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Viruses causing respiratory infections. Influenza viruses. Paramyxoviruses. Measles and mumps viruses. Vinnitsa National Pirogov Memorial Medical University / Department of microbiology. Classification of an Orthomyxoviridae.
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Viruses causing respiratory infections. Influenza viruses. Paramyxoviruses. Measles and mumps viruses. Vinnitsa National Pirogov Memorial Medical University / Department of microbiology
Classification of an Orthomyxoviridae Family Orthomyxoviridae includes three pathogenic for human species: • Influenza virus A • Influenza virus B • Influenza virus C
Antigenic structure of influenza virus Internal antigens (S-antigen) • Ribonucleoprotein (RNP) • M-protein from inner layer of envelope External antigens (V-antigen) • Hemagglutinin (HA) • Neuraminidase (N)
Antigenic variation of influenza virus • Antigenic variability may be of two different types: • Antigenic drift • Antigenic shift
Epidemiology of the flu • The source of infection may be: • Infected person • Wild and domestic birds • Domestic animals • Characteristics of the viruses have caused the most famous pandemics: • In 1917-1919 “Spanish flu” was caused by A (H1N1) virus • In 1957 “Asian flu” was caused by A (H2N2) virus • In 1968 “Hong Kong flu” was caused by A/Hong Kong (H3N2) • In 1977 “Red flu” was caused by A (H1N1) • From 1968 and 1977 pandemics both types (H1N1 and H3N2) have been circulated together
Endemic influenza annually in the US1 • 5% to 20% of the population gets the flu • More than 200,000 people are hospitalized from flu complications • About 36,000 people die from flu • Avian Influenza, cumulative data2 • 379 cases reported, 239 deaths (63%) • 2008: 28 cases / 22 deaths • 1http://www.cdc.gov/flu/keyfacts.htm • 2APR 08, WHO
Avian Influenza, cumulative data2 379 cases reported, 239 deaths (63%) 2008: 28 cases / 22 deaths
Laboratory diagnostics • Collected samples are nasal or throat swabs, nasal or throat washing, sputum, nasal prints • Rapid tests are based on the demonstration of the virus antigens in the collected material. They include: • Direct immunofluorescence • Reversed indirect hemagglutination test (RIHA) • FLU OIA and QUICKVUE Influenza Test are based on detection of the viral antigens with monoclonal antibody • ZSTATFLU is based on detection of viral neuraminidase with colored substrate of the enzyme
Laboratory diagnostics • Microscopy • Isolation of the virus (culture or virological method) • Serology (serological method)
Laboratory diagnostics of the flu Immunofluorescence Virus inoculation into chicken embryo
Specific prophylaxis • Specific prophylaxis is immunization with subunit influenza vaccines 3-4 weeks before predictable onset of epidemic (Fluarix, Influvac, Vaxigrippe, Grippol and others).
Paramyxoviruses • Family Paramyxoviridae • Subfamily Paramyxovirinae includes three genera: • Respirovirus (four serotypes of parainfluenza viruses) • Morbillivirus (measles virus) • Rubulavirus (mumps virus) • Subfamily Pneumovirinae contains one genus Pneumovirus (respiratory syncytial virus)
Antigenic structure and biological features Outer antigens:HN and F Inner antigens:RNP and M-protein
Epidemiology and pathogenesity Parainfluenza viruses cause croup (acute laryngotracheo-bronchitis), laryngitis, brochiolitis and pneumonia in children and a disease resembling the common cold in adults. They are responsible for 50-80% of respiratory tract infections Measles virus causes measles Mumps virus causes mumps The source of infection is an ill person Paramyxoviruses are transmitted via respiratory droplets (airborne diseases)
Laboratory diagnostics • Rapid tests: • Immunofluorescence test • Cytoscopy • Culture method • Serological investigation
Treatment and prophylaxis Prophylaxis is made by immunization with alive attenuated vaccine For current prophylaxis in pregnant women, children with immunodeficiency anti-measles and normal human immunoglobulin are used
Mumps: clinical findings and immunity • Mumps is acute infectious disease commonly affecting children and characterized by nonsuppurative enlargement of parotid glands
Laboratory diagnostics • Virus isolation (culture method) • Serological tests Prevention of mumps may be done with alive attenuated vaccine Current prophylaxis is possible with either alone vaccine (active immunization) or normal human immunoglobulin (passive immunization)
Parainfluenza virus • Type 1 and type 2 cause croup ( acute laryngotracheobronchitis) in children • Type 3 cause tracheobronchitis, bronchiolitis and pneumonia in children before 5 years. • Type 4 provokes mild respiratory infections Laboratory diagnosis is based on virus isolation from throat and nasal swabs. Serological tests with paired sera can confirm diagnosis by 4-fold and greater rising of antibody titer