1887

Chapter 1 : Viral Zoonoses

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Abstract:

This chapter talks about the alphaviruses, arboviruses, flaviviruses, orthopoxviruses and other viruses. The etiology, occurrence, transmission, clinical manifestations, diagnosis, therapy and prophylaxis of each virus are explained in detail. This sequence makes it possible to point out the similarities within individual virus groups. Viral zoonoses are also compared with nonviral zoonotic diseases. A section deals with some viruses that reflect the modern concept of emerging and reemerging infections. Birds are the most important vertebrate hosts in encephalitis viruses group of viruses. Due to the extreme length of the viral genome for paramyxoviruses, Hendra virus together with Nipah virus was initially classified as a megaparamyxovirus but is now in the genus Henipavirus in the family Paramyxoviridae. The causative agent of swine vesicular disease (SVD) is an enterovirus which is biochemically and serologically closely related to human coxsackievirus B5, which is now classified as the human enterovirus B, serotype 5. The following orthopoxviruses have to be considered as zoonotic agents: monkeypox virus (only known since 1970), vaccinia virus (Jenner’s smallpox vaccine virus), buffalopox virus (closely related to vaccinia virus), camelpox virus (closely related to smallpox virus), cowpox virus (not identical to vaccinia virus), and elephantpox virus (closely related to cowpox virus). It is debatable whether the virus, which is today classified as cowpox virus, is identical to vaccinia virus.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figures

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Figure 1.1

(A) Urban infectious cycles where humans are the source of infection for mosquitoes have been demonstrated or are possible if the level of viremia is sufficient. Infected people have to be protected from mosquito bites. This type of infection cycle has been found for yellow fever, dengue, St. Louis encephalitis, Venezuelan equine encephalitis, and Chikungunya fever and is possible for O'nyong-nyong, Mayaro, Ross River, Oropouche, Rift Valley, and Wesselsbron fevers. (B) Humans are the dead-end hosts in the infection chain and do not serve for amplification. This type of infection chain exists for eastern and western equine encephalitides and Rocio, West Nile, and Sindbis fevers. (C) A vertical transmission (transovarial and transstadial) exists in arthropods and is of importance epidemiologically. This type of transmission is found in the following tick-transmitted virus infections: spring-summer meningoencephalitis, Russian spring-summer meningoencephalitis, louping ill, Kyasanur Forest fever, Omsk hemorrhagic fever, Crimean-Congo hemorrhagic fever, and Colorado tick encephalitis. It is found in the following mosquito-transmitted infections: California and Japanese encephalitides and Murray Valley fever.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.2

Areas in Eurasia where TBE is endemic. The transition from the eastern to the western type of TBE is indicated. Outside the areas of endemicity, sporadic autochthonous TBE infections have been found. (Courtesy of Chiron Behring.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.3

Infectious cycle of the TBE virus complex.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.4

Distribution and numbers of reported cases of Japanese encephalitis in regions of endemicity in Asia between 1986 and 1990. (Reprinted with permission from the WHO, Wkly. Epidemiol. Rec. 16:113–118, 1994.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.5a

Distribution of YF in Africa (A) and South and Central America (B). Source: WHO International Travel and Health: Vaccination Requirements and Health Advice (WHO Geneva, Switzerland, 1996).

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.5b

Distribution of YF in Africa (A) and South and Central America (B). Source: WHO International Travel and Health: Vaccination Requirements and Health Advice (WHO Geneva, Switzerland, 1996).

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.6

Maculopapular exanthema at day 6 of Marburg virus disease. (Courtesy of G. Baltzer.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.7

Patient with Marburg virus disease in a prefinal stage. (Courtesy of W. Stille.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.8

Infection chain of rabies.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.9

Hemorrhagic conjunctivitis after infection with NDV. (Photo: J. Kösters, Institute for Poultry Diseases, University of Munich, Munich, Germany.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.10

Lesions on the hand of an animal keeper, caused by FMD virus infection. (Archival photo, Institute of Veterinary Hygiene and Animal Infectious Diseases, Justus Liebig University, Giessen, Germany.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.11

Local pox after vaccination with vaccinia virus. (Photo: J. Pilaski.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.12

Facial poxvirus lesion (arrow) in a cat. (Photo: D. von Bomhard.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.13

Poxvirus lesion transmitted from a diseased cat. (Photo: T. Nasemann.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.14

Contagious ecthyma of sheep. (Photo: J. Pilaski.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.15

Human infection with orf virus. (Photo: Dr. Valder, Bundesministerium für Ernährung, Landwirtschaft und Forster, Bonn, Germany.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.16

Pseudocowpox infection on the udder of a cow (udder pox).

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Figure 1.17

Generalized pseudocowpox virus infection in a human. (Photo: J. Pilaski.)

