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Arthropod-Borne Viruses
Dr.T.V.Rao MD
Part 1
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What Is An Arbovirus?
Arbovirus = arthropod-borne viruses Arboviruses are maintained in nature through biological transmission between susceptible vertebrate hosts by blood-feeding arthropods Vertebrate infection occurs when the infected arthropod takes a blood meal
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Arboviral Infections.
100s of Arbovirus, Around 100 are Human pathogens, Prevalent in Temperate and Tropical areas. Most common in tropics, Out of Many 10 are very important.
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Arthropod-borne Viruses
Arthropod-borne viruses (arbovirus) are viruses that can be transmitted to man by arthropod vectors.
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Arbovirus belong to
Arbovirus belong to three families 1. Toga viruses e.g. EEE, WEE, and VEE 2. Bunya viruses e.g. Sandfly Fever, Rift Valley Fever, Crimean-Congo Haemorrhagic Fever 3. Flavivirus e.g. Yellow Fever, dengue, Japanese Encephalitis
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Dengue Yellow fever St. Louis encephalitis West Nile encephalitis Venezuelan encephalitis Western equine encephalitis Eastern equine encephalitis Japanese encephalitis
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Man-Arthropod-Man Cycle
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Animal-Arthropod-Man Cycle
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INDIAN SCENARIO
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Arthropod Vectors
Mosquitoes
Japanese encephalitis, dengue, yellow fever, St. Louis encephalitis, EEE, WEE, VEE etc.
Ticks
Crimean-Congo hemorrhagic fever, various tickborne encephalitis's etc.
Sandflies
Sicilian sandfly fever, Rift valley fever.
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Aedes Aegyti
Assorted Ticks
Culex Mosquito
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Phlebotmine Sandfly
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Animal Reservoirs
In many cases, the actual reservoir is not known. The following animals are implicated as reservoirs
Birds
encephalitis, Pigs Monkeys Rodents encephalitis
Japanese
encephalitis,
St
Louis
2.Dengue,
3.Japanese B Encephalitis,
4.St Louis Encephalitis, 5.Russian spring summer encephalitis. 6.Eastren Equine Encephalitis, 7.West Nile Fever, 8.Sand fly Fever
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Togaviridae
Eastern equine encephalitis Western equine encephalitis
Bunyaviridae
La Crosse encephalitis
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17 http://www.cdc.gov/ncidod/dvbid/arbor/schemat.pdf
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La Crosse Encephalitis
Bunyaviruses On average 75 cases per year reported to the CDC Most cases occur in children under 16 years old Zoonotic pathogen that cycles between the daytime biting tree hole mosquito, and vertebrate amplifier hosts (chipmunk, tree squirrel) in deciduous forest habitats Most cases occur in the upper Midwestern state, but recently cases have been reported in the MidAtlantic region and the Southeast 1963 isolated in La Crosse, WI from the brain of a child who died from encephalitis
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Togaviridae
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Togaviridae
The name Togaviridae derived from Toga meaning roman mantle or clack refers to the viral surface
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1952 Epidemic in Tanzania. Manifest as Bend Up with Severe Joint pains. Spread from wild primates Mosquito-Man Appears , reappears,
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Indian outbreaks
The virus first appeared in India in 1958 the virus caused large epidemics in Thailand In 1963 India Chikungunya outbreaks occurred at irregular intervals along the east coast of India and in Maharashtra
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Viral Morphology
Spherical 50 - 70 nm Bears the Nucleocapsid, 42 capsomeres Positive sense ss stranded RNA
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Prevalence of Chikungunya
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Transmission of Infection
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Hemorrhagic tendencies.
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Diagnosis
Isolation of viruses, Serology Ig M Nt and HI tests,
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Japanese B Encephalitis
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1. St Louis encephalitis, 2.Ilheus virus 3.West Nile Virus, 4.Murray valley encephalitis, 5.Japanese B encephalitis,
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Japanese Encephalitis
First discovered and originally restricted to Japan. Now large scale epidemics occur in China, India and other parts of Asia. Flavivirus, mosquitoes. transmitted by culex
The virus is maintained in nature in a transmission cycle involving mosquitoes, birds and pigs.
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Japanese Encephalitis
Most human infections are subclinical: the in apparent to clinical cases is 300:1 In clinical cases, a life-threatening encephalitis occurs. The disease is usually diagnosed by serology. No specific therapy is available. Since Culex has a flight range of 20km, all local control measures will fail. An effective vaccine is available.
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History
1870s: Japan
Summer encephalitis epidemics
Genus - Flavivirus
Japanese B encephalitis virus is Spherical, 40 60 nm in diameter Contain a positive sense Single stranded RNA, 11 kb in size RNA genome is infectious Several viruses in this group are related.
