Viral epidemiology is the branch of medical science that deals with the transmission and control of virus infections in humans.
Transmission of viruses can be,
1. Vertical transmission- from mother to child, Ex: hepatitis B virus and HIV
2. Horizontal transmission- from person to person. Ex: Influenza
Horizontal transmission is the most common mechanism of spread of viruses in populations.
@Transmission can occurs by the following methods,
- when the body fluids are exchanged during sexual activity, e.g., HIV;
- blood is exchanged by contaminated transfusion or needle sharing, e.g., hepatitis C;
- exchange of saliva by mouth, e.g., Epstein-Barr virus;
- contaminated food or water is ingested, e.g., norovirus;
- aerosols containing virions are inhaled, e.g., influenza virus;
- insect vectors such as mosquitoes penetrate the skin of a host, e.g., dengue.
o The rate or speed of transmission of viral infections depends on factors that include population density, the number of susceptible individuals, (i.e., those not immune), the quality of healthcare and the weather.
o Epidemiology is used to break the chain of infection in populations during outbreaks of viral diseases.
o Control measures are used that are based on knowledge of how the virus is transmitted.
o It is important to find the source, or sources, of the outbreak and to identify the virus.
o Once the virus has been identified, the chain of transmission can sometimes be broken by vaccines.
o When vaccines are not available, sanitation and disinfection can be effective.
o Often, infected people are isolated from the rest of the community, and those that have been exposed to the virus are placed in quarantine.
o Most viral infections of humans and other animals have incubation periods during which the infection causes no signs or symptoms.
o Incubation periods for viral diseases range from a few days to weeks, but are known for most infections. Somewhat overlapping, but mainly following the incubation period, there is a period of communicability — a time when an infected individual or animal is contagious and can infect another person or animal. This, too, is known for many viral infections, and knowledge of the length of both periods is important in the control of outbreaks.
o When outbreaks cause an unusually high proportion of cases in a population, community, or region, they are called epidemics.
o If outbreaks spread worldwide, they are called pandemics
A pandemic is a worldwide epidemic. The 1918 flu pandemic, which lasted until 1919, was a category 5 influenza pandemic caused by an unusually severe and deadly influenza A virus. The victims were often healthy young adults, in contrast to most influenza outbreaks, which predominantly affect juvenile, elderly, or otherwise-weakened patients. Older estimates say it killed 40–50 million people, while more recent research suggests that it may have killed as many as 100 million people, or 5% of the world's population in 1918
Most researchers believe that HIV originated in sub-Saharan Africa during the 20th century; it is now a pandemic, with an estimated 38.6 million people now living with the disease worldwide. The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization(WHO) estimate that AIDS has killed more than 25 million people since it was first recognised on June 5, 1981, making it one of the most destructive epidemics in recorded history. In 2007 there were 2.7 million new HIV infections and 2 million HIV-related deaths.
Several highly lethal viral pathogens are members of the Filoviridae. Filoviruses are filament-like viruses that cause viral hemorrhagic fever, and include the ebola and marburg viruses. The Marburg virus attracted widespread press attention in April 2005 for an outbreak in Angola. Beginning in October 2004 and continuing into 2005, the outbreak was the world's worst epidemic of any kind of viral hemorrhagic fever.
Host defense mechanisms
o The body's first line of defense against viruses is the innate immune system.
o This comprises cells and other mechanisms that defend the host from infection in a non-specific manner.
o This means that the cells of the innate system recognise, and respond to, pathogens in a generic way, but, unlike the adaptive immune system, it does not confer long-lasting or protective immunity to the host.
o RNA interference is an important innate defense against viruses.
o @ Dicer: Many viruses have a replication strategy that involves double-stranded RNA (dsRNA). When such a virus infects a cell, it releases its RNA molecule or molecules, which immediately bind to a protein complex called a dicer that cuts the RNA into smaller pieces.
o A biochemical pathway - the RISC complex, is activated, which ensures cell survival by degrading the viral mRNA.
o Rotaviruses have evolved to avoid this defense mechanism by not uncoating fully inside the cell, and releasing newly produced mRNA through pores in the particle's inner capsid.
o Their genomic dsRNA remains protected inside the core of the virion.
o Two types of antibodies are important. The first, called IgM, is highly effective at neutralizing viruses but is produced by the cells of the immune system only for a few weeks.
o The second, called IgG, is produced indefinitely.
o The presence of IgM in the blood of the host is used to test for acute infection, whereas IgG indicates an infection sometime in the past. IgG antibody is measured when tests for immunity are carried out.
