TRANS 2: ARBOVIRUS - Arthropod-Borne virus - 500 viruses transmitted by mosquito, ticks, flies Replication: - Arthropod eats blood of an infected

mammal or bird - Virus replicated in the gut wall - Travels to the salivary gland - Replicates in the salivary gland - (1-2 wks) arthropod becomes infectiuos **Some are capable of transovarian transmission ! HUMANS are ACCIDENTAL HOSTS - virus is capable of multisystem infections > replicate in the vascular endoth., CNS, muscles, skin > can cause arthritis ! IMPT ARBOVIRUSES IN THE PHILS: - Chikungunya, Dengue, Japanese B. encephalitis

Flaviviridae - ssRNA, enveloped, icosahedral - St. Louis enceph, West Nile virus -> encephalitis -> birds - Dengue, Yellow fever -> hemorrhagic fever (both mosquito) Bunyaviridae - ssRNA, enveloped, helical - La Cross virus -> fever -> small mammals Togaviridae - ssRNA, enveloped, icosahedral - Eastern Equine Encephalitis Virus, Western EEV, Venezuelan EEV -> encephalitis -> birds Reoviridae - dsRNA, naked, icosahedral - Colorado Tick fever -> ticks -> none _________________________________________________ CHIKUNGUNYA (Ross, 1953) - Togaviridae: fairly self-limiting - common manifestations: abrupt onset of high fever, arthralgia, pain in posture - Vector: Culicine (Culex) mosquitoes, w/ some Aedes - (+)ssRNA, icosa, enveloped w/ 3-4 STRUCTURAL POLYPEPTIDES - Budding - Inactivated easily by: acid, heat, lipid solv, detergents, phenol, alcohol, fo rmaldehyde - commonly seen in Africa & Asia

_________________________________________________ Transmission - Vector: Culicine mosquito w/ some Aedes - Reservoirs: monkeys, vertebrates, cattle, rodents, men - Mother-child transmission _________________________________________________ Pathogenesis inoculation of virus-> replication in lymphoid & myeloid tissues-> spread to org ans-> activation of HIR & CMIR _________________________________________________ Clinical features: Acute onset IP: 4-7 days Triad of symptoms: FAR- fever(>40deg), rash, arthralgia w/myalgia ! severe in infants because of lack immune system Tests: -Suspected: acute illness -Probable : positive serology with serum from acute/conv stage -Confirmed: 4-fold HI Ab diff, IgM detection, virus isolation, chik. virus nucle ic acid in sera _________________________________________________ MANAGEMENT - self-limiting, only supportive treatment - mortality is rare - some may require hospitalization _________________________________________________ PH measures - monitoring of fever cases - vector surveillance and control _________________________________________________ DENGUE Flaviviridae: (+)ssRNA, icosahedral, enveloped (lipid) 4 SEROTYPES: Dengue 1,2,3,4 Aedes aegypti, Aedes albopictus tropical & subtropical countries

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> VIRULENCE attachment of virus to specific receptors -> Ig attaches to FC receptors on macr ophage & monocytes _________________________________________________ > LIFE CEYCLE dengue virus enters by receptor-mediated endocytosis fusion of envelope to host membrane capsid enters cytoplasm structural proteins are made, RNA copied > assembly > budding CELL LYSIS

_________________________________________________ > PATHOGENESIS Dengue virus can cause either: lytic infection or persistent infection CYCLE OF TRANSMISSION - female mosquito acquires virus from infected blood - virus infects midgut - spreads to salivary gland (persistent infxn) - virus replicates in salivary gland - female regurgitates virus with saliva - virus circulates transiently in plasma - virus replicates in the lymph nodes _________________________________________________ MANIFESTATIONS IP: 5-6 days 3 types of manifestations - asymptomatic - CLASSICAL DENGUE - assoc with nonspecific illness _________________________________________________ CLASSICAL DENGUE - Triad of Symptoms: Fever, Erythematous rash, Severe myalgia - Clinical course abrupt onset of high fever-> myalgia-> rash-> temp back to normal-> 2nd rash in face, limbs, trunk-> fever abates-> resolves in the 2nd week _________________________________________________ DENGUE HEMORRHAGIC FEVER

- occurs when there is reinfection with a related strain - symptoms include: rupture of vasculature, DIC, loss of plasma 4 Clinical grades of DHF severity: I: fever II: I + spontaneous bleeding in skin, gums, GIT III: II + circulatory failure & agitation IV: III + profund shock, BP unobtainable _________________________________________________ Diagnosis, Treatment, Prevention -Treatment: supportive -control of mosquito vector _________________________________________________ JAPANESE B ENCEPHALITIS Flaviviridae: leading cause of encephalitis in ASIA a high proportion are subclinical (esp in children) often severe and fatal VECTOR: Culex tritaeniorhynchus

IP: 5-15 days - mostly asymptomatic - severe _________________________________________________ Viral Proteins - Envelope (E) protein: protectve Ag - NS proteins: NS1, 2a, 2b, 3, 4a, 4b, 5 Vector: Culex tritaeniorhynchus- seen in rice fields, marshes _________________________________________________ Vertebrate hosts: PIGS, birds, horses, HUMAN