Oleh :

Dr.dr.Efrida Warganegara, M.Kes., Sp.MK

Spheric or pleomorphic ; 150-300 nm

Have 3 kind of glycoproteins : HN, NA, & F
There are 4 genera :
1. Parainluenza virus (1-4)
2. Rubulavirus (mumps virus)
3. Morbilivirus (measles virus)
4. Pneumovirus (RSV)

Function of Glycoproteins :
- Surface Ag
- The role in infection pathogenesis
1. Hemaglutinase & Neuromidase proteins
> attachment virus with host cell
2. Fusion proteins
> Synthesized as non active precursors
> Active form ; If there are protease F1 splits and
establish jointing between host & virus

Pathogenesis
- Transmission : droplet, aerosol, or direct
contact.
- Primary replication at port of entry viremia
- Immune response : Local Ig A, Immune Ig M &
Ig G
for along live against mumps & measles.
Diagnosis
- Isolation on cell culture monkeys kidney
(MKTC) :
CPE ; giant cell
- Direct immunofluorescence test
- Serologic Cf, HI, or ELISA titter of Ig G

Control & Treatment

- Immunization ; mono or polyvalent
- Treatment : symptomatic & antibiotic if
super infection is found.

- Non suppuration enlargement of Parotids gland

(uni/bilateral)
- 1/3 of cases asymptomatic but infectious potentially .
- Human is single host.
- Port of entry : respiratory tract > droplet per inhalation
- Primary replication upper respiratory & nose epithelium
viremia salivary gland & distance organs (pancreas,
testis &
ovary)
- Incubation period : 7-25 days
- Virus can be found in saliva 6 days before - a week after

Clinical appearance
1. In apparent infection
2. Sub clinical infection
3. Acute infection = epidemical parotitis
> Prodromal symptoms followed by enlargement
of

along

parotid gland
> Painful to open the mouth or eating
> Fever spontaneous healing immune for
live

Complication

- Puberty infection Orchitis & adnexitis

INFECTIONS
INFECTIONSASSOCIATED
ASSOCIATEDWITH
WITHOTHER
OTHERHERPES
HERPESVIRUSES
VIRUSES
Virus
EpsteinBarr
virus

VZV

HHV-6

Syndrome Frequency Age group Tissue

involved
Mononucleosis

Very common

All

Lymphomas

Very rare

All

Chickenpox

Very common

All

Shingles
(Zoster)

Common

Older
adults

Roseola
Febrile
convulsions

Very common
Common

Infants
Infants

Usual
outcome

Lymph
Resolution
nodes, liver,
spleen
Lymph
Death
nodes, liver,
spleen, brain
Skin, others Resolution,
uncommon rarely death
Skin, nerves Resolution,
others
chronic pain,
uncommon rarely death
Skin
Resolution
Brain
Resolution,
developmental
problems

INFECTIONS
INFECTIONSASSOCIATED
ASSOCIATEDWITH
WITHOTHER
OTHERHERPES
HERPESVIRUSES
VIRUSES
Virus

Syndrome Frequency Age group Tissue

involved

HHV 7 Roseola

Common

Infants

Skin

Kaposis Kaposis

Common

Adults

Skin

Sarcoma sarcoma ?
Associated
Virus

in immunosuppressed
patients

(HHV-8) Lymphomas Uncommon Adults

in immunosuppressed
patients

Usual
outcome
Resolution
Death

metastatic

Body
cavities

Death

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)
Varicella (chickenpox) :
a mild, highly contagious disease
chiefly in children
characterized clinically by a
generalized vesicular eruption of the
skin & mucous membranes
The disease may be severe in adults &
immunocompromised children

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)

Zoster (shingles)
a sporadic, incapacitating disease of
adults or immunocompromised
individuals
characterized by rash limited to
distribution to the skin innervated by
a single sensory ganglion
lesions similar to those of varicella

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)
PROPERTIES OF VIRUSES

VZV is morphologically identical to

HSV
The virus propagated in cultures of
human embryonic tissue, produce
typical intranuclear inclusion bodies
Cytopathic changes are more focal and
spread much more slowly than HSV

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)
PATHOGENESIS

Varicella : route of infection is the mucosa

of the upper respiratory tract or
conjunctiva
blood

multiple cycle of replication

skin

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)

Zoster

skin lesion histopathologicaly identical to

varicella

acute inflammation of the sensory nerve &

ganglia

often only a single ganglion may be

involved

as a rule the distribution of lesions in the

skin corresponds closely to the areas of
innervation from an individual dorsal root
ganglion

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)
Varicella
Varicella

Herpes
Herpes Zoster
Zoster

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)
IMMUNITY

Previous infection with varicella is

believe to confer lifelong immunity
to varicella
However, zoster can occur in the
presence of relatively high level of
Nt Ab to varicella

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)
Laboratory diagnosis
Stained smear of scraping or swabs of
the base vesicles :
multinucleated giant cells
Virus isolated from vesicle fluid using
culture of human cells 3 7 days
Cytopathic effects develop more
slowly

VARICELLA-ZOSTER
VARICELLA-ZOSTER VIRUS
VIRUS (VZV)
(VZV)
Treatment

Gamma globulin of high VZV Ab titer (VZ

Ig) can be used to prevent the development
of the illness of immunocompromised
patients exposed to varicella
It has no therapeutic value once varicella
has started
Antiviral : acyclovir, valacyclovir,
vidarabine