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Krishna
Associate Professor
Microbiology & Molecular Cell Biology
Pediatrics
KrishnNK@EVMS.EDU
LH 3184, x5677
Research Experience:
Molecular Virology, Complement Biology,
Complement Drug Development
Caliciviruses
Calicivirus
Viral pathogens
causing gastroenteritis
Proven causes Uncertain role
Caliciviruses Picornaviruses (Aichi virus)
Astroviruses Picobirnaviruses
Reoviruses (rotavirus) Toroviruses
Enteric adenovirus Coronaviruses
Others
Outcome
Diarrhea
World
Physician visits
2 3.7 million
Hospitalizations
>200,000
45 90 million
~500
3 3.5 million**
Deaths
Caliciviruses
Small, non-enveloped, (+)
strand RNA viruses with
icosahedral symmetry.
Characteristic cuplike
depression on surface of virion
that are readily visualized by
electron microscopy.
Acid stable and resistant to
the low pH encountered in the
stomach.
Not able to be efficiently
propagated in tissue culture
and therefore our knowledge
of the replicative cycle of this
virus is limited.
Calicivirus
Replication
Key
concepts
Caliciviruses
are small, non-
Calicivirus
Replication
Caliciviruses
Medically relevant
caliciviruses
are divided into two genera:
Norovirus
type species: norovirus (Norwalk-like
viruses)
Number of strains > 52 (2009)
Sapovirus
type species: Sapporo-like virus
Number of strains > 6 (2002)
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orovirus Transmission/Epidemiolog
Norwalk virus is named for an outbreak of
gastroenteritis in a school in Norwalk, Ohio (1969).
Transmitted horizontally by the fecal-oral route.
The most common cause of gastroenteritis
outbreaks among adults in the US and cause an
estimated 23 million cases annually.
Have a worldwide distribution and affect all age
groups, whereas acute gastroenteritis caused by
astrovirus and rotavirus is a disease of infants and
young children.
As
few as 10 viral particles will initiate disease in
humans.
Up to 100 billion virions are released per gram of
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feces!
orovirus Transmission/Epidemiolog
Outbreaks have occurred in schools, camps, cruise
ships, restaurants and families.
While noroviruses have gained notoriety for
causing outbreaks of acute gastroenteritis on
cruise ships, 60-80% of all such outbreaks occur
on land.
Outbreaks are associated with the ingestion of
contaminated food or water, direct person-toperson contact and contact with contaminated
environmental surfaces (fomites).
Noroviruses have no seasonal incidence.
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Laboratory Diagnosis
RT-PCR assays have been developed to detect norovirus in
stools and other clinical or environmental samples.
ELISAs are also available to detect virus, viral antigens or
norovirus-specific antibody in serum. Serology can be used to
confirm the diagnosis.
ImmunoEM can be used to concentrate and identify virus from
the stool.
In reality, laboratory diagnosis is not routinely performed
unless there is a significant outbreak or for epidemiological
purposes.
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