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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References

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Tables

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Untitled

PCR Techniques for Detection of Alphaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

PCR Techniques for Detection of Alphaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

PCR Techniques for Detection of Alphaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

RT-PCR Techniques for Detection of Flaviviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
Generic image for table
Untitled

RT-PCR Techniques for Detection of Flaviviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

RT-PCR Techniques for Detection of Flaviviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.1

Zoonotic bunyaviruses

a Only selected members of the genus are listed.

b Simbu subgroup.

c Hosts of hantaviruses serve as virus reservoirs and are the sources of human infections.

d Viruses found in Eurasia with hosts from the subfamily Murinae.

e New World hantaviruses with hosts from the family Cricetidae.

f Viruses with hosts from the subfamily Arvicolinae.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

PCR Techniques for Detection of Bunyaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
Generic image for table
Untitled

PCR Techniques for Detection of Bunyaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
Generic image for table
Untitled

PCR Techniques for Detection of Bunyaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
Generic image for table
Untitled

PCR Techniques for Detection of Bunyaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
Generic image for table
Untitled

PCR Techniques for Detection of Bunyaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

RT-PCR Technique for Detection of Coltiviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.2

Zoonotic arenaviruses

a Mopaia, Mobala, and Ippy viruses are closely related to Lassa virus. They infect other hosts and are not considered to be pathogenic for humans.

b The Tacaribe complex includes at least six additional arenaviruses. They are not known to cause disease in humans.

c There are three different genetic lineages (A, B, and C) in the Tacaribe complex. The newly discovered Whitewater Arroyo virus is believed to be a natural recombinant from lineage A (the N gene) and lineage B (the GPC gene).

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

RT-PCR Techniques for Detection of Arenaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

RT-PCR Techniques for Detection of Arenaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.3

Viruses in the family Filoviridae

a Reston virus, the Asian subtype of Ebola virus, is nonpathogenic for humans.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

PCR Techniques for Detection of Filoviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.4

Genus Lyssavirus a

a Based on molecular genetics and immunological differences, it has been proposed that two phylogroups within the seven known subtypes of rabies virus be formed. Group 1 includes the classical rabies virus (type 1) as well as bat viruses (types 4 to 7). Phylogroup 2 covers the two West African bat viruses (types 2 and 3).

b This is the most important rabies agent. It induces more than 99% of all rabies cases worldwide. Only some countries with insular or peninsular geography are free from rabies virus (e.g., New Zealand, Australia, Japan, United Kingdom, and Scandinavia).

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.5

Genus Vesiculovirus a

a There are more than 20 virus types within this genus. Only five of them are known to cause human disease.

b Virus sometimes classified as a subtype of VSV Indiana.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.6

Recommendations for postexposure rabies prophylaxis a

a It is important to vaccinate within 24 h after exposure if indicated. It is life-threatening to wait, e.g., to observe the animal that has bitten a person. The decision to vaccinate is no longer influenced by possible side effects of the vaccine when modern vaccines are used.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.7

Recommendations for treatment of animal bites

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

Primers for Diagnostic RT-PCR for Rhabdoviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.8

Zoonotic paramyxoviruses

a An additional virus in this genus, Tioman virus, was isolated from Pteropus hypomelanus in Malaysia. There is at present no evidence of a zoonosis. The classification of Menangle virus and Tioman virus is preliminary.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

PCR Techniques for Diagnosis of Paramyxoviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
Generic image for table
Untitled

PCR Techniques for Diagnosis of Paramyxoviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

PCR Techniques for Diagnosis of Influenza Viruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

PCR Techniques for Diagnosis of Influenza Viruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

PCR Techniques for Diagnosis of Picornaviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

Detection of Herpes B Virus by PCR

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.9

Poxvirus subfamily Chordopoxvirinae

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Untitled

Use of PCR for Diagnosis of Orthopox- and Parapoxviruses

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.10

Transmissible encephalopathies in animals and humans

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.11

Criteria for diagnosis of human BSE (nvCJD) a

a Roman numerals indicate groups of diagnostic criteria with increasing stringency.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1
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Table 1.12

Differential diagnosis of CJD and human BSE (nvCJD) a

a Modified from R. G. Will, J. W. Ironside, M. Zeidler, S. N. Cousens, K. Estibeiro, A. Alperovitch, S. Poser, M. Pocchiari, A. Hofman, and P. G. Smith, Lancet 347:921–925, 1996.

b Florid plaques are amyloid plaques surrounded by vacuoles in rosette formation.

Citation: Krauss H, Weber A, Appel M, Enders B, Isenberg H, Schiefer H, Slenczka W, von Graevenitz A, Zahner H. 2003. Viral Zoonoses, p 1-172. In Zoonoses. ASM Press, Washington, DC. doi: 10.1128/9781555817787.ch1

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