Teresita S.

de Guzman
Department of Medical Microbiology
College of Public Health
University of the Philippines, Manila
Virus Virus
group
Disease Animal of
origin
Lethality Geographical
distribution
Lymphocytic
choriomeningitis
(LCM)
arenaviru
s
LCM Mouse,
hamster
-

World-wide
Lassa fever arenaviru
s
Lassa fever African
bush rat
(Mastomys
natalensis)
+ West-Africa
Machupo arenaviru
s
Bolivian
Haemorrha
gic fever
Bush
mouse
(Calomys
callosus)
+ NE Bolivia
Junin arenaviru
s
Argentinian
Haemorrha
gic fever
Calomys
sp.
Mice
+ Argentina
VIRAL FEVERS AND HAEMORRHAGIC DISEASES ACQUIRED FROM
VERTEBRATES OR FROM UNKNOWN SOURCES
VIRAL FEVERS AND HAEMORRHAGIC DISEASES ACQUIRED FROM
VERTEBRATES OR FROM UNKNOWN SOURCES
Virus Virus
group
Disease Animal of
origin
Lethality Geographical
distribution
Hantaan bunyavirus Haemorrhagic
fever
Fever w/ renal
syndrome
(Korean
haemorrhagic
fever)
Unknown + Far East,
Scandinavia
E. Europe
Marburg filovirus Marburg fever unknown ++ Africa (lab.
Infections in
Marburg,
etc.)
Ebola filovirus Ebola disease ++ Africa
(Sudan,
Zaire)
Examples of Newly Described
Viral Pathogens
1976 Ebola virus
1977 Hantaanvirus
1977 Rift Valley fever virus
1979 Ross River virus
1980 HTLV-1
1982 HTLV-II
1983 HIV-1
1986 HIV-2
1986 Human herpes virus 6
1989 Hepatitis C virus
1993 Sin Nombre virus
1994 Sabia virus
1995 Equine morbilivirus
VIRUSES ASSOCIATED WITH
HEMORRHAGIC FEVER



VIRUS FAMILY DISTRIBUT
ION
ANIMAL
CARRIERS/
VECTORS
Yellow Fever

Marburg
Ebola
Lassa
Machupo
Hantaan

Togavirus

Filovirus
Filovirus
Arenavirus
Arenavirus
Bunyavirus
Central &
South America
Eastern Africa
Sudan & Zaire
Western Africa
South America
Korea
Monkeys/mos-
quitoes
Monkeys
Monkeys
Rodents
Rodents
Rodents
Marburg virus
In 1967, dozens of scientists
in West Germany fell seriously ill, &
several died, from a mysterious
disease
Victims suffered from breakdown of
liver function, & bizarre combination
of bleeding and blot clots
WHO traced the outbreak to a batch
of monkey kidney cells the scientists
used to grow polio viruses.
The cells from imported Ugandan
green vervet monkeys were infected
with lethal tropical Marburg virus that
caused Marburg viral hemorrhagic
fever.
Other clinical manifestations were
bleeding from the gums & throat, and
gatrointestinal bleeding which are
characteristic features
Mortality rates during epidemics tend
to be high.
Subsequent studies done in monkeys
population in Uganda proved
unsatisfactory in establishing natural
infection;

This suggested that these monkeys
were not the reservoir hosts of the
virus



EBOLA HEMORRHAGIC FEVER
(Ebola HF)
a severe, often fatal disease in
humans and nonhuman primates
(monkeys & chimpanzees) that has
appeared sporadically since its
initial recognition in 1976
(1975 1
st
recognized outbreak from
index case, a man who traveled in
Zimbabwe)
Ebola Zaire
Ebola Sudan
Ebola Ivory Coast
(Ebola Tai)
Ebola Reston (caused disease
in nonhuman primates but not
in humans)