Antibodies can continue to be an effective defence mechanism even after viruses have managed to gain entry to the host cell.
@ TRIM21 : During viral infection,a protein that is in host cells, called TRIM21, can attach to the antibodies on the surface of the virus particle. This primes the subsequent destruction of the virus by the enzymes of the cell's proteosome system.
A second defense of vertebrates against viruses is called cell-mediated immunity and involves immune cells known as T cells.
The body's cells constantly display short fragments of their proteins on the cell's surface, and, if a T cell recognises a suspicious viral fragment there, the host cell is destroyed by killer T cells and the virus-specific T-cells proliferate.
@ Interferon: During viral infection, the production of interferon is an important host defense mechanism. This is a hormone produced by the body when viruses are present. Its role in immunity is complex; it eventually stops the viruses from reproducing by killing the infected cell and its close neighbors.
Not all virus infections produce a protective immune response in this way. HIV evades the immune system by constantly changing the amino acid sequence of the proteins on the surface of the virion. These persistent viruses evade immune control by sequestration, blockade of antigen presentation,cytokine resistance, evasion of natural killer cell activities, escape from apoptosis, and antigenic shift. Other viruses, called neurotropic viruses, are disseminated by neural spread where the immune system may be unable to reach them.
Viral Structure and Replication
Viruses are noncellular genetic elements that use a living cell for their replication and have an extracellular state. Viruses are ultramicroscopic particles containing nucleic acid surrounded by protein, and in some cases, other macromolecular components such as a membranelike envelope.
Outside the host cell, the virus particle is also known as a virion. The virion is metabolically inert and does not grow or carry on respiratory or biosynthetic functions.
At present, there are no technical names for viruses. International committees have recommended genus and family names for certain viruses, but the process is still in a developmental stage.
Viruses vary considerably in size and shape. The smallest viruses are about 0.02 μm (20 nanometers), while the large viruses measure about 0.3 μm (300 nanometers). Smallpox viruses are among the largest viruses; polio viruses are among the smallest.
Viral structure. Certain viruses contain ribonucleic acid (RNA), while other viruses have deoxyribonucleic acid (DNA). The nucleic acid portion of the viruses is known as thegenome. The nucleic acid may be single-stranded or double-stranded; it may be linear or a closed loop; it may be continuous or occur in segments.
The genome of the virus is surrounded by a protein coat known as a capsid, which is formed from a number of individual protein molecules called capsomeres. Capsomeres are arranged in a precise and highly repetitive pattern around the nucleic acid. A single type of capsomere or several chemically distinct types may make up the capsid. The combination of genome and capsid is called the viral nucleocapsid.
A number of kinds of viruses contain envelopes. An envelope is a membranelike structure that encloses the nucleocapsid and is obtained from a host cell during the replication process. The envelope contains viral-specified proteins that make it unique. Among the envelope viruses are those of herpes simplex, chickenpox, and infectious mononucleosis.
The nucleocapsids of viruses are constructed according to certain symmetrical patterns. The virus that causes tobacco mosaic disease, for example, has helical symmetry. In this case, the nucleocapsid is wound like a tightly coiled spiral. The rabies virus also has helical symmetry. Other viruses take the shape of an icosahedron, and they are said to have icosahedral symmetry. In an icosahedron, the capsid is composed of 20 faces, each shaped as an equilateral triangle (Figure 1 ). Among the icosahedral viruses are those that cause yellow fever, polio, and head colds.
An array of viruses. (a) The helical virus of rabies. (b) The segmented helical virus of influenza. (c) A bacteriophage with an icosahedral head and helical tail. (d) An enveloped icosahedral herpes simplex virus. (e) The unenveloped polio virus. (f) The icosahedral human immunodeficiency virus with spikes on its envelope.