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Structure of Virus
The outer envelope is formed by envelope (E) protein and is the protective antigen. It aids in entry of the virus to the inside of the cell. The genome also encodes several nonstructural proteins also (NS1,NS2a,NS2b,NS3,N4a,N S4b,NS5). NS1 is produced as secretary form also. NS3 is a putative helicase, and NS5 is the viral polymerase.
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A Flavivirus
Japanese encephalitis ( previously known as Japanese B encephalitis is a disease caused by the mosquito-borne Japanese encephalitis virus. The Japanese encephalitis virus is a virus from the family Flaviviridae. Domestic pigs and wild birds are reservoirs of the virus; transmission to humans may occur
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INDIAN SCENARIO
Japanese encephalitis ( previously known as Japanese B encephalitis is a disease caused by the mosquito-borne Japanese encephalitis virus. The Japanese encephalitis virus is a virus from the family Flaviviridae. Domestic pigs and wild birds are reservoirs of the virus; transmission to humans may occur
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History
1940-1978
Disease spread with epidemics in China, Korea, and India
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Animal-Arthropod-Man Cycle
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Transmission
Vector-borne disease Enzootic cycle
Mosquitoes: Culex species
Culex tritaeniorhynchus
Reservoir/Amplifying hosts
Pigs, bats Ardeid (wading) birds Possibly reptiles and amphibians
Incidental hosts
Horses, humans, others
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INCIDENCE
Leading cause of viral encephalitis in Asia with 30-50,000 cases reported annually Fewer than 1 case/year in U.S. civilians and military personnel travelling to and living in Asia Rare outbreaks in U.S. territories in Western Pacific
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Clinical Manifestations
The incubation period is 6 to 16 days. There is a prodrome of fever, headache, nausea, diarrhoea, vomiting, and myalgia, which may last for several days. This may be followed by a spectrum of neurological disease ranging from mild confusion, to agitation, to overt coma. Two thirds of patients have seizures. It is more common in children, while headache and meningism are more common in adults.
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Irritability or restlessness
Tremors or convulsions Vomiting and diarrhea
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The isolation of virus from Blood, CSF, or tissues. Detection of Arbovirus specific RNA in blood,CSF, or Tissue However very few reference laboratories can perform the isolation in view of the biosafety considerations
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Serology by ELISA
IgM capture enzyme-linked immunoassay (ELISA) of serum or CSF is the standard diagnostic test. Sensitivity is nearly 100% when both serum and CSF are tested. False-negatives may result if the samples are tested too early, as in the first week of illness. New IgM dot enzyme immunoassays for CSF and serum are portable and simple tests that can be used in the field. Compared with ELISA as the gold standard, the sensitivity and specificity are around 98 and 99% respectively.
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Preventive measures
Preventive measures include mosquito control and locating piggeries away from human dwellings A formalin inactivated mouse brain vaccine using the Nakayama strain has been employed in human immunization in Japan Two doses at two weeks interval followed by a booster 6 12 months later constitute a full course. However the immunity was short lived
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The third is manufactured in Japan and distributed abroad by arrangement with Sanofi-Pasteur
Licensed as JE-VAXR and is the only FDA approved vaccine for use in the U.S. Has been in wide use worldwide since the 1960s Three subcutaneous injections over a month with a booster at 3 years 91% efficacy in a large field trial in Thailand Dr.T.V.Rao MD 67
Vaccination
Live attenuated vaccine
Used in equine and swine Successful for reducing incidence
Later vaccines
A live attenuated vaccine has been developed in China from JE strain SA 14-14-2, passed through weanling mice The vaccine is produced in primary bay hamster kidney cells. Administered in two doses, one year apart, the vaccine has been reportedly effective in preventing clinical disease
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Prevention
Vector control
Eliminate mosquito breeding areas Adult and larvae control
Vaccination
Equine and swine Humans
Mosquito Borne disease Present in Africa, Central and South America. Absent in India.
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Flavivirus
Spherical 40-60 nm in diameter glycosylated. Diameter, Ss-RNA positive sense Three or Four structural polypeptides, Two are glycosylated. Replicates in Cytoplasm. Produces Councilman bodies
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Clinical Features
Incubation period 3-6 days, Fever, chills, Intoxication, Fever, Jaundice Clotting disorders, Mortality > 20% May recover totally
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Laboratory Diagnosis
Intracerebral inoculation, Mosquito cell lines, PCR Serology ELISA Ig M Raise of titers,
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Email; doctortvrao@gmail.com
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