VIRUSES INFECTION

Japanese Encephalitis. Dengue,

DNA/RNA Virus, Infectious
mononucleosis
Prof. Dr. Mochammad Hatta, PhD, SpMK (K)
Molecular Biology and Immunology Laboratory,
Medical Microbiology, Faculty Medicine,
Hasanuddin University,
Makassar, Indonesia
mochammad hatta@ 2013
 Japanese Encephalitis
Japanese encephalitis virus
Flavivirus
Culex tritaeniorhynchus
Amplifier host : pig

mochammad hatta@ 2013

 Clinical manifestation
Incubation period 1-2 weeks
Age 6-14 years
Asymptomatic
Acute encephalitis, Acute
meningoencephalitis, Aseptic
meningitis

mochammad hatta@ 2013

 Clinical manifestation
3 stages
Prodromal stage
Acute encephalitis stage
Late stage and sequelae

mochammad hatta@ 2013

 Lab investigation
CBC : wbc neutrophil
CSF : pressure
wbc ~ 200 (3-4,200) lymp
slightly protein level
sugar

mochammad hatta@ 2013

 Lab (Dengue and JE)
Hemagglutination Inhibition Assay
(HAI)
Titer vs DEN-1, DEN-2, DEN-3,
DEN-4, JE, CHIK
ELISA / EIA measure OD
Unit of DEN IgM DEN IgG
JE IgM JE IgG

mochammad hatta@ 2013

Haemagglutination Inhibition
No evidence of recent Flavivirus
infection
Undetectable Ab
Stable titers (<1:2560)
Acute primary Flavivirus Infection
Fourfold (<1:1280)
Acute secondary Flavivirus infection
Fourfold (>1:1280)
Recent secondary Flavivirus infection
No fourfold (1:2560)
mochammad hatta@ 2013
LOGNO. HAI (TITER)
DEN-1 DEN-2 DEN-3 DEN-4 JE CHIK
02A00291 20 20 40 40 40 <10
02F00291 160 320 640 2560 320 <10
Acute Secondary Dengue Infection
mochammad hatta@ 2013
 EIA
IgM 40 units is positive
Dengue IgM / JE IgM
>1 Dengue infection
<1 JE infection
Dengue IgM / Dengue IgG
1.8 Primary infection
<1.8 Secondary infection

mochammad hatta@ 2013

 Treatment and prevention
Supportive and symptomatic Px
Vaccine
Mouse brain-derived inactivated
vaccine
Cell culture-derived, inactivated
vaccine
Cell culture-derived, live attenuated
vaccine
mochammad hatta@ 2013
 Viruses
DNA viruses are Double stranded
except Parvoviridae is Single strand

RNA viruses are Single stranded DNA

except Reoviridae is Double strand

(families : - viridae)

mochammad hatta@ 2013

 DNA viruses
Adenoviridae : adenovirus

Hepadnaviridae : Hepatitis B

Papovaviridae :Papillomavirus,
Polyomaviruses

mochammad hatta@ 2013

 DNA viruses (cont.)
Herpesviridae :
Herpes simplex virus type 1
Herpes simplex virus type 2
Varicella-zoster virus
Epstein-Barr virus
Cytomegalovirus
Human herpesvirus 6
Human herpesvirus 7
Human herpesvirus 8

mochammad hatta@ 2013

 DNA viruses (cont.)

Parvoviridae : Parvovirus B19

Poxviridae : Molluscum contagiosum

mochammad hatta@ 2013

 RNA viruses
Coronaviridae : Human coronaviruses
Paramyxoviridae : Parainfluenza,
Mumps, Measles , RSV
Orthomyxoviridae : Influenza

Piconaviridae : Enteroviruses
(Polio, coxsakievirus, echoviruses,
enterovirus, Hep A)

mochammad hatta@ 2013

 RNA viruses (cont.)

Flaviviridae: Dengue, JE, Yellow fever,

West Nile, Hep C, Hep G
Togaviridae : Rubella, Chikungunya
Reoviridae : Rotaviruses
Retroviridae : HIV
Rhabdoviridae : Rabies

mochammad hatta@ 2013

 Infectious Mononucleosis

Etiology: Epstein-Barr virus (EBV)

Herpesvirus 4
incubation period 30-50 days

mochammad hatta@ 2013

 Diagnosis test
PCR :serum ,tissue
in immunocompromised ,complex
clinical
Heterophil Ab (non-specific IgM)
Atypical lymphocyte
VCA-IgG and VCA-IgM :
-earlier than the heterophile antibody
and more specific

mochammad hatta@ 2013

 Diagnosis test
Serologic testing

infection VCA IgM VCA IgG EA(D) EBNA

No previous - - - -
infection
Acute + + +/- -

Recent +/- + +/- +/-

Past - + +/- +
mochammad hatta@ 2013
Treatment:
Supportive Tx ; not given ampicillin/amoxycillin
Steroid : prednisolone 1 mg/kg/day,max
20mg/day x7 day then tapering)
- Marked tonsillar inflammation with impending
airway obstruction
- Massive splenomegaly,myocarditis, hemolysis
anemia,
hemophagocytic syndrome
cytotoxic,immunomodulator: Life-threatening
hemophagocytic syndrome
mochammad hatta@ 2013