Oleh :

Dr.dr.Efrida Warganegara, M.Kes., Sp.MK

Spheric or pleomorphic ; 150-300 nm Have 3 kind of glycoproteins : HN, NA, & F

There are 4 genera :1. Parainluenza virus (1-4)2. Rubulavirus (mumps virus)3. Morbilivirus (measles virus)4. Pneumovirus (RSV)

Function of Glycoproteins :- Surface Ag- The role in infection pathogenesis1. Hemaglutinase & Neuromidase proteins > attachment virus with host cell

2. Fusion proteins > Synthesized as non active precursors > Active form ; If there are protease F1 splits and establish jointing between host & virus

Pathogenesis - Transmission : droplet, aerosol, or direct contact. - Primary replication at port of entry viremia - Immune response : Local Ig A, Immune Ig M & Ig G for along live against mumps & measles.

Diagnosis - Isolation on cell culture monkeys kidney (MKTC) : CPE ; giant cell - Direct immunofluorescence test - Serologic Cf, HI, or ELISA titter of Ig G

Control & Treatment

- Immunization ; mono or polyvalent - Treatment : symptomatic & antibiotic if super infection is found.

- Non suppuration enlargement of Parotids gland (uni/bilateral)- 1/3 of cases asymptomatic but infectious potentially .- Human is single host.- Port of entry : respiratory tract > droplet per inhalation- Primary replication upper respiratory & nose epithelium viremia salivary gland & distance organs (pancreas, testis & ovary)- Incubation period : 7-25 days Virus can be found in saliva 6 days before - a week after the symptoms emerge.

Clinical appearance1. In apparent infection2. Sub clinical infection3. Acute infection = epidemical parotitis > Prodromal symptoms followed by enlargement of parotid gland > Painful to open the mouth or eating > Fever spontaneous healing immune for along live

Complication - Puberty infection Orchitis & adnexitis

- Slightly aseptic meningitis heavy meningoencephalitis

- Nephritis, pancreatitis

Virus Syndrome FrequencyAge group Tissue Usual involved outcomeINFECTIONS ASSOCIATED WITH OTHER HERPES VIRUSESEpstein- Mononucleosis Very common All Lymph ResolutionBarr nodes, liver,virus spleen Lymphomas Very rare All Lymph Death nodes, liver, spleen, brainVZV Chickenpox Very common All Skin, others Resolution, uncommon rarely death Shingles Common Older Skin, nerves Resolution, (Zoster) adults others chronic pain, uncommon rarely deathHHV-6 Roseola Very common Infants Skin Resolution Febrile Common Infants Brain Resolution, convulsions developmental problems

Virus Syndrome FrequencyAge group Tissue Usual involved outcomeINFECTIONS ASSOCIATED WITH OTHER HERPES VIRUSESHHV 7 Roseola CommonInfants Skin Resolution

Kaposis Kaposis CommonAdults Skin Death

Sarcoma sarcoma ? in immuno- metastaticAssociated suppressedVirus patients

(HHV-8) Lymphomas Uncommon Adults Body Death in immuno- cavities suppressed patients

Varicella (chickenpox) :a mild, highly contagious disease chiefly in childrencharacterized clinically by a generalized vesicular eruption of the skin & mucous membranesThe disease may be severe in adults & immunocompromised childrenVARICELLA-ZOSTER VIRUS (VZV)

Zoster (shingles)a sporadic, incapacitating disease of adults or immunocompromised individualscharacterized by rash limited to distribution to the skin innervated by a single sensory ganglionlesions similar to those of varicellaVARICELLA-ZOSTER VIRUS (VZV)

VZV is morphologically identical to HSV The virus propagated in cultures of human embryonic tissue, produce typical intranuclear inclusion bodiesCytopathic changes are more focal and spread much more slowly than HSVVARICELLA-ZOSTER VIRUS (VZV)PROPERTIES OF VIRUSES

Varicella : route of infection is the mucosa of the upper respiratory tract or conjunctiva

blood multiple cycle of replication

skinVARICELLA-ZOSTER VIRUS (VZV)PATHOGENESIS

Zosterskin lesion histopathologicaly identical to varicellaacute inflammation of the sensory nerve & gangliaoften only a single ganglion may be involvedas a rule the distribution of lesions in the skin corresponds closely to the areas of innervation from an individual dorsal root ganglionVARICELLA-ZOSTER VIRUS (VZV)

Varicella Herpes ZosterVARICELLA-ZOSTER VIRUS (VZV)

Previous infection with varicella is believe to confer lifelong immunity to varicellaHowever, zoster can occur in the presence of relatively high level of Nt Ab to varicellaVARICELLA-ZOSTER VIRUS (VZV)IMMUNITY

VARICELLA-ZOSTER VIRUS (VZV)Laboratory diagnosisStained smear of scraping or swabs of the base vesicles :multinucleated giant cellsVirus isolated from vesicle fluid using culture of human cells 3 7 days Cytopathic effects develop more slowly

VARICELLA-ZOSTER VIRUS (VZV)TreatmentGamma globulin of high VZV Ab titer (VZ Ig) can be used to prevent the development of the illness of immunocompromised patients exposed to varicellaIt has no therapeutic value once varicella has startedAntiviral : acyclovir, valacyclovir, vidarabine