Hemorrhagic Fevers课件.ppt

Destruction of the Immune System 1. Infects mononuclear phagocytes and fibroblastic reticular system (associated with lymph nodes) - Failure of early T-cell activation -Disrupts antigen trafficking and cytokine production -Extensive apoptosis of blood leukocytes -Lymphopenia (reduction in lymphocyte #) and severe damage to lymphoid tissue 2. Macrophages and circulating monocytes help transmit virus to other tissues 精品文档 3. VP35 protein – Type 1 IFN Antagonist -Combats the host interferon response possibly enhancing the replicative ability of the virus 精品文档 Key to Surviving Ebola French National Institute- Early Immune Response 1996 – Two large outbreaks in Gabon Compared immune responses Survived -IgG response against virus’s protein coat early on -Cleared circulating antigen -Activated cytotoxic T-cells Died -No IgG response -Barely detectable levels of IgM 精品文档 Pathology of Marburg and Ebola EARLY STAGE: Striking lesions usually in liver, spleen and kidney Necrosis prominent in liver, lymph tissue, and spleen little inflammatory response Viral particles invade phagocytic cells 精品文档 Pathology of Marburg and Ebola LATE STAGE: Liver and spleen become enlarged with excess blood Hemorrhage in the gastrointestinal tract, pleural, pericardial and peritoneal spaces and into the renal tubules with deposition of fibrin Abnormalities in coagulation parameters suggest that disseminated intravascular coagulation is a terminal event. There is usually also profound leukopenia in association with bacteremia. Example of cervical tissues with severely enlarged and hemorrhagic lymph nodes from a laboratory Rhesus monkey. 精品文档 Differential Diagnosis High Fever Severe prostration Diffuse maculopapular rash Bleeding Myalgia Bradychardia Desquamation Loss of apetite 精品文档 OTHER DIAGNOSTIC CRITERIA Coagulation Studies Serologic Study Leukopenia (Low White Blood Cell Count) Thrombocytopenia (Low Platelet Count) Low Electrolytes lymphopenia followed by neu