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Chapter 1 : Epidemiology
Category: Clinical Microbiology; Viruses and Viral Pathogenesis
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Salient organizing principles for understanding the epidemiology of enterovirus infection and disease include evolutionary and adaptational strategies, the interaction of the virus with its human host and the environment, and characteristic modes of transmission. The epidemiology of a particular agent, or of a disease associated with a particular agent, reflects not only the properties of the agent, host, and environment but also the mode of transmission. The spectrum of enteroviral infection and disease can be better understood and categorized according to epidemiologic features that include modes of transmission as well as evolutionary-adaptational aspects of the relationships between the viral agents, their human hosts, and the environment. The chapter provides a discussion on molecular epidemiology that focuses on three of the most useful techniques: partial genome sequencing, analysis of RNA genome relationships by screening oligonucleotide mapping of the entire genome, and analysis of viral epitope distribution by use of monoclonal antibodies. In recent years, molecular techniques have been increasingly used to study the epidemiology of other polioviruses. The technique of oligonucleotide mapping produces characteristic patterns for given strains of viruses that have been referred to as "fingerprints." Fingerprint studies of wild and vaccine polioviruses have revealed many fascinating aspects of poliovirus molecular epidemiology. Molecular epidemiology promises new insights into the origin, evolution, and prevention of human enteroviruses.