances of genetic reassortment
• Divided into A, B & C depending on antigenic characteristics of nucleoprotein (NP) & Matrix (M)
antigens
• Influenza A further divided into strains-hemagglutinin (H) & neuraminidase (N) antigens–
glycoproteins embedded in the lipid envelope.
• Hemagglutinin is the site at which virus binds to cell receptor. Antibodies to H Ag are major
determinants of immunity to Influenza virus.
• Neuraminidase degrades the receptor & also causes release of virus from infected cells Antibodies to
N Ag limits viral spread
 Antigenic Drift Antigenic Shift
a. Gradual sequential change in antigenic structure a. Sudden, drastic, discontinuous variation in
occurring at frequent intervals. antigenic structure.
b. d/t mutation & selection occurs under selection b. d/t antigenic variation (changes involve
pressure of community. hemagglutinin, neuraminidase or both antigens)
c. Accounts for small periodic epidemics (which c. Responsible for major epidemic & pandemic.
can occur between major pandemics). d. Result from genetic recombination of human
d. Drift is accumulation of point mutations. with avian/animal viruses
e. Associated with type A or B e. Associated with type A only

• Pandemics occur every 10 - 15yrs

• Epidemics occur mainly due to Influenza A virus due to Antigenic variation in H & N Ag.
• Influenza C causes mild, sporadic respiratory disease.
• Incidence peaks in winters.
• Infection spreads by aerosols. Most of the infected are aymptomatic.
• In symptomatic-Abrupt onset of symptoms- Moderate fever, dry cough, myalgia,chills
• Acute illness lasts for 2 - 5days. Self limited
• Pneumonia - Most common complication
• Reye's Syndrome: Mainly associated with Influenza 'B', especially with the use of aspirin.
• Best specimen for diagnosis-nasopharyngeal secretion-
• Amantadine & Rimantadine are active only against some strains of influenza A
• KILLED Vaccines against Influenza A & B are effective in 50 - 80% cases
• LAV against Influenza A is given intranasally.
• During outbreaks amantadine & vaccine can be given simultaneously

ARBOVIRUSES- compiled by Dr Shivika J Sethi

VIRAL FAMILIES: REOVIRIDAE, FLAVIVIRIDAE, TOGAVIRIDAE AND BUNYAVIRIDAE

FLAVIVIRIDAE
Icosahedral symmetry, 40-50nm, Single-stranded, positive sense RNA, Enveloped
Two genera of medical importance—
Flavivirus: Arthropod borne viruses -JEV, DENGUE, KFD, etc.
Hepacivirus: Hepatitis C virus, non-arthropod borne

JAPANESE B ENCEPHALITIS
• Vector is Culex tritaeniorhyncus which breeds in rice or paddy fields
• Amplifier hosts – Pigs. They allow manifold virus multiplication without suffering from disease and
maintain prolonged viraemia.
• Water birds-herons, cranes and egrets are reservoir hosts
• Man – incidental and dead end host. Humans do not develop sufficient viraemia to infect feeding
mosquitoes. No human to human transmission.
• Iceberg phenomenon-symptomatic to asymptomatic ratio is 1:300 to 1:1000.
• Incubation period-5-15 days
• Cases occur primarily in children 2-10 yrs of age.
• Severe encephalitis- fever, headache, neck stiffness, coma, seizures, spastic paralysis and death.
• Serum IgM ELISA is the method of choice for diagnosis.
• CFR - 25-50%. Neurologic complications - seizures, CN palsies, motor deficits may persist for 5 yrs.
• No antiviral treatment for JE. Treatment is supportive
• Inactivated mouse brain vaccine- Based on Nakayama and Beijing 1 strain
• Cell culture (BHK) derived live attenuated -SA14-14-2 strain
WEST NILE FEVER VIRUS
• Occurs in Europe, Middle East, Africa, Russia and South West Africa. Appeared for the first time in
USA in 1999.
• It is a member of Japanese B Encephalitis antigenic complex
• I antigenic type.
• Vector- mainly Culex
• Most common reservoir- birds (crows, sparrows, jays)
• 80% infections are asymptomatic. 20% - febrile illness. Less than 1 % have neuro-invasive disease

ST LOUIS ENCEPHALITIS VIRUS

• Mainly affects the United States; Vector –Culex sp.
• Related to Japanese B encephalitis virus

ILHEUS VIRUS
• Closely related to the Japanese B encephalitis virus complex
• Vector- several genera of mosquitoes
• subclinical to severe febrile disease with gastrointestinal or respiratory symptoms lasting ≈1 week

