View
222
Download
0
Category
Preview:
Citation preview
7/23/2019 Infeksi Virus Multi-sistem-
1/39
INFEKSI VIRUS
MULTI-SISTEM
Riyani Wikaningrum
Bag. Mikrobiologi
Fakultas Kedokteran Univ. Yarsi
7/23/2019 Infeksi Virus Multi-sistem-
2/39
Penyakit Infeksi berdasar Sistem
7/23/2019 Infeksi Virus Multi-sistem-
3/39
Infeksi Multi-sistem
Vector-borne
Zoonosis
Fever of Unknown Origin (FUO) Infection of the compromised host
7/23/2019 Infeksi Virus Multi-sistem-
4/39
Vector Borne Disease
Arboviruses are arthropod-borne viruses
Arbovirus replicate in: Vascular endothelium
CNS Skin and Muscle
Arbovirus infection: Yellow fever
Dengue fever Arbovirus encephalitis
Arbovirus and hemorrhagic fever
7/23/2019 Infeksi Virus Multi-sistem-
5/39
Yellow Fever
Yellow fever virus is transmitted bymosquitoes and is restricted to Africa,Central and South America and the
Caribbean Clinical features of yellow fever may be
mild, but liver damage can prove fatal
The diagnosis is usually clinical, there isno specific treatment, but there is avaccine
7/23/2019 Infeksi Virus Multi-sistem-
6/39
Dengue Fever
Dengue virus is transmitted by mosquitoes
and occurs in southeast Asia, the Pacific
area, India and the Caribbean
Dengue fever may be complicated by
dengue hemorrhagic fever shock
syndrome
There is no antiviral therapy or vaccine for
dengue fever
7/23/2019 Infeksi Virus Multi-sistem-
7/39
7/23/2019 Infeksi Virus Multi-sistem-
8/39
Arbovirus Enchephalitis
The encephalitic arboviruses only
occasionally cause encephalitis
7/23/2019 Infeksi Virus Multi-sistem-
9/39
7/23/2019 Infeksi Virus Multi-sistem-
10/39
7/23/2019 Infeksi Virus Multi-sistem-
11/39
Zoonosis
Some multisystem infections in man
are animal diseases (i.e. zoonoses)
Viral Haemorrhagic Fever caused by:
Arenaviruses
Filoviruses
Bunyaviruses
Flaviviruses
7/23/2019 Infeksi Virus Multi-sistem-
12/39
ARENAVIRUS INFECTIONS
Arenaviruses are transmitted to humans inrodent excreta
Arenavirus infection is diagnosed byserology, virus isolation or viral genome
detection Lymphocytic choriomeningitis virus occurs
worldwide
Lassa fever virus is an arenavirus thatinfects a bush rat in parts of west Africa
7/23/2019 Infeksi Virus Multi-sistem-
13/39
7/23/2019 Infeksi Virus Multi-sistem-
14/39
KOREAN HEMORRHAGIC FEVER
The Hantaan virus causes Korean
hemorrhagic fever and infects rodents
7/23/2019 Infeksi Virus Multi-sistem-
15/39
MARBURG AND EBOLA
HEMORRHAGIC FEVERS
7/23/2019 Infeksi Virus Multi-sistem-
16/39
Outbreaks
1976- First Major
Outbreak (ZEBOV)
1976- Sudan(SEBOV)
Occur Sporadically
www.cdc.govfor
more information
http://www.cdc.gov/http://www.cdc.gov/7/23/2019 Infeksi Virus Multi-sistem-
17/39
Where does Ebola hide?
2002- Fruit Bats
Antibodies against
Ebola
Ebola Gene sequences
in liver and spleen
Fruit bats do not show
any symptoms
Best candidate to be
the reservoir
More research needs to
be done
7/23/2019 Infeksi Virus Multi-sistem-
18/39
Clinical Observations
Incubation period:2-21 days
Stage I (unspecific):
-Extreme asthenia (body weakness)
-diarrhea, nausea and vomiting, anorexia
abdominal pain
- headaches
- arthralgia (neuralgic pain in joints)
- myalgia (muscular pain or tenderness), back pain
- mucosal redness of the oral cavity, dysphagia (difficulty inswallowing)
- conjunctivitis.- rash all over body except in face
** If the patients dont recover gradually at this point, there is a highprobability that the disease will progress to the second phase,resulting in complications which eventually lead to death (Mupapa et
al., 1999).
7/23/2019 Infeksi Virus Multi-sistem-
19/39
Stage II (Specific):
- Hemorrhage
- neuropsychiatric abnormalities- anuria (the absence of urine formation)
- hiccups
- tachypnea (rapid breathing).
** Patients who progressed to phase two EHF almost always die.(Ndambi et al., 1999)
Late Complications:
-Arthralgia
- ocular diseases (ocular pain, photophobia andhyperlacrimation)- hearing loss
- unilateral orchitis( inflammation of one or both of the testes)
** These conditions are usually relieved with the treatment of 1%
atropine and steroids
7/23/2019 Infeksi Virus Multi-sistem-
20/39
Epidemiology Ebola Hemorrhagic Fever was first found in 1976
It struck two countries within that year a. Sudanin a town called Nzara
b. Zaire, now known as the Democratic Republic ofCongo
In these two instances the mortality rate wasbetween
5090%
Following those epidemics, Ebola hit Africa in manyother instances the worst yet being in the year 2000
when it struck Uganda infecting more than 400people.
