Updated: 5/29/2019

RNA Viruses

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RNA Virus Table
 
(+) Strand RNA 
Picornavirus 
  Disease Treatment or Vaccine
Poliovirus 
  • Paralytic poliomyelitis (paralysis)
  • Aseptic meningitis 
  • Post-polio syndrome
  • Sabin vaccine (live)
  • SalK vaccine (Killed)
Rhinovirus 
  • Common cold (most common cause)
  • No specific treatment
Coxsackievirus 
  • Aseptic meningitis 
  • Carditis
  • Hand, foot, and mouth disease
  • Herpangia
  • Pleurodynia
  • Bornholm disease (Devil's grip)
  • No specific treatment
Echovirus 
  • Aseptic meningitis
-
Hepatitis A virus  
  • Mild acute hepatitis 
  • Killed vaccine
  • Serum globulin
Calicivirus
Norwalk virus 
  • Acute gastroenteritis (schoolchildren)
  • No specific treatment
Togavirus
Rubella virus 
  • Rubella (German measles)
  • Congenital rubella 
  • Live attenuated vaccine (MMR)
Eastern equine encephalitis -
  • Killed vaccine
Western equine encephalitis -
  • Killed vaccine
Flavivirus
Yellow fever virus 
  • Yellow fever
  • Live attenuated vaccine
Dengue 
  • Dengue ("break bone fever")
  • Supportive only
Hepatitis C virus 
  • Chronic hepatitis
  • IFN
  • Ribavirin
West Nile virus 
  • Aseptic meningitis
  • Encephalitis
  • Paralysis
  • Supportive only
St. Louis encephalitis 
  • Encephalitis
  • Supportive only
Coronavirus
Coronavirus 
  • Common cold
  • SARS
  • Self-limiting
Retrovirus 
HIV 
  • AIDS
  • HAART
Human T cell leukemia virus
  • T-cell leukemia
-
Hepevirus
Hepatitis E virus 
  • Mild acute hepatitis (fatal when prEgnant)
  • Self-limiting
(-) Strand RNA
Bunyavirus
Hantavirus 
  • Hantavirus pulmonary syndrome (50% mortality)
  • Supportive only
CA Encephalitis virus
  • Encephalitis
-
Orthomyxovirus
Influenza virus 
  • Flu
  • Zanamivir/oseltamivir
Paramyxovirus
Rubeola 
  • Measles
  • Live attenuated vaccine (MMR)
Mumps virus 
  • Mumps
  • Live attenuated vaccine (MMR)
RSV 
  • Pneumonia (infants)
  • Palivizumab
Parainfluenza 
  • Croup
  • Bronchiolitis
  • Pneumonia
  • Supportive only
Rhabdovirus
Rabies virus 
  • Rabies
  • hRIG
Arenavirus
Lassa fever virus 
  • Hemorrhagic fever (50% mortality)
  • Ribavirin
Lymphocytic choriomeningitis virus (LCMV)
  • Meningitis
-
Filovirus
Ebola and marburg viruses 
  • Hemorrhagic fever (up to 90% mortality)
  • Supportive only
Double-Stranded (ds) RNA
Reovirus
Reovirus 
  • Common cold
  • Gastroenteritis
  • Self-limiting
Rotavirus 
  • Gastroenteritis (infants)
  • Self-limiting
Colorado tick fever virus
  • Flu-like
  • Supportive only
 