Four Subtypes of Ebola HF



Biology of the Ebola Virus
one of the 2 members of a
family of RNA viruses called
Filoviridae, Order Mononegavirales
along with Marburg virus
negative stranded, non-segmented
ss RNA viruses (w/ 7 polypeptides)
formerly classified under family
Rhabdoviridae; found to have closer
affinity to Paramyxoviruses



appear as long filamentous forms
or as shorter U- shaped, 6-
shaped or circular forms in their
natural state.
among the most pathogenic of
human viruses
classified as Biological Level 4
agents based on their high
mortality , person-to-person
transmission, potential aerosol
infectivity & absence of vaccine
chemotherapy
natural reservoir (origin & natural
habitat) is unknown

believed to be zoonotic (animal borne)
& normally maintained in an animal
host native to the African continent

Ebola Virus Found in Nature



appears sporadically
usually spread within a
health-care setting (a situation
known as amplification)
Transmission
Infection with the virus in
humans is incidental



Modes of Transmission
DIRECT CONTACT
o researches hypothesized that
the 1
st
patient become infected
thru contact w/ an infected
animal
o exposure to blood &/or secretions
of infected persons
o contact with objects, e.g. needles
contaminated w/ infected secretions
o frequently associated with
outbreaks of Ebola HF


NOSOCOMIAL TRANSMISSION
SSx of EBOLA Infection
Time Frame in most Pt in some Pt
W/in a few high fever sore throat
days of headache hiccups
becoming muscle aches rash, red &
infected w/ stomach pain itchy eyes
the virus fatigue vomiting blood
diarrhea bloody
diarrhea
w/in 1 wk chest pain blindness
of becoming shock bleeding
infected & death
with the
virus
Time Frame in most Pt in some Pt
Clinical Diagnosis
Screening
Tests
blood film examination
blood culture
stool culture
Confirmatory Laboratory Test
Antigen capture ELISA
IgG ELISA
PCR
Virus isolation
Hanta virus
Hanta viruses belong to the family
Bunyaviridae which also includes
several genera of arboviruses
General properties of Bunyaviruses:
enveloped virus
with segmented (-) RNA genome
helical symmetry of nucleocapsid
Hantaviruses are rodent viruses
which can spread to humans
Rodent infection is chronic and
symptomless, but in humans, they cause
severe febrile illness
Three main syndrome seen:
Hemorrhagic fever with renal syndrome
Nephropathia epidemica
Hantavirus pulmonary syndrome
Four main virus-specific syndromes
are seen:
Hantaan virus: found in Korea,
Eastern Russia, China (asscd with rats)
causes hemorrhagic fever with renal
syndrome
Puumala virus: endemic in bank voles
(& probably also in other rodents) in
Scandinavia and Western Europe
Causes nephropathia epidemica
Sin Nombre (no name): the cause of
hantavirus pulmonary syndrome
the natural host is the deer mouse
Found mainly in Western USA
Seoul virus: is wide spread in rats
world wide, but seems rarely cause
disease in humans
Transmission
Mainly airborne but arthropod
vectors may play a role

No human to human transmission has
been demonstrated yet
Clinical Manifestations of Hantaviruses
Clinical
Manifestations
Hantavirus Geographic location
Hemorrhagic-fever with
renal syndrome
Hantaan
Seoul
Dobrava/Belgrade
Asia
Worldwide
Balkans
Hantavirus pulmonary
syndrome
Sin Nombre
Bayou
Black Creek Canal
New York-1
United States
Louisiana
Florida
New York
Nephropathia epidemica
Nonpathogenic
Puumala
El Morro Canyon
Isla Vista
Thottopalayam
Thailand
Andes
Prospect Hill
Europe, western Russia
United States
California
India
Thailand
Argentina
United States
Clinical Manifestations Vector
Hemorrhagic fever with
renal syndrome
* Apodemus agrarias (striped field
mouse)
* Rattus spp. (brown rat)
* Apodemus flavicollis (yellow-
necked mouse)
Hantavirus pulmonary
syndrome
* Peromyscus maniculatus (deer
mouse)
* Rice rat
* Cotton rat
* White-footed deer mouse
Nephropathia epidemica * Clethrionomys glariolus
(bank vole)