HES 087 (Microbiology - Lecture)

STUDENT ACTIVITY SHEET Doctor of Dental Medicine /SECOND YEAR

Session # 14

LESSON TITLE: Viral, Fungal and Parasitic Disease of

Medical Importance Materials: Book, pen and
Upon completion of this lesson, the student can:
notebook, paper
1. Correlate a particular
Vicera, viral, P.fungal
Chloe Marlene DDM 3and
A4 parasitic References:
disease with its major characteristics, etiologic
agent, reservoir(s) mode(s) of transmission and Engelkirk, P., & Engelkirk, J. (2015). Burton's
diagnostic laboratory procedures Microbiology for the Health and Sciences. 10th
ed., Philadelphia: Lipincott Williams & Wilkins

Productivity Tip:
“YOU HAVE FINISHED BACTERIOLOGY! Congratulations you’re on your last session. You rock!”

REVIEW (5 minutes)

Okay, let’s check first your previous knowledge!

1. What is the most important virulence factor of M. tuberculosis? ____Cord Factor_________________

2. It is also known as the energy parasites: Chlamydia trachomatis__________________

Compare your answers to page

5. Let’s get started!

MAIN LESSON (40 minutes)

Open and read your book (Burton’s book of Microbiology for the Health Sciences.) to Chapter 18, 19 and 20 book.
Below are concepts that can aid you in studying the constructs of this topic.

VIROLOGY
 Overview of Hepatitis
 Overview of HIV
 Overview of Corona virus
 Viral infections of the Oral Region
MYCOLOGY
 Fungal infection of the CNS
 Fungal infection of the Oral Region
PARASITOLOGY
 Malaria
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 I. VIROLOGY
Genital herpes
i. Viral infections of the Oral Region Cold sore (Fever Blister, infection s are most
Herpes Labialis) often caused by HSV -2
 Superficial clear vesicles on an erythematous (reddened)
base, which may appear on the face or lips.
 Causative agent: Herpes simplex virus type 1 (HSV-1)
and Herpes simplex virus type 2 (HSV-2)
- both are DNA viruses in the family Herpesviridae

ii. Overview of Hepatitis Virus

Hepatitis means inflammation of the liver. This condition is most often caused by a virus.
In the United States, the most common causes of viral hepatitis are hepatitis A virus (HAV), hepatitis B virus
(HBV), and hepatitis C virus (HCV).

HBV and HCV are common among people who are at risk for, or living with, HIV.

You can get some forms of viral hepatitis the same way you get HIV—through unprotected sexual contact and
injection drug use. HAV, which causes a short-term but occasionally severe illness, is usually spread when the
virus is ingested from contact with food, drinks, or objects (including injection drug equipment), contaminated by
feces (or stool) of an infected person.

Based on the information above, classify HAV, HBV and HCV according to its mode of transmission (MOT):

Hepatitis Virus MOT

HAV Ingestion of contaminated fecal matter from an infected person, sexual contact with an
infected person or contaminated food, drink, or objects including injection equipment.
HBV Contact with body fluids liker blood, semen; sexual contact with an infected person;
sharing of contaminated needles or syringes. In addition, an infected woman can pass
the virus to her newborn.
HCV Contact with blood of an infected person, primarily through contaminated needles,
syringes, or other injection drug equipment and less commonly, sexual contact with an
infected person, birth to an infected mother and needle-sticks or other sharp instruments
from an infected person.

People with HIV infection are often affected by viral hepatitis; about one-third are coinfected with either HBV or
HCV, which can cause long-term illness and death. More people living with HIV have HCV than HBV.

Viral hepatitis progresses faster and causes more liver-related health problems among people with HIV than
among those who do not have HIV. Although drug therapy has extended the life expectancy of people with HIV,
liver disease—much of which is related to HCV and HBV—has become the leading cause of non-AIDS-related
deaths in this population.

People with HIV who are coinfected with either HBV or HCV are at increased risk for serious, life-threatening

