USMLE

Filovirus

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Viruses - RNA Viruses
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Summary

Filoviruses are a class of RNA viruses that contain single-stranded, negative-sense RNA. They utilize a helical capsid, and are further surrounded by a viral envelope. The most well-known filovirus is the ebola virus, which is a highly contagious and life-threatening virus that causes hemorrhage and DIC. Another lesser-known virus is the Marburg virus, which causes Marburg Hemorrhagic Fever. Diagnosis of filovirus infections involves a PCR to detect the viral RNA. As of now, no curative treatment for Ebola and Marburg viruses exists and most patients receive general supportive care. 

Key Points

  • Filoviruses
    • Characteristics
      • RNA viruses
        • replicate in the cytoplasm of cells
        • Single-stranded
        • - sense
        • Linear
      • Enveloped
      • Helical capsid
    • Presentation
      • Ebolaviruses
        • Transmission
          • Travel to endemic countries
            • direct contact with bodily fluids, fomites (including dead bodies), infected bats or primates (apes/monkeys)
          • high incidence of nosocomial (health-care related) infection
        • Pathogenesis
          • Targets endothelial cells, hepatocytes, phagocytes
        • Presentation
          • incubation period of up to 21 days
          • abrupt onset of flu-like symptoms (high fever, myalgia), diarrhea, and vomiting
          • DIC, diffuse hemorrhage, shock, conjunctival injection
        • Diagnosis
          • RT-PCR
            • Viral RNA detectable within 48 hrs of sxs onset
        • Treatment
          • Supportive ; no definitive treatment
            • High mortality rate
          • Strict isolation for infected individuals and barrier practices for health care workers are key in preventing transmission
      • Marburg hemorrhagic fever