Lecture 22 - Respiratory Viruses
1. General Concepts
- Variation in severity depends on age, previous infection, and immune status
- Specific viruses associated with specific syndromes and seasonal variation
- Routes of transmission are from contaminated secretions or aerosol ingestion
2. Influenza Virus
- 6th leading cause of death
- Hemagglutinin: stick to receptors on respiratory epithelial cells
- Neuraminidase: eats away neighbor receptors decreasing the number of times other virions can affect the same cell
- Vaccine is a mix of hemagglutinin and neuraminidase protein
- Replicative cycle: adsorption --> penetration --> uncoating --> traverse membrane --> replication --> hemagglutinin and neuraminidase made --> viral assembly --> hemagglutinin and neuraminidase inserted --> virus buds off
- Signs and symptoms of influenza: fever above 100 degrees, non-productive cough, chills and/or sweats, headache, myalgia, sore throat, malaise, substernal soreness, photophobia, and ocular problems
- Complications: pneumonia, exacerbation of asthma, myocarditis, pericarditis, meningitis, encephalitis, Reye syndrome, Guillain-Barre syndrome, myositis, myoglobinuria
- Peak influenza activity in January and February
- Antigenic drift: minor change in antigenicity due to mutations in genes coding for hemagglutinin or neuraminidase
- Antigenic shift: acquisition of new gene coding for hemagglutinin or neuraminidase
- Control influenza with vaccination, treatment and prophylaxis with antiviral agents
- Treatment
- M2 (only found on Influenza A) inhibitors: amantadine and rimantadine
- Neuraminidase inhibitors: zanamivir and oseltamivir
- Shorten illness by 1.5 days when used for treatment
3. Adenovirus
- Can cause pharyngitis, pneumonia, pertussis-like syndrome, keratoconjunctivitis, meningoencephalitis, gastroenteritis
4. Parainfluenza Viruses
- Types I and II cause fall epidemics
- Type III is endemic
- Causes croup, pneumonia, and bronchiolitis
5. Rhinovirus
- Picornavirus with >100 serotypes
- No cross protection between strains
- Spring, autumn peak activity
- Causes common cold with potential sinusitis, otitis media, and asthmatic bronchitis complication
6. Coronavirus
- Cause of upper respiratory infection and rarely lower respirator tract illness
- Respiratory spread from person to person
- Accounts for 15% of adult upper respiratory illnesses
- Identified as agent of SARS
7. Respiratory Syncytial Virus
- #1 cause of hospitalization in first year of life
- By 2 years of age, 100% of individuals infected
- In most, infection confined to upper respiratory tract and does not cause bronchiolitis (cannot get oxygen in and out of alveoli) B. 0-2 months: apneic spells
- 2-24 months: cough, rhinorrhea, wheezes, tachypnea
- >2 years: acute asthmatic bronchitis
- Adults: fever, cough, rhinorrhea