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complications. As a result, anyone living with HIV should be tested for HBV and HCV. Coinfection with hepatitis
may also complicate the management of HIV infection. To prevent
coinfection for those who are not already infected with HBV, the
Advisory Committee on Immunization Practices recommends HAV
Fast Facts
and/or HBV vaccination of high-risk patients (including those who are
gay, bisexual, and other men who have sex with men [MSM]; injection • People with HIV infection are
drug users;) with HIV infection or AIDS. disproportionally affected by viral
hepatitis.
You may read more about the recommendation at http://www.cdc.gov/
at your most convenient time. • About 80% of people with HIV
who inject drugs also have hepatitis
Viral Hepatitis Transmission
C virus (HCV).
People can be infected with the three most common types of hepatitis
in these ways:
• HAV: Ingestion of contaminated fecal matter, even in tiny
amounts, from close person-to-person contact with an infected person, sexual contact with an infected person,
or contaminated food, drink, or objects, including injection equipment.
• HBV: Contact with infectious blood, semen, or other body fluids; sexual contact with an infected person;
sharing of contaminated needles, syringes, or other injection drug equipment; and needle-sticks or other sharp-
instrument injuries.
In addition, an infected woman can pass the virus to her newborn.
• HCV: Contact with blood of an infected person, primarily through sharing contaminated needles, syringes,
or other injection drug equipment, and, less commonly, sexual contact with an infected person, birth to an infected
mother, and needle-sticks or other sharp-instrument injuries from an infected person.

iii. Overview of HIV

HIV stands for human immunodeficiency virus, which is the virus that causes HIV infection, classified
as the retrovirus lentivirus. The abbreviation “HIV” can refer to the virus or to HIV infection.

AIDS stands for acquired immunodeficiency syndrome. AIDS is the most advanced stage of HIV
infection.

Pathophysiology:

HIV attacks and destroys the infection-fighting CD4 cells of the immune system. The loss of CD4 cells makes it
difficult for the body to fight off infections and certain cancers. Without treatment, HIV can gradually destroy the
immune system and advance to AIDS.

The spread of HIV from person to person is called HIV transmission.

HIV is spread only in certain body fluids from a person who

has HIV.

These body fluids include:

 Blood
HIV transmission is only possible
 Semen through contact with HIV -infected
 Pre-seminal fluid body fluids.
 Vaginal fluids
 Rectal fluids
 Breast milk

HIV is spread mainly by:

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  Having anal or vaginal sex with someone who has HIV without using a condom or taking medicines
to prevent or treat HIV
 Sharing injection drug equipment (works), such as needles, with someone who has HIV
 The spread of HIV from a woman with HIV to her child during pregnancy, childbirth, or
breastfeeding is called mother-to-child transmission of HIV.

What are the symptoms of HIV/AIDS?

Within 2 to 4 weeks after infection with HIV, some people may have flu-like symptoms, such as fever,
chills, or rash. The symptoms may last for a few days to several weeks. During this earliest stage of
HIV infection, the virus multiplies rapidly.

After the initial stage of infection, HIV continues to multiply but at very low levels. More severe
symptoms of
HIV infection, such as signs of opportunistic infections, generally don’t appear for many years.
(Opportunistic infections are infections and infection-related cancers that occur more frequently or are
more severe in people with weakened immune systems than in people with healthy immune systems.)
Without
treatment with
HIV medicines,
HIV transmission is HIV infection
possible at any stage of usually
advances to
HIV infection—even if a
AIDS in 10
person with HIV has no years or longer,
symptoms of HIV. though it may
advance faster
in some people.

How is AIDS diagnosed?

Symptoms such as fever, weakness, and weight loss may be a

sign that a person’s HIV has advanced to AIDS. However, a
diagnosis of AIDS is based on the following criteria:
A drop in CD4 count to less than 200 cells/mm3. A CD4 count
measures the number of CD4 cells in a sample of blood. or the
presence of certain
opportunistic infections.

Although an AIDS diagnosis indicates severe damage to the immune system, HIV medicines can still
help people at this stage of HIV infection.

iv. Overview of the Coronavirus

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 A) SARS (Severe Acute Respiratory Syndrome)

Cause
SARS coronavirus (SARS-CoV) – virus identified in 2003. SARS-CoV is thought to be an animal virus from an as-
yetuncertain animal reservoir, perhaps bats, that spread to other animals (civet cats) and first infected humans in
the Guangdong province of southern China in 2002.

Transmission
An epidemic of SARS affected 26 countries and resulted in more than 8000 cases in 2003. Since then, a small
number of cases have occurred as a result of laboratory accidents or, possibly, through animal-to-human
transmission (Guangdong, China).

Nature of the disease

Transmission of SARS-CoV is primarily from person to Currently, no areas of the world are reporting
person. It appears to have occurred mainly during the transmission of SARS. Since the end of the global
second week of illness, which corresponds to the peak of epidemic in July 2003, SARS has reappeared four
virus excretion in respiratory secretions and stool, and times – three times from laboratory accidents
when cases with severe disease start to deteriorate (Singapore and Chinese Taipei), and once in
clinically. Most cases of human-to-human transmission southern China where the source of infection
occurred in the health care setting, in the absence of remains undetermined although there is
adequate infection control precautions. Implementation of circumstantial evidence of animal-to-human
appropriate infection control practices brought the global transmission.
outbreak to an end.
Symptoms are influenza-like and include fever, malaise, myalgia, headache, diarrhoea, and shivering (rigors). No
individual symptom or cluster of symptoms has proved to be specific for a diagnosis of SARS. Although fever is the

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most frequently reported symptom, it is sometimes absent on initial measurement, especially in elderly and
immunosuppressed patients.