Virus Overview
  • Viruses are obligate intracellular infectious agents with the following basic components
    • DNA or RNA
      • never both
    • capsid
      • a protein coat that surrounds the genetic material
      • icosahedral or helical symmetry
      • made of capsomers
        • polypeptide chains organized into a globular subunit
        • in helical symmetry, capsomers are bound to RNA and coiled
          • forms a helical nucleoprotein capsid
    • sometimes an envelope
  • Viruses are classified by 
    • nucleic acid
      • DNA or RNA
      • double stranded or single stranded
      • (+) or (-) stranded RNA
      • single or segmented pieces of nucleic acid
      • complexity of genome
    • capsid
      • icosahedral or helical
    • envelope
      • naked
        • DNA or RNA + capsomers and other structural proteins = nucleocapsid
      • enveloped
        • nucleocapsid + host membrane with viral-specified glycoproteins = enveloped virus
    • size
      • diameter or number of capsomers
    • ploidy
      • all viruses are haploid (1 copy of DNA or RNA)
      • except retroviruses
        • retroviruses have 2 identical copies of their ssRNA, approximating diploidy
    • infectivity of purified nucleic acid 
      • purified nucleic acid that is intrinsically infectious
        • dsDNA from most viruses
          • except poxviridae
          • except HBV
        • (+) strand ssRNA from most viruses
          • (+) linear, nonsegmented ssRNA can be translated immediately into a large protein by host machinery
          • virus must carry protease to cleave the 1 large protein product that will be generated by the host machinery
      • purified nucleic acid that is NOT intrinsically infectious
        • (-) ssRNA
          • viruses must carry an RNA-dependent RNA polymerase to generate mRNA the host machinery can read
        • dsRNA
        • they require enzymes contained in the complete virion for infectivity
RNA Viruses
  • Most RNA viruses
    • are single-stranded (ssRNA, like human mRNA)
    • have helical symmetry
    • replicate in the cytoplasm
    • are enveloped
  • Exceptions
    • double-stranded (dsRNA)
      • reo
    • icosahedral
      • reo
      • picorna
      • toga
      • flavi
      • calici
    • replicate in nucleus 
      • retro
      • orthomyxo
    • non-enveloped
      • picorna
      • calici
      • reo
      • hepe
 