The newest cases 2014
7/23/2019 Infeksi Virus Multi-sistem-
21/39
Transmission
contracted
through contact
of any infected
individuals bodyfluids
Ebola HF prevention
poster used in Kikwit
outbreak.
7/23/2019 Infeksi Virus Multi-sistem-
22/39
Controlling the spread of Ebola Hospitals must follow precautionary methods, such as:
1. wearing gloves
2. isolating infected individuals
3. practicing nurse barrier techniques
4. proper sterilization and disposal of all equipment
Burials must be done correctly
1. no washing or touching carcass
2. put into body bags and bury outside city
Report any questionable illness to officials
7/23/2019 Infeksi Virus Multi-sistem-
23/39
Ebola Subtypes
Ebola-Zaire
(ZEBOV)
Ebola-Sudan(SEBOV)
Ebola Ivory-Coast
(ICEBOV)
Ebola-Reston
(REBOV)
7/23/2019 Infeksi Virus Multi-sistem-
24/39
MOLECULAR STRUCTURE
Characterization of the virus Order: Mononegavirales
Family: Filoviridae
Genus: Ebolavirus
Species: Ebola-Zaire, Ebola-Sudan, Ebola-Cote d-Ivoire,Ebola-Reston
Morphology under electron microscope filamentous, enveloped RNA virus
approx. 19 kb in length (1 kb = 1000 RNAbases/nucleotides) or 60-80 nm in diameter
single-stranded, linear, non-segmented
negative-sense RNA (encoded in a 3 to 5 direction)
appears to have spikes due to glycoprotein on
outside membrane
7/23/2019 Infeksi Virus Multi-sistem-
25/39
Structure of Ebola genome and proteins
Transcribed into 8 sub-genomic mRNA proteins: 7structural and 1 nonstructural
7 structural proteins: nucleoprotein (NP)
4 viral/virion proteins (VP35, VP40, VP30, VP24) glycoprotein (GP)
RNA-dependent RNA polymerase (L protein)
NP, VP35, VP30, L protein: required for transcription &
replication
VP40, GP, VP24: associated with the membrane
7/23/2019 Infeksi Virus Multi-sistem-
26/39
Viral Multi-System InfectionMucocutaneous Lessions
7/23/2019 Infeksi Virus Multi-sistem-
27/39
Patogenesis
Infeksi HSV & VZV
7/23/2019 Infeksi Virus Multi-sistem-
28/39
Manifestasi Infeksi HSV
7/23/2019 Infeksi Virus Multi-sistem-
29/39
Manifestasi
Infeksi VZV
7/23/2019 Infeksi Virus Multi-sistem-
30/39
SMALLPOX atau VARIOLA
7/23/2019 Infeksi Virus Multi-sistem-
31/39
Smallpox (variola)
caused by a poxvirus
No animal reservoir
spread from person to person by
contact with skin lesions via the respiratory tract
The disease was severe, with a generalizedrash and was fatal in up to 40% of cases
Officially eradicated December 1979Effective vaccine
7/23/2019 Infeksi Virus Multi-sistem-
32/39
MORBILLI atau MEASLES (RUBEOLA)
Kopliks spots
7/23/2019 Infeksi Virus Multi-sistem-
33/39
MORBILLI atau MEASLES (RUBEOLA)
Measles outbreaks occur every few years inunvaccinated populations
Clinical features of measles include respiratorysymptoms, Koplik's spots and a rash
Measles rash results from a cell-mediatedimmune response
Complications of measles are particularly likely
among children in developing countries Measles is usually diagnosed clinically; there is
no antiviral treatment, but there is a vaccine
7/23/2019 Infeksi Virus Multi-sistem-
34/39
7/23/2019 Infeksi Virus Multi-sistem-
35/39
RUBELLA (GERMAN MEASLES)
Rubella virus infection causes a
multisystem infection, but its main impact
is on the fetus
Rubella is diagnosed serologically; there is
no treatment, but there is a vaccine
7/23/2019 Infeksi Virus Multi-sistem-
36/39
Rubella (German Measles)
Togavirus single-stranded RNA
one serotype
It is transmitted bydroplet infection
less contagious than
measles, but more so
than mumps Vaccine available
(MMR)
Clinical consequences of rubella virus
7/23/2019 Infeksi Virus Multi-sistem-
37/39
Clinical consequences of rubella virus
invasion of different body tissues
Site of virus
growth
Result Comment
Respiratory
tract
Virus shedding but
symptoms minimal (mild
sore throat, coryza,
cough)
Patient infectious 5 days
before to 3 days after
symptoms
Skin Rash Often fleeting, atypical;
immunopathology involved
(Ag-Ab complexes)
Lymph nodes Lymphadenopathy More common in posterior
triangle of neck or behindear
Joints Mild arthralgia, arthritis Immunopathology involved
(circulating immune
complexes)
Placenta/fetus Placentitis, fetal damage Congenital rubella
7/23/2019 Infeksi Virus Multi-sistem-
38/39
The pathogenesis of rubella:
Rubella is generally a very mild
often subclinical infection Arthritis
major impact when it infects the fetus
7/23/2019 Infeksi Virus Multi-sistem-
39/39
Organ involvement and effects in
congenital rubella
Recommended