Cough (initially dry), shortness of breath, and diarrhea are present in the first and/or second week of
illness. Severe cases often evolve rapidly, progressing to respiratory distress and requiring intensive care.

Geographical distribution
The distribution is based on the 2002–2003 epidemic. The disease appeared in November 2002 in the Guangdong
province of southern China. This area is considered as a potential zone of re-emergence of SARS-CoV.

Other countries/areas in which chains of human-to-human transmission occurred after early importation of cases
were Toronto in Canada, Hong Kong Special Administrative Region of China, Chinese Taipei, Singapore, and
Hanoi in Viet Nam.

B) COVID-19

What is COVID-19?  COVID-19 is a disease caused by a new strain of coronavirus. ‘CO’ stands for corona,
‘VI’ for virus, and ‘D’ for disease. Formerly, this disease was referred to as ‘2019 novel coronavirus’ or
‘2019-nCoV.’ The COVID-19 virus is a new virus linked to the same family of viruses as Severe Acute
Respiratory Syndrome (SARS) and some types of common cold.

According to the latest edition of the book of Robbins and Cotran Basic Pathology:

A novel coronavirus SARS-CoV 2-mediated disease called COVID-19 was first detected in Wuhan, China,
and was reported to the WHO in December 2019. By the end of March 2020, the infection had become a
worldwide pandemic, devastating pandemic has caused major social and economic disruptions, in addition
to its severe health consequences.

Epidemiologic studies:

The origin was a seafood, and animal-to-human transmission followed by Histologic analysis
person-to-person spread soon thereafter.
of lung tissue done
Spectrum of infection: in a few patients
revealed diffuse
Sequencing of the full viral genome led to development of a rapid alveolar damage
molecular diagnostic assay during the evolving outbreak. and inflammation
with mainly
Clinical manifestations: Mild to severe respiratory illness
The vast majority of individuals who contract the virus recover after a mononuclear cells
flulike compromise, often associated with bilateral ground-glass and those
with comorbidities such as diabetes, COPD, and heart failure/ the
genomic sequence shows COVID-19 is related to bat coronaviruses and
the SARS coronavirus.

FAQs about COVID-19

What are the symptoms of COVID-19?

 Symptoms can include fever, cough and shortness of breath. In more severe cases, infection can cause
pneumonia or breathing difficulties. More rarely, the disease can be fatal. These symptoms are similar to the flu

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(influenza) or the common cold, which are a lot more common than COVID-19. This is why testing is required to
confirm if someone has COVID-19.

How does COVID-19 spread? 

The virus is transmitted through direct contact with respiratory droplets of an infected person (generated through
coughing and sneezing). Individuals can also be infected from and touching surfaces contaminated with the virus
and touching their face (e.g., eyes, nose, mouth). The COVID-19 virus may survive on surfaces for several hours,
but simple disinfectants can kill it.
Who is most at risk? 
We are learning more about how COVID-19 affects people every day.  Older people, and people with chronic
medical conditions, such as diabetes and heart disease, appear to be more at risk of developing severe
symptoms.  As this is a new virus, we are still learning about how it affects children. We know it is possible for
people of any age to be infected with the virus, but so far there are relatively few cases of COVID-19 reported
among children. This is a new virus and we need to learn more about how it affects children. The virus can be fatal
in rare cases, so far mainly among older people with pre-existing medical conditions.

What is the treatment for COVID-19? 

There is no currently available vaccine for COVID-19. However, many of the symptoms can be treated and getting
early care from a healthcare provider can make the disease less dangerous. There are several clinical trials that
are being conducted to evaluate potential therapeutics for COVID-19.

How can the spread of COVID-19 be slowed down or prevented?

As with other respiratory infections like the flu or the common cold, public health measures are critical to slow the
spread of illnesses.
Public health measures are everyday preventive actions that include:
✓ staying home when sick;
✓ covering mouth and nose with flexed elbow or tissue when coughing or sneezing. Dispose of used tissue
immediately;
✓ washing hands often with soap and water;
and ✓ cleaning frequently touched surfaces and objects

As we learn more about COVID-19 public health officials may recommend additional actions.

II. MYCOLOGY

Fungal Infections of the Oral Region: Thrush

Disease: It is a yeast infection that is common in infants, elderly patients, and immunosuppressed individuals.
White, creamy patches occur on the tongue, mucous membranes, and the corners of the mouth.

