Page 312 - Review of Medical Microbiology and Immunology ( PDFDrive )

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CHAPTER 37 DNA Enveloped Viruses
301
Routine vaccination of civilians was discontinued, and it is
no longer a prerequisite for international travel. Military
personnel are still vaccinated.
In response to the possibility of a bioterrorism attack
using smallpox virus, the U.S. federal government has insti-
tuted a program to vaccinate “first responders” so that they
can give emergency medical care without fear of contract-
ing the disease. To protect the unimmunized general popu-
lation, the concept of “ring vaccination” will be used. This
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is based on the knowledge that an exposed individual can
mebooksfree.com mebooksfree.com mebooksfree.com FIGURE 37–11 Molluscum contagiosum—note two fleshy mebooksfree.com
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be immunized as long as 4 days after exposure and be
protected. Therefore, if an attack occurs, people known to
be exposed will be immunized as well as the direct contacts
of those people and then the contacts of the contacts, in an
expanding ring. Several military personnel and civilians
have experienced myocarditis following vaccination, and as
of this writing, caution has been urged regarding expand-
ing this program to the general population.
papular lesions under the eye caused by molluscum contagiosum
Vaccinia immune globulins (VIG), containing high-titer
antibodies against vaccinia virus, can be used to treat most of
from Usatine RP et al. The Color Atlas of Family Medicine. New York: McGraw-Hill,
2009. Copyright © 2009 by The McGraw-Hill Companies, Inc.)
the complications of vaccination. In the past, methisazone was
used to treat the complications of vaccination and could be virus, a member of the poxvirus family. (Reproduced with permission
useful again. Rifampin inhibits viral DNA-dependent RNA
mebooksfree.com mebooksfree.com mebooksfree.com whom lesions often occur around the eyes and on the mebooksfree.com
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polymerase but was not used clinically against smallpox.
MCV is transmitted by close personal contact, includ-
ing sexually. The disease is quite common in children, in
MOLLUSCUM CONTAGIOSUM VIRUS
trunk. Adults often have lesions in the genital area. The
Molluscum contagiosum virus (MCV) is a member of the
lesions can be large and numerous in patients with
poxvirus family but is quite distinct from smallpox and
reduced cellular immunity, such as AIDS patients. In
vaccinia viruses. The lesion of molluscum contagiosum is a
immunocompetent patients, the lesions are self-limited
but may last for months.
small (2–5 mm), flesh-colored papule on the skin or
The diagnosis is typically made clinically; the virus is not
mucous membrane that is painless, nonpruritic, and not
inflamed (Figure 37–11). The lesions have a characteristic
helpful. Removal of the lesions by curettage or with liquid
cup-shaped (umbilicated) crater with a white core. The
lesion is composed of hyperplastic epithelial cells within isolated in the clinical laboratory, and antibody titers are not
nitrogen is often effective. There is no established antiviral
which a cytoplasmic inclusion body can be seen. The inclu-
therapy, but cidofovir may be useful in the treatment of the
mebooksfree.com mebooksfree.com mebooksfree.com restore sufficient immunity to cause the lesions to resolve. mebooksfree.com
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extensive lesions that occur in immunocompromised
sion body contains progeny MCV.
Note that these lesions are different from warts,
patients. In AIDS patients, antiretroviral therapy may
which are caused by papillomavirus, a member of the
papovavirus family.
There is no vaccine.
HEPADNAVIRUSES
HEPATITIS B VIRUS
HSV-2.
Hepatitis B virus, a DNA enveloped virus, is described in
(B) The main site of latency by HSV-1 is the neurons in the sen-
Chapter 41 with the other hepatitis viruses. (A) Acyclovir can eradicate the latent state of HSV-1 but not
sory ganglia of the face.
(C) HSV-1 is an enveloped virus that has a DNA genome and a
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DNA polymerase in the virion.
(D) The lesions of primary HSV-1 infections are less extensive
SELF-ASSESSMENT QUESTIONS
and less severe than the lesions of recurrent HSV-1
1. Your patient is a 30-year-old man who has frequent episodes of
infections.
herpes labialis. He asks you to tell him something about herpes
(E) The laboratory diagnosis of HSV-1 infections typically
involves the detection of a greater than fourfold rise in anti-
simplex virus type 1 (HSV-1). Which one of the following would
body titer against the virus.
be the most accurate statement to make?

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