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Questions (2)
Lab Values
Blood, Plasma, Serum Reference Range
ALT 8-20 U/L
Amylase, serum 25-125 U/L
AST 8-20 U/L
Bilirubin, serum (adult) Total // Direct 0.1-1.0 mg/dL // 0.0-0.3 mg/dL
Calcium, serum (Ca2+) 8.4-10.2 mg/dL
Cholesterol, serum Rec: < 200 mg/dL
Cortisol, serum 0800 h: 5-23 μg/dL //1600 h:
3-15 μg/dL
2000 h: ≤ 50% of 0800 h
Creatine kinase, serum Male: 25-90 U/L
Female: 10-70 U/L
Creatinine, serum 0.6-1.2 mg/dL
Electrolytes, serum  
Sodium (Na+) 136-145 mEq/L
Chloride (Cl-) 95-105 mEq/L
Potassium (K+) 3.5-5.0 mEq/L
Bicarbonate (HCO3-) 22-28 mEq/L
Magnesium (Mg2+) 1.5-2.0 mEq/L
Estriol, total, serum (in pregnancy)  
24-28 wks // 32-36 wks 30-170 ng/mL // 60-280 ng/mL
28-32 wk // 36-40 wks 40-220 ng/mL // 80-350 ng/mL
Ferritin, serum Male: 15-200 ng/mL
Female: 12-150 ng/mL
Follicle-stimulating hormone, serum/plasma Male: 4-25 mIU/mL
Female: premenopause: 4-30 mIU/mL
midcycle peak: 10-90 mIU/mL
postmenopause: 40-250
pH 7.35-7.45
PCO2 33-45 mmHg
PO2 75-105 mmHg
Glucose, serum Fasting: 70-110 mg/dL
2-h postprandial:<120 mg/dL
Growth hormone - arginine stimulation Fasting: <5 ng/mL
Provocative stimuli: > 7ng/mL
Immunoglobulins, serum  
IgA 76-390 mg/dL
IgE 0-380 IU/mL
IgG 650-1500 mg/dL
IgM 40-345 mg/dL
Iron 50-170 μg/dL
Lactate dehydrogenase, serum 45-90 U/L
Luteinizing hormone, serum/plasma Male: 6-23 mIU/mL
Female: follicular phase: 5-30 mIU/mL
midcycle: 75-150 mIU/mL
postmenopause 30-200 mIU/mL
Osmolality, serum 275-295 mOsmol/kd H2O
Parathyroid hormone, serume, N-terminal 230-630 pg/mL
Phosphatase (alkaline), serum (p-NPP at 30° C) 20-70 U/L
Phosphorus (inorganic), serum 3.0-4.5 mg/dL
Prolactin, serum (hPRL) < 20 ng/mL
Proteins, serum  
Total (recumbent) 6.0-7.8 g/dL
Albumin 3.5-5.5 g/dL
Globulin 2.3-3.5 g/dL
Thyroid-stimulating hormone, serum or plasma .5-5.0 μU/mL
Thyroidal iodine (123I) uptake 8%-30% of administered dose/24h
Thyroxine (T4), serum 5-12 μg/dL
Triglycerides, serum 35-160 mg/dL
Triiodothyronine (T3), serum (RIA) 115-190 ng/dL
Triiodothyronine (T3) resin uptake 25%-35%
Urea nitrogen, serum 7-18 mg/dL
Uric acid, serum 3.0-8.2 mg/dL
Hematologic Reference Range
Bleeding time 2-7 minutes
Erythrocyte count Male: 4.3-5.9 million/mm3
Female: 3.5-5.5 million mm3
Erythrocyte sedimentation rate (Westergren) Male: 0-15 mm/h
Female: 0-20 mm/h
Hematocrit Male: 41%-53%
Female: 36%-46%
Hemoglobin A1c ≤ 6 %
Hemoglobin, blood Male: 13.5-17.5 g/dL
Female: 12.0-16.0 g/dL
Hemoglobin, plasma 1-4 mg/dL
Leukocyte count and differential  
Leukocyte count 4,500-11,000/mm3
Segmented neutrophils 54%-62%
Bands 3%-5%
Eosinophils 1%-3%
Basophils 0%-0.75%
Lymphocytes 25%-33%
Monocytes 3%-7%
Mean corpuscular hemoglobin 25.4-34.6 pg/cell
Mean corpuscular hemoglobin concentration 31%-36% Hb/cell
Mean corpuscular volume 80-100 μm3
Partial thromboplastin time (activated) 25-40 seconds
Platelet count 150,000-400,000/mm3
Prothrombin time 11-15 seconds
Reticulocyte count 0.5%-1.5% of red cells
Thrombin time < 2 seconds deviation from control
Volume  
Plasma Male: 25-43 mL/kg
Female: 28-45 mL/kg
Red cell Male: 20-36 mL/kg
Female: 19-31 mL/kg
Cerebrospinal Fluid Reference Range
Cell count 0-5/mm3
Chloride 118-132 mEq/L
Gamma globulin 3%-12% total proteins
Glucose 40-70 mg/dL
Pressure 70-180 mm H2O
Proteins, total < 40 mg/dL
Sweat Reference Range
Chloride 0-35 mmol/L
Urine  
Calcium 100-300 mg/24 h
Chloride Varies with intake
Creatinine clearance Male: 97-137 mL/min
Female: 88-128 mL/min
Estriol, total (in pregnancy)  
30 wks 6-18 mg/24 h
35 wks 9-28 mg/24 h
40 wks 13-42 mg/24 h
17-Hydroxycorticosteroids Male: 3.0-10.0 mg/24 h
Female: 2.0-8.0 mg/24 h
17-Ketosteroids, total Male: 8-20 mg/24 h
Female: 6-15 mg/24 h
Osmolality 50-1400 mOsmol/kg H2O
Oxalate 8-40 μg/mL
Potassium Varies with diet
Proteins, total < 150 mg/24 h
Sodium Varies with diet
Uric acid Varies with diet
Body Mass Index (BMI) Adult: 19-25 kg/m2
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