Causative agent: Candida albicans

Fungal Infections of the CNS (Central Nervous System): Crytococcosis (Cryptococcal Meningitis)

Disease: It starts as a lung infection but spread via the bloodstream to the brain. It usually presents as a subacute
or chronic meningitis. It is common infection in acquired immunodeficiency syndrome (AIDS) patients.

Causative agents: Cryptococcus neoformans – an encapsulated yeast

Adhere to mucosal surfaces and avoid phagocytosis (recall the stages of phagocytosis) by white blood cells

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Reservoir: Pigeon nests; pigeon, chicken, turkey, and bat
droppings; solid contaminated with bird droppings/ Transmission:
Inhalation of yeasts Cryptococcus is not
transmitted from person
to person or animal to
III. PARASITOLOGY person
Malaria

Causative agent: Plasmodium species - most important parasitic

disease in man
MOT: Bite of infected female mosquito (Anopheles minimus flavirostris)
Transplacental transmission; blood transfusions; intravenous drug

Infective stage: Sporozoites

Diagnostic stage: Trophozoites (ring forms)

FEEDBACK EXERCISE:

1. What is the most important virulence factor of M.

tuberculosis? Cord factor
2. It is also known as the energy parasites:
Chlamydia trachomatis

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CHECK FOR UNDERSTANDING (10 minutes)

1-3) Cite precautionary measures/preventions of the hepatitis virus:

HAV – The best way to prevent HAV is to practice good hygiene, especially washing hands. As well as
getting vaccinated, it the best and most effective way to keep you from getting Hepatitis A.
HBV – To best way to prevent Hepatitis B is by getting fully vaccinated. Another way of prevention is by
using condoms as well as practicing good hygiene by washing hands thoroughly.
HCV – The best way to prevent Hepatitis C, is by avoiding direct exposure to blood or blood products,
never share [personal care items, never share needles, and practice safe sex.

4-5) Differentiate Malaria from Dengue: (Cite at least two differences)

Both Dengue and Malaria have different vectors (Malaria: Anopheles mosquito); (Dengue: Aedes aegypti).
Malaria is caused by a PARASITE (Plasmodium falciparum) while Dengue is caused by a VIRUS (Dengue
Virus).

6. Statement 1: AIDS is the causative agent of HIV.

Statement 2: HIV can be transmitted by sexual intercourse only.
A. Statement 1 is true; statement 2 is false
B. Statement 2 is true; statement 1 is false
C. Both of the statements are true
D. Both of the statements are false
Answer: D

7. Which of the following pertains to Cryptococcus neoformans?

A. Causative agent of fungal meningitis
B. Flagellated, non-capsulated microorganism
C. Transmitted via a bite of an Anopheles mosquito
D. Viral strain that causes flu-like syndrome among infected individuals.
Answer: A

8. Statement 1: Adenovirus transmission may be associated with poorly chlorinated swimming pools;
Statement 2: HSV may also cause keratoconjunctivitis
A. Statement 1 is true; statement 2 is false
B. Statement 2 is true; statement 1 is false
C. Both of the statements are true
D. Both of the statements are false
Answer: C

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9-10. Critique this news headline based on your scientific knowledge.
Guide questions:
(1) Why is an influenza vaccine recommended by health experts?
(2) What is the relationship of the aforementioned vaccine to the SARS-CoV-2 or COVID-19 infection?

Answer:
(1)Getting the flu vaccine has a lot of benefits. It can reduce for an individual to have flu illnesses,
especially since flu viruses evolve so quickly. (2) Although a flu vaccine is available, and should be taken
annually, it does not protect against all strains of influenza virus or even COVID-19. There is no vaccine to
prevent colds.

RATIONALIZATION ACTIVITY
The instructor will now rationalize the answers to the students. You can now ask questions and debate among
yourselves. Write the correct answer and correct/additional ratio in the space provided.

1. ANSWER: ________
2. ANSWER: ________
3. ANSWER: ________
4. ANSWER: ________
5. ANSWER: _________
6. ANSWER: _________
7. ANSWER: _________
8. ANSWER: _________ 9-10. ANSWER:
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LESSON WRAP-UP (5 minutes)

Teacher directs the student to mark (encircle) their place in the work tracker which is simply a visual to help
students track how much work they have accomplished and how much work there is left to do. This tracker will be
part of the student activity sheet.

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 - END -

MICROBIOLOGY MODULE
Prepared by: Kate C. Lim, RMT, (BCHPEd) DHPEd
Microbiology and Parasitology Professor
Southwestern University PHINMA

Email: kclim@swu.phinma.edu.ph

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