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~ Childhood fever :

Measles virus

Mumps virus

Rubella virus

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- Genom Measles virus tdd 15900 nt yang mengkode

protein N, P, M, F, H, L (C&V ~ infeksi).

Journal of General Virology (2006), 87, 2767

2779

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- Dapat dikultur pada human & monkey kidney cells

- Inaktivasi oleh : pelarut lipid (ether, aseton), deterjen,

pH asam ( anak-anak)

- Epidemik, Endemik : pre vaksinasi

- Morbiditas dan mortalitas ~ infant/usia tua, sosioek rendah,

malnutrisi, defisiensi vit A.

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- Seasonal : late winter & early spring (temperate)

hot/dry season (tropics)

- Transmisi : via droplet sekresi saluran napas

- The most contagious infections of humans,

no latent/persistent infections, no animal reservoirs- :Lifelong immunity

- Reinfeksi hampir selalu asimtomatik.

~ immunosuppression(multifaktorial)

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Manifestasi Klinis

- Sangat jarang subklinis

Prodromal (demam, malaise) gejala katarhal : coryza,

conjunctivitis, sneezing, cough Kopliks spot rash.

- Komplikasi : otitis media, diare, pneumonia, ensefalitis.

Diagnosis

- Berdasar klinis

- Laboratoris : Spesimen : sekresi respiratorius,

swab nasofaring/conjuctiva

- Isolasi virus (kultur) dan deteksi CPE

- Uji sitologis (+ HE)

- Uji serologis(deteksi ag dan ab)

- Deteksi asam nukleat (RT-PCR)

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Prevensi (vaksin MMR, IG, isolasi)Program vaksin MMR : sejak 1988

Terapi (Simtomatik, vitamin A, no antiviral, tx komplikasi)

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Mumps virus

Klasifikasi, Struktur, Genom & Kultur Virus

- GenusRubulavirus, FamiliParamyxoviridae.

1 serotipe

- Virion (pleomorphic, irregularly spherical particles) tdd :

a.Linear, ss negative-sense RNA

b.Helically coiled nucleocapsid

c.Envelope tdd :glycoprotein spikes, lipid bilayer,inner structural matrix protein

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- Genom tdd 15300 nt yang mengkode 7 protein utama

(N, P, M, F,SH, HN, L)

- Dapat dikultur pada a.l. Vero cells, HeLa cells,

human embryonic kidney cells

- Inaktivasi oleh : formalin, ether, chloroform, deterjen, panas, uv

Epidemiologi

- Worldwide(>school-aged children, 5-9 years old)

- Lifelong immunity- Transmisi : ~ airborne/ droplet

- Highly contagious

- Human : the only known natural host

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Manifestasi Klinis

- Parotitis (30-40%) dan meningitis aseptik

Tanpa gejala : > 20%

- Komplikasi : gonadal infections (orchitis) ~ post pubertas pria,

pankreatitis, polyarthritis, myocarditis, dll

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Diagnosis Laboratoris

- Spesimen : saliva- Deteksi as. nukleat (PCR)

- Uji serologis (CFT, ELISA) : deteksi ab

Prevensi (vaksin)

Terapi (Simtomatik)

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Rubella (German measles)Virus

Klasifikasi, Struktur , Genom dan Kultur Virus- Termasuk dalam GenusRubivirus, Famili Togaviridae

1 serotipe

- Struktur virus :

a. Single stranded positive-sense RNA

b.Envelope with glycoprotein projections

c. Spherical particle

- Genom tdd 10000 nt

Protein struktural : C, E1(haemaglutinin), E2

- Pada kultur sel : tak menghasilkan reliable CPE

- Inaktivasi oleh : 56C, pH asam (8.1), uv,

ether, klorin, 70% alkohol

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1. RV virion attaches to the cell surface & is translocated to the coated pit.

2. The coated pit then pinches off to form a coated vesicle contains the virion3. The virion passes through a series of endosomes with progressively acidic pH

until it arrives at an endosome where the environment is sufficiently acidic to

trigger the uncoating process. The E1 and capsid proteins undergo conforma-

tional changes that result in the release of the viral genom into the cytoplasm.

4. Release of the viral RNA triggers the transformation of the endosome, and

vesicles are induced to form within the endosome. This leads to the formation

of the replication complex. Concomitantly, the RER migrates to the vicinity of

the virus-modified endosome. At the early stage of infection, the RER is asso-

ciated with the side of the vacuole containing the vesicles.

5. As infection progresses, the RER surrounds the entire vacuole, which is lined

internally with vesicles. While these events are occurring, the virus-modifiedendosome fuses to a lysosome as part of its life cycle.

6. The replication complex continues in its life cycle as a virus-modified lysosome

and eventually expels its lysosomal contents, including the vesicles, after fusion

of the lysosomal vacuole membrane to the plasma membrane.

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Manifestasi Klinis

- Rubella kongenital(triad : katarak, jantung abnormal, deafness- Rubella postnatal

Gejala prodromal : KGB > (painful), demam ringan,

ophthalmalgia, conjunctivitis,

cough, coryza, sore throat

- Komplikasi : arthritis, arthralgia, gejala neurologis, perdarahan

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Diagnosis Laboratoris

- Spesimen : usap tenggorok, conjunctiva, urin, darah, CSF

- Deteksi ab (ELISA, CFT)

Prevensi (imunisasi aktif dan pasif)

Terapi- no tx warranted

- IFN dan Amantadine : untuk Rubella kongenital