RESPIRATORY VIRAL

INFECTION
MICROBIOLOGY UNIT

TYPES OF RESPIRATORY VIRUS

. Adenovirus
.Influenza virus
.Parainfluenza virus
.Rhinovirus
.Respiratory Syncytial Virus (RSV)
.Coronavirus
.Human Metapneumovirus

1.ADENOVIRUS
Family : Adenoviridae
Double-stranded, linear, snonenveloped DNA
Mastadenovirus are most genera that
infects human.
5% of acute respiratory disease in
young children
Rarely cause serious illness or death.
High risk : infants with weakened
immune system, existing cardiac or
respiratory disease.

CLINICAL MANIFESTATION

Acute febrile pharyngitis : Cough,stuffy nose fever and sore throat

Pharyngoconjunctival fever : symptoms of acute pharyngitis +

conjunctivitis

Acute respiratory disease : pharyngitis, fever, cough, malaisey

ADENOVIRUS
INCUBATION :
TRANSMISSION:
respiratory droplets
feco-oral route
contaminated formite.
LABORATORY DIAGNOSIS : fluorescent
antibody test

PREVENTION AND TREATMENT

No adenovirus vaccine available for general public.

A vaccine against adenovirus types 4 and 7 for U.S. military personnel

only.

Preventation by handwashing, cover mouth and nose while coughing

and sneezing, avoid contact with sick people and stay home if you are
sick.

No specific treatment.

RHINOVIRUS
CLINICAL FINDINGS

Family : Picornaviridae

Sore throat

Positive-sense (+), Single-stranded

linear RNA.

Runny nose

Sneezing

Isolated chiefy from the nose and

throat.

Cough

Coryza symptoms :

Other symptoms : headache, mild cough, chilly sensation, little/no

fever.

Secondary bacterial infection : acute otitis media, sinusitis, bronchitis,

pneumonitis, asthma exacerbations.

INCUBATION : 2-3 days

TRANSMISSION:
close contact;

hand to hand,

hand to eye contact.

LABORATORY DIAGNOSIS :
Nasopharyngeal aspirate :
immunofluorencent staining.

PREVENTION AND TREATMENT

Handwashing

No vaccine to prevent from common cold

INFLUENZA VIRUS
Family : Orthomyxoviruses

CLINICAL FINDINGS

3 types:

Influenza A

2 subtypes : hemagglutinin (HA) and

neuraminidase (NA)

Influenza B

Influenza C

Sudden onset of high great fever

Chills, rigor

Myalgia
Sore throat

Cough

Runny nose

Most will recovered in one week duration.

INCUBATION : short, 2 days (1-4 days).

TRANSMISSION:
Respiratory droplet

PREVENTION & TREATMENT

Tamiflu (Oseltamivir)

Relenza (Zanamivir)

Short distance airborne transmission

LABORATORY DIAGNOSIS :

Immunocompromised

Antigen Detection Immunofluorescence (IF) staining

Respiratory disease

Older >65yo

Molecular assay PCR method

Chilren < 2 yo

Antiviral

Given to high risk people

Influenza Vaccine

PARAINFLUENZA VIRUS
Family : Paramyxoviridae
(-), single-strands linear, enveloped RNA
Consists of 4 serotypes

CLINICAL SYMPTOM
PIVV TYPE 1 & 2

Major pathogen of severe respiratory tract

disease in infant and young children
May only involve nose and throat
May extensive and involve larynx and upper
trachea resulting croup
(laryngotracheobronchitis).

Croup symptoms : fever, hoarseness, barking cough, inspiratory

stridor

PIV TYPE 3

Bronchiolitis and pneumonia in infant and children

Mild upper respiratory illness in children and adult

PIV TYPE 4

TRASMISSION :
Large-droplet aerosols
Direct contact with secretion/fomites
INCUBATION : 2 to 6 days
LAB DIAGNOSIS :
Antigen Detection Immunofluorescence (IF) staining
Molecular detection reverse
transcriptase polymerase chain
reaction (RT-PCR)

TREATMENT AND PREVENTION

Preventation by handwashing, cover mouth and nose while coughing

and sneezing, avoid contact with sick people and stay home if you are
sick.