Compiled by Dr Shivika J Sethi

DENGUE VIRUS- M/C ARBOVIRAL DISEASE
• 4 serotypes 1 -4. Infection with one serotype gives partial immunity to other serotypes
• Vector - Aedes aegypti mosquito Others- A. albopinctus, A. polynesiensis.
• Breed in uncovered water storage containers, vases, flower pots, cans.
• They shelter indoors and are day biters.
• Transmission mainly in tropics.
• Reservoir - Man & Monkey (sylvatic cycle). Infected person infective to mosquitoes 6 to 12
hours before the onset of the disease and remains so upto 3 to 5 days.
• IP - 5-8 days. All age groups & both sexes are equally affected
• Saddle back fever (biphasic), severe headache and retro-orbital pain, muscle and joint pains
(breakbone fever), nausea, vomiting and rash. Self limited.
o Dengue hemorrhagic fever- in individuals (usually children) with preexisting nonneutralizing
heterologous dengue antibody caused by a previous infection with a different serotype of the
virus. Evidence suggests that a secondary infection with serotype 2 after a serotype 1
infection is at particular risk.
LAB DIAGNOSIS
• Leukopenia, TCP, elevated AST levels
• Serological diagnosis- Capture IgM and IgG ELISA, ICT or IFAT.
• Neutralization tests like plaque reduction assays are more specific, though time consuming
and expensive. Serotype-Specific Neutralization test is used to differentiate the 4 serotypes.
• No specific antiviral treatment is available. Treatment is supportive.
• No vaccine available yet; A tetravalent vaccine using molecular attenuation is being evaluated.

YELLOW FEVER
• Disease of tropical America & Africa;
• Not reported from Asia including India.
• One serotype
• 2 forms: In forest / Sylvatic cycle -Runs between monkeys & mosquitoes
• Urban cycle — Man and Aedes aegypti mosquito
• IP-3-6 days
• In epidemics: infection to case ratio is 20:1 to 2:1
• Virus multiplies in kupffer cells - jaundice & decreased prothrombin formation
• TORRES BODIES are inclusion bodies in infected liver cells.
• COUNCILMAN BODIES are eosinophilic masses formed due to hyalinized necrosed cells
• Hematemesis & malena -Renal failure & death
• Mortality rate-20% (young children and elderly)
 • If patient survives- no long term sequelae.
• Diagnosis-IgM antibody by ELISA in a single sample and confirmation by a 4-fold rise in titer of
neutralizing antibody between acute and convalescent phase serum.
• No specific antiviral treatment
• Vaccine -live Attenuated vaccine K/a 17 D vaccine (prepared in eggs); Protection starts in 10
days and lasts for at least 10 years.

KYASANUR FOREST DISEASE (KFD)

• Epidemic in Karnataka in 1957-1st report. Five Karnataka districts are endemic.
• Now also few reports from Goa, Kerala (2014), TN
• Forest birds and small mammals are reservoirs
• I antigenic type.
• Tick - Haemophysalis spinigera is vector; Monkeys - Amplifier host (fatal disease-sentinel
animal)
• In humans accidental infection
• IP-3-8 days
• Fever, myalgia with massive haemorrhages in GIT & chest & nose
• KFD anti-IgM antibodies can be detected using ELISA during the acute phase (4 days onward)
• The front-line test for KFD is RT-PCR from blood/ serum.
• Vaccine ---> Killed vaccine

TICK BORNE ENCEPHALITIS-

1. Russian spring summer encephalitis virus
• Related to KFD virus; Main vector-male and female Ixodid ticks.
• Reservoir-goats

2. Powassan V-related to RSSE. Seen in N.America

• Reservoir- squirrels, woodchucks
• Ixodid and dermacentors are vectors
• Man is dead end host.
• Powassan encephalitis is severe, and neurologic sequelae are common.

3. Louping-ill (Ovine Encephalomyelitis)-acute viral disease primarily of sheep

• Human infection was first reported in 1934.
• Tick bites or exposure to tissues
• Four clinical syndromes are seen, an influenza-like illness, a bi-phase encephalitis, a poliomyelitis-like
illness and a hemorrhagic fever.