The envelope of certain viruses is a lipid bilayer containing glycoproteins embedded in the lipid. The envelope gives a somewhat circular appearance to the virus and does not contribute to the symmetry of the nucleocapsid. Projections from the envelope are known as spikes. The spikes sometimes contain essential elements for attachment of the virus to the host cell. The virus of AIDS, the human immunodeficiency virus, uses its spikes for this purpose.
Bacteriophages are viruses that multiply within bacteria. These viruses are among the more complex viruses. They often have icosahedral heads and helical tails. The virus that attacks and replicates in Escherichia coli has 20 different proteins in its helical tail and a set of numerous fibers and “pins.” Bacteriophages contain DNA and are important tools for viral research.
Viral replication. During the process of viral replication, a virus induces a living host cell to synthesize the essential components for the synthesis of new viral particles. The particles are then assembled into the correct structure, and the newly formed virions escape from the cell to infect other cells.
The first step in the replication process is attachment. In this step, the virus adsorbs to a susceptible host cell. High specificity exists between virus and cell, and the envelope spikes may unite with cell surface receptors. Receptors may exist on bacterial pili or flagella or on the host cell membrane.
The next step is penetration of the virus or the viral genome into the cell. This step may occur by phagocytosis; or the envelope of the virus may blend with the cell membrane; or the virus may “inject” its genome into the host cell. The latter situation occurs with the bacteriophage when the tail of the phage unites with the bacterial cell wall and enzymes open a hole in the wall. The DNA of the phage penetrates through this hole.
The replication steps of the process occur next. The protein capsid is stripped away from the genome, and the genome is freed in the cell cytoplasm. If the genome consists of RNA, the genome acts as a messenger RNA molecule and provides the genetic codes for the synthesis of enzymes. The enzymes are used for the synthesis of viral genomes and capsomeres and the assembly of these components into new viruses. If the viral genome consists of DNA, it provides the genetic code for the synthesis of messenger RNA molecules, and the process proceeds.
In some cases, such as in HIV infection (as discussed below), the RNA of the virus serves as a template for the synthesis of a DNA molecule. The enzyme reverse transcriptase catalyzes the DNA's production. The DNA molecule then remains as part of the host cell's chromosome for an unspecified period. From this location, it encodes messenger RNA molecules for the synthesis of enzymes and viral components.
For the release of new viral particles, any of a number of processes may occur. For example, the host cell may be “biochemically exhausted,” and it may disintegrate, thereby releasing the virions. For enveloped viruses, the nucleocapsids move toward the membrane of the host cell, where they force themselves through that membrane in a process called budding. During budding, a portion of cell membrane pinches off and surrounds the nucleocapsid as an envelope. The replication process in which the host cell experiences death is called the lytic cycle of reproduction. The viruses so produced are free to infect and replicate in other host cells in the area.
Lysogeny. Not all viruses multiply by the lytic cycle of reproduction. Certain viruses remain active within their host cells for a long period without replicating. This cycle is called the lysogenic cycle. The viruses are called temperate viruses, or proviruses, because they do not bring death to the host cell immediately.
In lysogeny, the temperate virus exists in a latent form within the host cell and is usually integrated into the chromosome. Bacteriophages that remain latent within their bacterial host cell are called prophages. This process is a key element in the recombination process known as transduction.
An example of lysogeny occurs in HIV infection. In this case, the human immunodeficiency virus remains latent within the host T-lymphocyte. An individual whose infection is at this stage will not experience the symptoms of AIDS until a later date.
محتويات مواقع أعضاء هيئة التدريس بما فيها من نصوص وملفات وصور وأبحاث وأية مواد أخرى هي مسئولية عضو هيئة التدريس بالكامل بصفته صاحب الموقع وبما له من صلاحية مطلقة في الإضافة والحذف، وتخلي الجامعة مسئوليتها عن محتويات تلك المواقع.
جميع الحقوق محفوظة © عمادة تقنية المعلومات والتعليم عن بعد 2018م ــ 1440هـ.