No specific treatment/vaccine.

RESPIRATTORY SYNCYTIAL VIRUS

Family : Paramyxoviridae
(-), single-strands linear, enveloped RNA
CLINICAL SYMPTOMS

Cause significant illness in young infants and

elderly people.
Affected 90% of infant and young children by
age of two. Peak incidence by infant age 6 weeks
to 6 months.
Most important cause of lower respiratory tract
illness in infants and children, as cause
bronchiolitis and pneumonia under 1 year of age.

febrile bronchitis in infants and older children (50-90%)

Common cold in adult

pneumonia in infants (95-40%)

bronchiolitis in very young babies.

1/3 complicated with acute otitis media

Prone to be severe in infants with cardio-pulmonary disease,

immunocompromised patient, bone marrow transplant patient.

Reinfection is common in both children and adults.

TRASMISSION :
Spread of large droplet
Contamination hand / surface
INCUBATION : 4 to 5 days
LAB DIAGNOSIS :
Antigen Detection Immunofluorescence (IF) staining

TREATMENT

Primarily on supportive care (eg removal of secretion, administration

of oxygen)

Passive immunization using monoclonal antibody (palivizumab)

premature infants / infants with chronic lung disease (to reduce
subsequent of hospitalization)

Aerosolised ribavirin given to infants with severe RSV infection.

HUMAN METAPNEUMOVIRUS (HMPV)

Family : Paramyxoviridae
(-), single-strands linear, enveloped RNA

CLINICAL SYMPTOM

Cause of bronchiolitis and pneumonia in

infant
Cause severe illness in
immunocompromised patient
Role in exacerbation of COPD in adult
and exacerbation of asthma in children.

Cough

Rhinorrhea

Wheezing

Fever

Dyspnea
Bronchiolitis

Pneumonia

HUMAN METAPNEUMONIA VIRUS (HMPV)

TRASMISSION :
unknown, presumed respiratory
droplets/airborne.
INCUBATION : 5 to 6 days
LAB DIAGNOSIS :
Antigen Detection Immunofluorescence (IF) staining
PCR

TREATMENT

Preventation by handwashing, cover mouth and nose while coughing

and sneezing, avoid contact with sick people and stay home if you are
sick.

No specific treatment/ vaccine.

CORONAVIRUS
Family : Coronaviridae
(+), single-strands linear, enveloped
RNA

CLINICAL SYMPTOMS

Second to rhinovirus to cause common

cold
SARS: 2002,southern China, kill 774
individual over 5000 before termination
2005.
MERS-COV:2012, 1st reported in Saudi
Arabia 2015 reported in 21 countries

Mild coryza to mild severe threatening pneumonia

Fever, rigor, dry cough, headache,

dyspnoea

Worsening lung function

Progressive chest xray changes

Mostly found in immunocompromised patient

CORONAVIRUS
TRASMISSION :
Human to human in close contact

TREATMENT

INCUBATION :
SARS : 6 days
LAB DIAGNOSIS :
PCR

No vaccine/treatment
isolation of sick patient

Supportive treatment.

SYNDROMES

MAIN
SYMPTOMS

INFANTS

CHILDREN

ADULT

Common Cold

Nasal
obstruction
Nasal
ddischarge

Rhino
Adeno

Rhino
Adeno

Rhino
Corona

Pharyngitis

Sore throat

Adeno
Herpes simplex

Adeno
Coxsackie

Adeno
Coxsackie

Laryngitis/crou
p

Hoarsenss,
barking
cough

Parainfluenza
Influenza

Parainfluenza
Influenza

Parainfluenza
Influenza

Tracheobronchit Cough
is

Parainfluenza
Influenza

Parainfluenza
Influenza

Influenza
Adeno

Bronchiolitis

Cough,dyspnea

Respiratory
syncytial
Parainfluenza

Rare

Rare

Pneumonia

Cough
Chest pain

Respiratory
syncytial

Influenza
Parainfluenza

Influenza
Adeno