Microbiology

presentation on
Mumps, Measles
&
Poliovirus

Prepared by Group 7

Group Members
Name
ID. No
1. Alemu Negi
MEDR- 08/06
2. Bitewu Arage
MEDR- 12/06
3. Eyayou Chanie
MEDR- 18/06
4. Meseret Wube
MEDR- 28/06
5. Sirak T/Mariam
63/04
3

MEDR-

Outline
Introduction to virus

Mumps, Measles and Poliovirus

Epidemiology
Pathogenesis
Manifestations
Immunity
Complications
Diagnosis
Prevention and Treatment
References

Introduction
A virus is an infectious agent that is minimally

constructed of two components:

Genome consisting of either RNA or DNA, but not both,

and
Protein-containing structure (capsid)

Many viruses have additional structural features.

E.g. an envelope composed of a protein-containing lipid
bilayer, whose presence or absence further
distinguishes one virus group from another.

A complete virus particle combining

structural elements is called a virion.

these

 The pathogenicity of a virus depends on a

great variety of structural and functional

characteristics.

1. Mumps
Mumps virus is a paramyxovirus
It contains single-stranded, negative-sense

RNA surrounded by an envelope.

There are two glycoproteins on the surface
of
the
envelope;
one
mediates
neuraminidase
and
hemagglutination
activity, and the other is responsible for
lipid membrane fusion to the host cell.

Model of

Mumps

Epidemiology
Has high frequency in the 5 -15 year age group.
The

disease
is
communicable
from
approximately 7 days before until 9 days after
onset of illness; however, virus has been
recovered in urine for up to 14 days following
onset.
Virus can be transmitted by direct contact, air
borne droplets, or fomites contaminated with
saliva or urine
The highest incidence of infection is usually
during the late winter and spring months, but it
can occur during any season.
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Mumps

Pathogenesis
Humans are the only natural hosts for

mumps virus.
Primary replication occurs in nasal or upper
respiratory tract epithelial cells.
Viremia then disseminates the virus to the
salivary glands and other major organ
systems.
The incubation period may range from 2
weeks to 4 weeks but is typically about 14
18 days.
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Mumps
Pathg
Virus is shed in the saliva from about 3 days

before to 9 days after the onset of salivary

gland swelling.
The central nervous system is also commonly
infected and may be involved in the absence
of parotitis.
It is difficult to control transmission of mumps
because of the variable incubation periods,
the presence of virus in saliva before clinical
symptoms develop, and the large number of
asymptomatic but infectious cases.
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Mumps

Immunity
The early antibody response is predominantly

with IgM, which is replaced gradually over

several weeks by specific IgG antibody.
The latter persists for a lifetime but can often
be detected only by specific neutralization
assays.
Immunity is associated with the presence of
neutralizing antibody.
After
primary
infection,
immunity
to
reinfection is virtually always permanent.
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Mumps

Manifestations
After an incubation period of 12 to 29 days

(average, 16 to 18 days)- fever and

swelling with tenderness of the salivary
glands, especially the parotid glands.
Swelling may be unilateral or bilateral and
persists for 7 to 10 days.
All appear to be a direct result of virus
spread to other sites and illustrate the
extensive tissue tropism of mumps.

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Mumps

Complications
Mild meningitis
Severe Encephalitis .
Pancreatitis
Orchitis
Oophoritis- usually benign inflammation of the

ovarian glands.

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Mumps

Diagnosis
Mumps virus can be readily isolated from the

saliva, pharynx, CSF, and urine.

Rapid diagnosis can be made by direct
detection of viral antigen in pharyngeal cells or
urine sediment.
The
usual serologic tests are enzyme
immunoassay
(ELISA)
and
indirect
immunofluorescence to detect IgM- and IgGspecific antibody responses.
Other serologic tests are, complement fixation,
hemagglutination
inhibition,
and
neutralization(most sensitive).
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Mumps

Prevention
No specific therapy is available.
Live attenuated vaccine (1967) available.
It is commonly combined with measles and

rubella vaccines (MMR) and given as a

single injection at 12 to 15 months of age.
Duration of immunity, especially if the twodose regimen is followed, appears to be
more than 25 years and may be lifelong.

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2. Measles
Measles

virus is classified in the

paramyxovirus family, genus Morbillivirus.
It contains linear, negative-sense, singlestranded RNA.
Measles infections often produce severe
illness in children, associated with high
fever, widespread rash, and transient
immunosuppression.
This condition remains a major cause of
mortality among children in developing
countries.
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Measles

Epidemiology
In

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developing nations it is common in

children below 5 years.
In developing countries an estimated 1
million children still die from this disease
each year.
Transmission is mainly by respiratory route.
Epidemics tend to occur during the winter
and spring.
The period of communicability is 3 to 5 days
before appearance of the rash to 4 days
afterward.

