Chapter 97 : Arenaviruses and Filoviruses

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Arenaviruses and Filoviruses are zoonotic viruses associated with one or more nonhuman host or vector species, mostly rodent and bats. Vascular leak, shock, and multi-organ dysfunction are prominent features and lead frequently to fatal hemorrhagic fever. However, confirming early clinical impressions requires further, specific virologic and serologic testing. A combination of several laboratory techniques should be used to confirm any clinical suspicion, keeping in mind that the manipulation of these dangerous viruses requires specific biosafety requirements. A correct understanding of the order of appearance of RNA, antigen, virus, antibodies in blood, secretions, tissues over the period of the infectious process, as well as accurate knowledge of a patient’s clinical status, is important to understand and interpret laboratory results. During the acute phase of the disease, the amplification and sequence of viral genome, PCR-based assays, are certainly the most sensitive assays, assuming that the primers match with an eventual new virus. The antigen capture ELISA seems to be less virus-specific and readily detects antigen during the obvious clinical phase of disease. Because of the time required for culture and the associated biohazard, virus isolation data for these viruses are usually available only retrospectively. A rising IgM or IgG ELISA titer constitutes a strong presumptive diagnosis. Early recognition of viral hemorrhagic fever infection is valuable, as it can trigger strict isolation procedures, thus preventing or limiting the spread of disease, and allowing specific treatment, when available, to be initiated early in the infectious process.

Citation: Rollin P, Nichol S, Zaki S, Ksiazek T. 2015. Arenaviruses and Filoviruses, p 1669-1686. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch97
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Image of FIGURE 1

Ultrastructural characteristics of LCM virus and Ebola virus as seen in tissue culture cells. (A) LCM virus, an arenavirus, showing pleomorphic enveloped particles with internal ribosome-like granules. Scale bar, 100 nm. (Courtesy of C. S. Goldsmith.) (B) Isolate of Ebola virus, a filovirus, showing enveloped filamentous particles around 80 nm wide. Some filaments can occasionally measure up to 15,000 nm in length. Scale bar, 100 nm. (Courtesy of C. S. Goldsmith.) doi:10.1128/9781555817381.ch97.f1

Citation: Rollin P, Nichol S, Zaki S, Ksiazek T. 2015. Arenaviruses and Filoviruses, p 1669-1686. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch97
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Image of FIGURE 2

Ebola virus HF. (A) Section of liver showing hepatocellular necrosis, numerous intracytoplasmic, eosinophilic Ebola viral inclusions, as well as sinusoidal dilatation and congestion. Hematoxylin and eosin stain; original magnification, ×250. (B) Several Ebola viral inclusions are seen in a thin-section electron micrograph of liver. The inclusions consist of viral nucleocapsids mostly seen in longitudinal section. Numerous viral particles are also seen in sinusoidal spaces. Scale bar, 100 nm. (Courtesy of C. S. Goldsmith.) doi:10.1128/9781555817381.ch97.f2

Citation: Rollin P, Nichol S, Zaki S, Ksiazek T. 2015. Arenaviruses and Filoviruses, p 1669-1686. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch97
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Image of FIGURE 3

(A) Using immunohistochemistry, abundant Ebola virus antigens (in red) are seen in the lymph node of a pig infected by Ebola Reston virus. Original magnification, ×158. (B) Skin showing massive viral burden as seen in this section immunostained for Ebola virus antigens. Original magnification, ×50 (immunoalkaline phosphatase staining; naphthol fast red substrate with light hematoxylin counterstain). doi:10.1128/9781555817381.ch97.f3

Citation: Rollin P, Nichol S, Zaki S, Ksiazek T. 2015. Arenaviruses and Filoviruses, p 1669-1686. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch97
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Image of FIGURE 4

Using immunohistochemistry, abundant virus antigens are seen within the cytoplasm of hepatocytes and sinusoidal lining cells in the liver of patients infected by (A) Lassa virus (original magnification, ×158), (B) Lujo virus (original magnification, ×158), or (C) LCM virus (transplant patient) (original magnification, ×50) (immunoalkaline phosphatase staining; naphthol fast red substrate with light hematoxylin counterstain). doi:10.1128/9781555817381.ch97.f4

Citation: Rollin P, Nichol S, Zaki S, Ksiazek T. 2015. Arenaviruses and Filoviruses, p 1669-1686. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch97
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Currently recognized arenaviruses and filoviruses and associated human diseases

Citation: Rollin P, Nichol S, Zaki S, Ksiazek T. 2015. Arenaviruses and Filoviruses, p 1669-1686. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch97

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