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  1. 1. Enteroviruses<br />New Emerging Disease<br />April 2010<br />HuthayfaMujahed<br />
  2. 2. Outline<br />Introduction<br />Virus Properties<br />Clinical Aspects<br />Pathogenesis<br />Vaccines & Treatment<br />Epidemiology<br />
  3. 3. Introduction<br />Most common human pathogens.<br />Distribution world wild.<br />Usually cause mild fever.<br />Rarely progress to severe and fatal disease.<br />
  4. 4. Properties<br />Classification :<br /> Family : Picornaviridae<br /> Genus : Enterovirus<br /> 10 species <br />
  5. 5. Properties<br />2. Morphology :<br />Small 30 nm.<br />Icosahedral.<br />Non-enveloped.<br />60 protomers forms the capsid<br />- Variant VP = Different Ag serotypes.<br />
  6. 6. Properties<br />3. Genome :<br />+ssRNA<br />7500 b<br />(De Palma, et. al 2008 )<br />
  7. 7. Properties<br />4. Replication<br />EndocytosisCytoplasm Cell lysis<br />(Zoll, et. al 2009)<br />
  8. 8. Clinical Aspects<br />Symptoms :<br />Often NO symptoms.<br />Rash, Fever, Muscle aches, Common clod, flu-like.<br />Transmission :<br />Saliva, Blister fluid, stool, nasal mucus, and any thing contaminated with the virus. <br />
  9. 9. Pathogenesis<br />The University of Texas Medical Branch at Galveston, Pathogenesis of enterovirus infections 1996. <br />
  10. 10. Pathogenesis<br />Aseptic Meningitis<br />Less severe than bacterial meningitis.<br />Rarely fatal in people with normal immune systems.<br />Symptoms last from 7 to 10 days.<br />Completely recover within 2 weeks.<br />H. Enterovirus B species <br />
  11. 11. Pathogenesis<br />Hand Foot and Mouth Disease<br />causes fever, sores in the mouth, and a rash with blisters.<br />children <10 yr.<br />recover in 7–10 days.<br />Coxsackievirus A16<br />When pretty baby gets HFMD<br />
  12. 12. Lab Diagnosis<br />RT-PCR.<br />Recently Flow Cytometry .<br />
  13. 13. Vaccines<br />No vaccine, Good hygiene.<br />Treatment <br />No specific anti-viral agent.<br />
  14. 14. Epidemiology<br /> Centers for Disease Control and Prevention :Aseptic meningitis in Baltimore-USA during June 1 – September 30, 1998–2001.<br />
  15. 15. Epidemiology<br /> Centers for Disease Control and Prevention : Reported aseptic meningitis cases in Cuba, January through September 2000<br />
  16. 16. Epidemiology<br /> Centers for Disease Control and Prevention : Monthly distribution of aseptic meningitis incidence in Cuba 2000.<br />
  17. 17. Epidemiology<br /> Centers for Disease Control and Prevention : Total cases of HFMD and herpangina in Taiwan, March 19 to August 29, 1998.<br />
  18. 18. Epidemiology<br /> Centers for Disease Control and Prevention : Number of hospitalizations and severe cases of hand, foot, and mouth disease and herpangina in Taiwan, June-August, 1998 <br />
  19. 19. Epidemiology<br /> Centers for Disease Control and Prevention : Clinical features of HFMD in children admitted to hospital in southern Vietnam during 2005.<br />
  20. 20. Epidemiology<br /> Centers for Disease Control and Prevention : Monthly distribution of 387 cases of HFMD associated with isolation of either (CVA16) (214 cases) or (HEV71) (173 cases), southern Vietnam, 2005. <br /> March,2010 more than 77,000 cases of HFMD and 40 deaths were reported in China by CDC.<br />
  21. 21. References<br />Cordey. Samuel, Gerlach. Daniel, Junier. Thomas, Zdobnov. Evgeny M, Kaiser. Laurent, and Tapparel. Caroline. 2008. The cis-acting replecation elements define human enterovirus and rhinovirus species. RNA, 14:1568-1578.<br />De Palma. Armando M, Vliegen. Inge, De Clercq. Erik, Neyts. Johan. 2008. Selective inhibitors of Picornavirus replication. Medicinal Reasearch Reviews, 28:823-884. <br />Lin. Mong-Cheng, Chan. Yu-Jiun, Chen. Chun-Jen, Tang. Ren-Bin, and Wu. Keh-Gong. 2008. Epidemiology and diagnostic methodology for enterovirus infection, including cerebrospinal fluid analysis. MicrobioImmunol & infect, 41:450-455.<br />She. Rosemary C, Preobrazhensky. Sergey N, Taggar Edward W, Petti Cathy A, and BahlerDevid W. 2009. Flow cytometric detection and serotyping of enterovirus for the clinical laboratory. Jviromet, 162:245-250.<br />Zoll. Jan, Heus. Hans A, Kuppeveld. Frank J.M Van, and Melchers. Willem J.M. 2009. The structure-function relationship of the enterovirus 3’-UTR. Viruses, 139:209-216.<br />Centers for Disease Control and Prevention./<br />
  22. 22. When pretty baby gets HFMD…<br />Be a virus, see the world<br />