Adenovirus

Introduction Isolated from human adenoid cell culture.

Naked capsid (resist drying and GIT); Act as VAP
Cause wide range of Dz: bind same glycoprotein Ig family receptor as Coxsackie B virus
Used as a vector for gene therapy
“Weeds of virological garden”
Very important in respiratory problems.
Pathogenesis Infect epithelial cells lining respiratory and enteric organs + eyes.
3 outcomes:
1. Lytic infections in mucoepithelial cells
2. Latent infections in lymphoid tissues
3. Transforming infectons (not in humans)
Immunity & Immunity:
Epidemiology Abs: resolve lytic infections; CMI: limit viral spread
Epidemiology:
Naked capsid stable
Spread: fecal-oral, fomites, poorly chlorinated swimming pools
Only human to human spread; most infections are asymptomatic
Clinical 1. Acute febrile pharyngitis & pharyngconjunctival fever Pharyngitis (rapid strep test to confirm it is NOT Strep. Throat); m/c’ly mild URI with fever,
Syndromes rhinorrhea and cough. #4 viral respiratory Dz in children!
EXAM:
#1 RSV
#2 Parainfluenza Virus
#3 Rhino Virus
#4 Adenovirus
2. Acute respiratory disease Fever, cough, pharyngitis, cervical lymphadenopathy
3. Other Respiratory Diseases: Atypical Pneumonia; Laryngitis, croup, bronchiolitis (pertussis-like illnessEXAM: DDX with borditella pertussis and
mycoplasm pneumonia)
4. Conjunctivitis and Epidemic keratonconjuctivitis “shipyard eye” swimming pools, dust/debris (DDX: hemorrhagic conjunctivitis from Coxsackie
A)
5. Gastroenteritis 2nd only to rotaviruses as cause of acute gastroenteritis in children;!
#1 Rotavirus
#2 Adenovirus
- Chronic diarrhea in HIV/AIDS
6. Systemic infection in immunocompromised Less risk than HSV
7. Other diseases intussusception in young children
Lab Dx/ Tx/ Lab Dx:
Control Sample must be taken from site.
Culture: Characteristic cytopathological effects (CPE) grape like clusters after 6-20days
Microscopy: dark, dense, intranuclear inclusion bodies in infected epithelial cells similar to “Owl’s eye inclusion bodies in CMV but no cytomegaly)
Lab: ↑ed CRP (c-reactive protein) unique to viruses-similar to bacteria
Tx/ Control: Gene replacement therapy low pathogenic potential (use as vectors for treating disease like CF and tissue engineering of bone.

Human Papilloma Virus

Introduction Family papoviridae; 2 Genus
1. Papilloma (nipple like tumour): I. Cutaneous: verruca (warts); II. Mucosa: genital, oral, conjuctival papillomas, cervical CA
2. 2. Polyoma
Small; non-enveloped
Pathogenesis Cause lytic, chronic, latent or transforming infections (HSV also causes all 4 types)
Access through breaks in skin and mucosa; persistant infection that becomes active as keratinocytes differenciate (by inactivating tumour suppressor genes)
Transformation d/t:
HPV 16 & 18 binding and inactivating tumour suppressor molecules like p53 and p105RB.
NEED A COFACTOR! (ex: sex, smoking, ↓ folic acid)
Epidemiology Naked capsid;
transferred by fomites need direct contact with small break in the skin/mucosa (like rabies); also transferred as an STD, infected birth canal or by chewing
warts.
One of the most common STDs; Most prevalent STD but not as known as Chlamydia and Gonorrhoea.
Clinical 1. Common flat warts (verruca plana or verruca vulgaris):
Syndromes Hands and feet: surface is studded with black dots (thrombosed capillaries) way to DDX with mulluscum contagiosum
M/C’ly painless; but plantar is b/c it grows inwards and is on the points of maximal pressure.
2. Oral papillomas: ↑ed incidence if HIV+
3. Laryngeal papillomas:
M/C epithelial tumour in the larynx HPV 6 & 11; bimodal children (d/t infected birth canal) & adults (orogenital sex)
S & Sx: Hoarseness or abnormal cry; can be life threatening in children!
4. Condyloma acuminate (genital/venereal warts):
HPV 6 & 11; STD, vaginal birth or other?; rarely regress spontaneously like ones on hands and feet.
5. Cervical Dysplasia and cervical CA:
2nd m/c cancer in ♀ in US genome correlation (not causation) in 90% of cervical neoplasms
HPV 16 & 18; NEED A COFACTOR TO PROGRESS TO CA reason why vaccine may not be a cure all.
Lab Dx/ Tx/ Microscopy: PAP smear presence of Koilocytes (enlarged keratinocytes with clear halos); Topical: 5% acetic acid (vinegar) whitening of epithelium (not
Prevention specific for HPV); PCR and DNA probes.