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1 30/11/98 Herpes Viruses Cytomegalovirus
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2 30/11/98 Presentation Outline Structure Classification Multiplication Clinical manifestations Epidemiology Diagnosis Control
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3 30/11/98 Latent Infections ALL herpes viruses can establish latent infections. The viral genome may become incorporated into the host DNA or remain extrachromosomal Latent viruses can be reactivated by stress, menstruation or uv light Reactivation may be asymptomatic or lead to mild or severe disease.
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4 30/11/98 Herpes Diagnosis Isolation of virus by tissue culture herpevirinae cause cytopathic effects intranuclear fluorescence of scrapings using fluorescent antibodies PCR being developed CMV retiniitis is diagnosed clinically
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5 30/11/98 Cytomegalovirus
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6 30/11/98 Cytopathic effect on the host cell. The cell swells and a large inclusion body forms in the nucleus. Transmission: not highly infectious, virus found in saliva, urine and blood. infants and children acquire CMV from other children. congenital. In utero, at birth during perinatal period. see clinical note in the textbook. Clinical forms of Cytomegalovirus infection Congenital: the following possibilities relate to the congenital type. severe deformities and death. survive with serious defects - physical and mental. survive with out deformities. newborns: - Enlarged liver and spleen, jaundice, capillary bleeding, microcephaly, ocular inflammation.
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7 30/11/98 Disseminated cytomegalovirus Symptoms: fever, severe diarrhea, hepatitis, arthritis, pneumonia, high mortality. activation of inapparent infection. also due to: ä immunosuppressive therapy. ä cancer. ä AIDS. Virus in blood or organ: post transfusion. post organ transplant. Cytomegalovirus mononucleosis: teenage, young adult similar to other mono.
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8 30/11/98 Epidemiology of CMV whereever human populations tested - high percentage (40-100%) were positive for the antibodies. newborns 7.5% positive in the USA & UK. woman of child bearing age were 20-100% positive in many countries that were studied (pregnant - virus in the urine). IV drug users were 100% positive for the antibodies. homosexual males were 30% positive for the antibodies - high percentage shed virus. Transmission: saliva, respiratory mucus, milk, urine, semen, cervical secretions, feces and lymphocytes. Diagnosis: the differential diagnosis in neonates must include toxoplasmosis, rubella, herpes simplex, bacterial sepsis. in adults it must be differentiated from Epstein-Barra and hepatitis A & B.
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9 30/11/98 Cytomegalovirus - con’t Laboratory diagnosis: virus can be grown from all organs. many serological tests. Treatment: gancyclovir, foscarnet, hyperimmune CMV immunoglobulin, have some effect. interferon does not prevent infection or promote recovery. Prevention: no animal can be found that can be infected with CMV. Two deterents: vaccine stimulated antibodies may not be protective. Patients already seropositve can be reinfected. a vaccine could be oncogenic.
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10 30/11/98 EBV and burkitt’s lymphoma were shown to be the same virus when a lab technician acquired mononucleosis while working with the Burkitt’s lymphoma virus.
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11 30/11/98 Cytomegalovirus Urine isolate
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12 30/11/98 Intranuclear inclusions The cell swells and a large inclusion body forms in the nucleus.
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13 30/11/98 Cytomegalovirus Nuclear & cytoplasmic inclusions
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14 30/11/98 Transmission: CMV not highly infectious, virus found in saliva, urine and blood. infants and children acquire CMV from other children. congenital. In utero, at birth during perinatal period.
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15 30/11/98 Congenital: CMV the following possibilities relate to the congenital type. severe deformities and death. survive with serious defects - physical and mental. survive with out deformities. newborns: - Enlarged liver and spleen, jaundice, capillary bleeding, microcephaly, ocular inflammation.
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16 30/11/98 Disseminated cytomegalovirus fever, severe diarrhea, hepatitis, arthritis, pneumonia, high mortality. activation of inapparent infection. also due to: - immunosuppressive therapy. - cancer. - AIDS.
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17 30/11/98 Virus in blood or organ: post transfusion. post organ transplant.
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18 30/11/98 Cytomegalovirus mononucleosis: teenage, young adult similar to other mono.
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19 30/11/98 Epidemiology of CMV high percentage (40-100%) were positive for the antibodies. newborns 7.5% positive in the USA & UK. woman of child bearing age were 20-100% positive in many countries that were studied (pregnant - virus in the urine). IV drug users were 100% positive for the antibodies. homosexual males were 30% positive for the antibodies - high percentage shed virus.
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20 30/11/98 Transmission: saliva, respiratory mucus, milk, urine, semen, cervical secretions, feces and lymphocytes.
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21 30/11/98 Differential Diagnosis: the differential diagnosis in neonates must include toxoplasmosis, rubella, herpes simplex, bacterial sepsis. in adults it must be differentiated from Epstein-Barra and hepatitis A & B.
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22 30/11/98 Laboratory diagnosis: CMV virus can be grown from all organs. many serological tests.
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23 30/11/98 Treatment: CMV gancyclovir, foscarnet, hyperimmune CMV immunoglobulin, have some effect. interferon does not prevent infection or promote recovery.
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24 30/11/98 Prevention:CMV no animal can be found that can be infected with CMV. Two deterents: vaccine stimulated antibodies may not be protective. Patients already seropositve can be reinfected. a vaccine could be oncogenic.
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