BUNYAVIRIDAE
• Helical, 80-120nm diameter, enveloped
• Triple segmented, negative sense or ambisense, ss RNA
• Four important genera
o Bunyavirus: predominantly transmitted by mosquitoes
o Nairovirus: predominantly transmitted by ticks
o Phlebovirus: predominantly transmitted by sandflies
o Hantavirus: rodent borne, not transmitted by arthropods

Genus Virus Vector Human disease

Bunyavirus La Crosse Mosquito Encephalitis
Oropouche Mosquito Fever, arthralgia, myalgia
Phlebovirus Rift valley fever Mosquito Fever, myalgia, retinitis, hemorrhagic
fever
Sandfly fever Sandfly Fever, myalgia, conjunctivitis
Nairovirus Crimean-Congo Tick Hemorrhagic fever
hemorrhagic fever
 Hantavirus Hantaan - Hemorrhagic fever, nephropathy
Dobrevaa - Hemorrhagic fever, nephropathy
Seoul - Nephropathy
Puumala - Nephropathy
Saarema
Sin Nombre, Andes, New Hantavirus pulmonary syndrome
York Virus

Compiled by Dr Shivika J Sethi

CRIMEAN CONGO HEMORRHAGIC FEVER

• Vector-Hyalloma ticks- a variety of hard ticks.
• Main reservoir-hares, hedgehogs, rodents
• Common clinical features of CCHF include; high grade fever with chills, headache, body ache, myalgia,
vomiting, abdominal pain, weakness and bleeding from multiple sites.
• CFR may be as high as 50%.
• Since January 2011, the disease has been reported in Gujarat and Rajasthan with 4 reported deaths.

RIFT VALLEY FEVER VIRUS

• Pathogenic primarily for domestic livestock.
• Reported mainly from Africa
• Vector-Aedes mosquito
• Human infection-contact with infected animal blood or body fluids/ mosquito bite
• Mild febrile illness with total recovery; 15%-retinitis, 1%-encephalitis, 1%-hemorrhagic fever

SANDFLY FEVER/PHLEBOTOMUS FEVER

• Mild disease occurring in mediterranean countries, Russia, India, Pakistan, Brazil, panama.
• IP-3-6 days; Headache, nausea, vomiting, fever, photophobia, stiffness of neck and back, abdominal
pain and leukopenia.
• Total recovery. No specific treatment

CALIFORNIA ENCEPHALITIS VIRUS COMPLEX

• Vector- Aedes mosquito
• Reservoir-squirrels, chipmunks
• Includes the La Crosse virus, a significant human pathogen in the US- encephalitis and aseptic
meningitis

HEMORRHAGIC FEVER WITH RENAL SYNDROME/epidemic hemorrhagic fever/ nephropathia epidemica

• Rodents are the natural reservoir for hantaviruses
• Transmission via bites/inhalation of feces/urine or saliva of infected rodents
• An interstitial nephritis with generalized hemorrhage; CFR-5-35%. Especially reported from Korea.
• Hantaan and Dobrava virus infections usually cause severe symptoms, while Seoul, Saaremaa, and
Puumala virus infections are usually more moderate.

HANTAVIRUS PULMONARY SYNDROME/ HOUSE MOUSE FLU

• Hantaviruses causing-Sin Nombre virus, Andes virus, New York virus
• Disease develops between 1 and 5 weeks after exposure to aerosols of fresh urine, droppings, or
saliva of infected rodents-especially DEER MICE.
• Severe respiratory illness first reported from south western USA in 1993.
TOGAVIRIDAE
Icosahedral, 70nm diameter, positive sense, single stranded RNA, enveloped
Two genera: Alphavirus: arthropod borne viruses
Rubivirus: rubella virus, not arthropod borne
 • Human diseases caused by alphaviruses
Virus Vertebrate Mosquito vector Disease
reservoir
Eastern equine encephalitis Wild birds Culiseta, aedes, Encephalitis
culex
Western equine encephalitis Wild birds Culex Encephalitis
Venezuelan equine encephalitis Horses Aedes, culex Encephalitis
Chikungunya Monkeys, humans Aedes Fever, rash, arthralgia,
myalgia
Onyong-nyong Humans Anopheles Fever, rash, arthralgia,
myalgia
Mayaro Monkeys Haemagogus Fever, rash, arthralgia,
myalgia
Ross river Marsupials, rodents Aedes, culex Fever, rash, arthralgia,
myalgia
Sindbis Wild birds Culex, culiseta, Fever, rash, arthralgia,
aedes myalgia

CHIKUNGUNYA VIRUS
i. VECTOR- Aedes aegypti and Aedes albopictus mosquitoes.
ii. 1953, it was first described during an outbreak in Tanzania, Africa.
iii. Frequent outbreaks occur in tropical countries of Africa and Southeast Asia.
iv. Humans serve as major reservoirs during epidemics.
v. During inter-epidemic periods, virus is maintained in an epizootic cycle involving vertebrates such
as monkeys, rodents, and birds.
vi. Symptoms usually begin 3–7 days. The M/C symptoms are fever and joint pain. Some people, the
joint pain may persist for months.
vii. No vaccine available.
viii. A LAV to prevent CHIK fever (strain TSI-GSD-218) is in phase II clinical trials.

Compiled by Dr Shivika J Sethi