RNA Viruses

Annotations:

• quick note - arboviruses use ticks, mosquitoes, and flies to infect - include toga, flavi, and bunyaviridae 

1. Picornavirus
   1. Enterovirus

      Annotations:

      • mcc of aseptic meningitis especially in kids remember fungal meningitis mcc is cryptococcal
      1. Rhinovirus

         Annotations:

         • most common cause of hospitalizations in children. second mcc of bronchiolitis vaccine not feasible common cold.
      2. Coxsackie

         Annotations:

         • cav - herpangina (EV7) - always on posterior end of mouth (herpes leaves lesions on anterior mouth); exanthem and enanthem stuff CA16 - hand foot mouth (ev71) cbv - myocarditis and pericarditis
      3. Poliovirus

         Annotations:

         • 1 2 3  2 is pretty much gone. ev71 also cause polio. fecal oral. vaccines - opv ipv (we use ipv-inactivated) opv can cause disease (live)
      4. Echovirus
   2. Hepatovirus

      Annotations:

      • hep a vaccine preventable.  not that bad.
   3. Parechovirus
   4. Kobuvirus

      Annotations:

      • aiichi - diarrhea
2. Coronavirus

   Annotations:

   • sars mucosally restricted new outbreak in saudi arabia 5/2013 mainly causes respiratory ilness; can cause GI issues in infants. no vaccine.
3. Flaviviridae

   Annotations:

   • ixodes ticks - encephalitis these all cause encephalitis and hemorrhagic or normal fever.
   1. Japanese Encephalitis Virus Group

      Annotations:

      • JEV - vaccine preventable St. louis encephalitis West nile virus
   2. Yellow Fever Virus

      Annotations:

      • vaccine preventable. can be pretty darn serious. black vomitus
   3. Dengue Fever

      Annotations:

      • 4 serotypes. lifelong immunity if you get it. SOME cross reactivity.  no vaccine. 4 types of fever and rash: undifferentiated, classical hemorrhagic dengue shock
   4. Hepacivirus - Hep c
4. Astrovirus

   Annotations:

   • diarrhea. adenovirus 41 40 also cause diarrhea
5. Calicivirus

   Annotations:

   • smaller than rotavirus in size.
   1. Norovirus

      Annotations:

      • fluids and electrolytes. less severe than rota in children watery diarrhea.just wash your hands.cruise ship virus
6. Togaviridae
   1. Alphaviridae

      Annotations:

      • old world - chikungunya new world - WEEV, EEEV, VEEV no treatment. just supportive. essentially - chikungunya = rash
   2. Rubivirus

      Annotations:

      • rubella - mmr live vaccine. cataracts cardiac problems not an arbovirus - spread person to person congenital - dangerous during 1 tm of pregnancy only.

1. Orthomyxoviridae

   Annotations:

   • segmented boar
   1. Influenza A B C

      Annotations:

      • Na inhibitors - oseltamivir, zanamivir (>7 years old; inhaled, works better than oseltamivir) M2 ion channel inh (type A only) -  amantidine, rimantidine; current strains aren't susceptible. all HA's transmitted through water fowl parabasic region - makes virus "high path"
2. Paromyxoviridae
   1. Mucosally restricted
      1. Parainfluenza

         Annotations:

         • croup steeple sign. NOT epiglottitis (HITB) odd years have outbreaks use steroids to prevent closing of trachea
      2. hMPV
      3. RSV

         Annotations:

         • number one cause of bronchiolitis try ribavirin but really use synagis (mAB) need 10x more antibody for nose infection than lung infection.
   2. Systemic
      1. Morbillivirus - measles

         Annotations:

         • koplik's spots rash everywhere very infectious - can be lethal mmr - vaccine.
      2. rubulavirus - mumps

         Annotations:

         • parotitis (can be any gland really) isolate individual.  mmr - live vaccine.
3. Rhabdoviridae

   Annotations:

   • Rabies - vaccine 3 times before exposure. causes unstoppable encephalitis. bullet shaped virus. negri bodies. in texas - skunks and bats. 
4. Filoviridae

   Annotations:

   • fruit bats hemorrhagic fever
   1. Marburgvirus
   2. Ebolavirus
5. Bunyaviridae

   Annotations:

   • segmented boar
   1. Bunyavirus

      Annotations:

      • California encephalitis lacross
   2. Hantavirus

      Annotations:

      • HFRS - hantaan and seoul use ribavirin HPS - sin nombre virus. deer mouse and cotton rat. variants named by location. progresses quickly.
   3. Phlebovirus

      Annotations:

      • sandfly. rift valley fever
   4. Nairovirus

      Annotations:

      • tick borne crimean congo hemorrhagic fever use ribavirin for cchf
6. Deltavirus

   Annotations:

   • hep d?

1. Arenaviridae

   Annotations:

   • segmented boar
   1. LCM

      Annotations:

      • aseptic meningitis
   2. Lassa Fever

      Annotations:

      • hemorrhagic nausea, vomiting, diarrhea use ribavirin

1. Reoviridae

   Annotations:

   • segmented boar
   1. rotavirus

      Annotations:

      • watery diarrhea. 2 live vaccines; intussusception risk number 1 cause of diarrhea in developing countries. destroy the villi after 12 hours as seen on biopsy.
   2. coltivirus

      Annotations:

      • colorado tick fever
   3. reovirus
   4. orbivirus