Toledo, Meevie Love D.

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 5 subgroups:
Poliovirus
Coxsackie viruses A and B
ECHO virus
New enteroviruses
Hepatitis A

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 Group: Group IV ((+)
ssRNA)
Order: Picornavirales
Family: Picornaviridae
Genus: Enterovirus
Species: Human
enterovirus C
Scientific name:
Poliovirus

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 A. General Properties

1. Poliovirus particles
- Inactivated when heated at 55C for 30 minutes
- Mg2+, 1mol/L prevents the inactivation

2. Purified poliovirus
- Inactivated by a chlorine concentration of 0.1 ppm
Ether
Sodium deoxycholate

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 B. Animal Susceptibility and Growth of Virus

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 B. Animal Susceptibility and Growth of Virus

Primary or continuous
cell line culture

Primate-specific
membrane receptor
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 C. Antigenic Properties

Type I
Type II
Type III

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 Portal of Entry - Minor/Primary
Local multiplication
Mouth Viremia

Multiplies in To spinal cord or Major/

neurons brain Secondary Viremia

Lesions are mostly in

anterior horns of spinal cord DESTROYS THEM!
causing flaccid paralysis

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 Portal of Entry - Minor/Primary
Local multiplication
Mouth Viremia

Multiplies in To spinal cord or Major/

neurons brain Secondary Viremia

Lesions are mostly in

anterior horns of spinal cord DESTROYS THEM!
causing flaccid paralysis

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 Portal of Entry - Minor/Primary
Local multiplication
Mouth Viremia

Multiplies in To spinal cord or Major/

neurons brain Secondary Viremia

Lesions are mostly in

anterior horns of spinal cord DESTROYS THEM!
causing flaccid paralysis

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 Portal of Entry - Minor/Primary
Local multiplication
Mouth Viremia

Multiplies in To spinal cord or Major/

neurons brain Secondary Viremia

Lesions are mostly in

anterior horns of spinal cord DESTROYS THEM!
causing flaccid paralysis

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 Portal of Entry - Minor/Primary
Local multiplication
Mouth Viremia

Multiplies in To spinal cord or Major/

neurons brain Secondary Viremia

Lesions are mostly in

anterior horns of spinal cord DESTROYS THEM!
causing flaccid paralysis

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 Portal of Entry - Minor/Primary
Local multiplication
Mouth Viremia

Multiplies in To spinal cord or Major/

neurons brain Secondary Viremia

Lesions are mostly in

anterior horns of spinal cord DESTROYS THEM!
causing flaccid paralysis

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 Portal of Entry - Minor/Primary
Local multiplication
Mouth Viremia

Multiplies in To spinal cord or Major/

neurons brain Secondary Viremia

Lesions are mostly in

anterior horns of spinal cord DESTROYS THEM!
causing flaccid paralysis

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Portal of Entry Local Minor/Primary
- Mouth multiplication Viremia

Major/
Multiplies in To spinal
Secondary
neurons cord or brain
Viremia

Lesions are mostly

in anterior horns of DESTROYS
spinal cord causing THEM!
flaccid paralysis

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Incubation period: 7-14 days (3-35 days)
Abortive Polio
(Mild Disease)

Inapparent
(90-95%) Non-paralytic
poliomyelitis
(Aseptic meningitis)
Infection
Apparent
Paralytic
(5-15%) poliomyelitis

Progressive
postpoliomyelitis
Muscle Athropy
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 Specimen Identification
Throat swab Neutralization by
specific antiserum
Rectal swab or
PCR assays
Stool samples
Serology
Transportation
Very rarely used
Frozen Screening for
Culture immunocompromised
3-6 days individuals

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 Immunity is permanent
Predominantly antibody mediated
Low degree of heterotypic resistance

Passive immunity
Mother to offspring
3-5 weeks only

Virus-neutralizing antibody

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 1998 WHO campaign
1994 Polio-free
America
1999 No cases of
wild poliviovirus type 2
2000 Polio-free West
Pacific Region
2002 Polio-free
Europe
2011 Afghanistan,
India, Nigeria, and
Pakistan remained
polio endemic
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 Reservoir
Humans
6 months to 3 years old (Most vulnerable)
3:1 (Male to female ratio)
Transmission
Fecal-oral route
Oral-oral route
Temporal pattern
Summer months in temperate climate
No seasonal pattern for tropical climates

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 Communicability
7 to 10 days before and after the onset of
symptoms
May be present in the stool from 3 to 6 weeks
Environmental sources of infection
Contaminated water and food
Flies
Overcrowding and poor sanition

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 Sabins Live Polio Vaccine
Oral Poliovirus Vaccine (OPV)
Three types of polio virus grown in monkey kidney
tissue cultures (MKTC)
Contains neomycin and streptomycin
Stabilized by magnesium chloride

Salks Killed Polio Vaccine

Intramuscular Poliovirus Vaccine (IPV)
Attenuated strains grown in MKTC
Contains 2-phenoxyethanol, neomycin, streptomycin,
polymyxin B
Stabilized by magnesium chloride or sucrose

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 spherical,20-30nm.

Icosahedral
symmetry,

non-enveloped

Capsid:VP1-VP4

+ssRNA.
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Coxsackie A Coxsackie B

Mice: paralysis and death Mice: less severe

with extensive skeletal infection but
muscle necrosis. multiple organs can be
damaged.

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 Blood
Throat
Stool

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 Incubation period: 2-9 days
COXSACKIE A COXSACKIE B
Aseptic Aseptic

Meningitis Meningitis
Hand-Foot- Hand-Foot-
and-Mouth and-Mouth
Disease Disease

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 Herpangina
Hemorrhagic Conjuctivitis

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 Pleurodynia (Epidemic Myalgia)
Myocarditis
Pericarditis

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 Cell Culture Methods
Specimens Poor Growth Characteristics
Throat Washings
Stool Reverse Transcription-
Nasal Secretions
PCR Test
Broadly Reactive
(Coxsackievirus A21 ) More Specific
CSF
Conjunctival Swabs Immunofluorescence
(Coxsackievirus A24) Technique
Use Infected Cell Culture

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 Endemic Pattern Epidemic Pattern
Coxsackievirus Coxsackievirus B5
A9, B2 and B4

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 ECHO Viruses (Enteric Cytopathogenic Human Orphan Viruses )
Aseptic Meningitis, Rash, and Infantile Diarrhea

Enterovirus 70
Chief Cause of Acute Hemorrhagic Conjunctivitis

Enterovirus 71
Meningitis, Encephalitis and Poliomyelitis-Like Paralysis
Hand-Foot-and-Mouth Disease
Most Common Enterovirus in Fecal Samples of Patients with Flaccid
Paralysis

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 Specimens PCR
More Rapid Test for
Throat Swab diagnosis than viral
isolation
Rectal Swabs
Serological Test
Stool Impractical
CSF Neutralization Tests and
Hemagglutination
Inhibition Tests
Immunofluorescence or
Neutralization Tests

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 Various parts of the globe
Younger > Older
Temperate zone: summer and autumn

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