Measles
Pathogenesis
It replicate in the upper respiratory tract mucosal

epithelium, which results in disruption of the

cellular
cytoskeleton,
chromosomal
disorganization, and the appearance of inclusion
bodies within the nucleus and cytoplasm.
Replication is followed by viremic and lymphatic
dissemination throughout the host(lymphoid
tissues, bone marrow, abdominal viscera, and
skin.)
Virus can be demonstrated in the blood during the
first week after illness onset, and viruria persists
for up to 4 days after the appearance of rash.
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Measles
Immunity
Cell-mediated immune responses to other antigens

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may be acutely depressed during measles infection and

persist for several months.
Measles
virus-specific
cell
mediated
immunity
developing early in infection mediates some of the
features of disease(rash), and promote recovery from
the illness.
Antibodies appear in the first few days of illness, peak
in 2 to 3 weeks, and then persist at low levels.
Immunity to re-infection is lifelong and is associated
with the presence of neutralizing antibody.
Defects in cell-mediated immunity, infection is
prolonged and complications such as progressive viral
pneumonia are common.

Measles

Manifestations
Synonyms- rubeola, 5-day measles
The incubation period-7 to 18 days.
A typical illness begins 9 to 11 days after

exposure,
with
cough,
coryza,
conjunctivitis, and fever.
Within a day of the appearance of Kopliks
spots, the typical measles rash begins, first
on the head, then on the trunk and
extremities.
The rash persists for 3 to 5 days before
fading.
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Measles can be very severe, especially in

Measles

Complications
5-15%, bacterial superinfection.
Encephalitis
Abdominal

pain and acute appendicitis

secondary to inflammation and swelling of
lymphoid tissue.

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Measles

Diagnosis
Based on clinical findings (presence of

Koplik spots ),
If rapid diagnosis is desired, measles
antigen may be identified in urinary
sediment or pharyngeal cells (ELISA)

Treatment
No specific therapy is available

Supportive
measures
and

observation of complications
Live attenuated measles vaccine
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close

Measles

Prevention
Live,

attenuated measles vaccine most

commonly administered as MMR.
The vaccine should be given to infants of
12-15 months of age.

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3. Polioviruses

Poliovirus

is the
most intensively studied
picornavirus (Positive strand RNA virus).
They are small, naked (nonenveloped), icosahedral
viruses, which contain a single-stranded, nonsegmented RNA genome and four structural
proteins.

24

Poliovirus, a type of picornavirus, is

one of the simplest and smallest
viruses.

 Three serotypes of poliovirus (1, 2, and3)

but no common antigen.

Have identical physical properties but
only share 36-52% nucleotide homology.
Humans are the only susceptible hosts
Polioviruses are distributed globally

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Epidemiology
Important

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causes of disease in developed

temperate zone countries(19th C)
Children are most susceptible
Humans are only reservoir of infection
Crowded conditions, poor hygiene and
sanitation favors the transmission
It is mainly transmitted by contaminated water
with drinking water

Polioviruses

Pathogenesis
Following ingestion, the virus multiplies in

the oropharyngeal and intestinal mucosa.

Polioviruses reach CNS by crossing BBB
Motor neurons are particularly vulnerable
to infection
The
histopathologic findings in the
brainstem and spinal cord include necrosis
of neuronal cells and perivascular cuffing
by infiltration with mononuclear cells,
primarily lymphocytes.
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Polioviruses

Manifestations
Incubation

period-4 to 35 days, but is

usually between 7 and 14 days.
Three types of disease can be observed.
Abortive poliomyelitis; is a nonspecific
febrile illness of 2- to 3-day duration
Aseptic
meningitis
(nonparalytic
poliomyelitis); meningeal irritation (stiff
neck, pain, and stiffness in the back)
Paralytic poliomyelitis; occurs in <2%
of infections.
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Diagnosis
Virus Isolation
Mainstay of diagnosis of poliovirus infection
Can be readily isolated from throat swabs, faeces,
and rectal swabs.
It is rarely isolated from the CSF
Can be readily grown and identified in cell culture
Requires molecular techniques to differentiate
between the wild type and the vaccine type.
Serology
Very rarely used for diagnosis since cell culture is
efficient.
Occasionally used for immune status screening for
immuno-compromised individuals.
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Polioviruses

Prevention
No specific antiviral therapy is available. However

the
disease
may
be
prevented
through
vaccination. There are two vaccines available
Inactivated polio vaccine (IPV);
decrease
paralytic cases, SC.
Oral polio vaccine (OPV); it is live attenuated

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References

1.Sherris; Medical Microbiology, 4th Edition

2. Jawetz; Melnick, & Adelberg's- Medical
Microbiology, 24th Edition
3. Harrisons; Principles of Internal medicine
18th ed.
4. Buruner; Medical Surgical Nursing 10th ed.

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