Abnormal Development - Viral Infection
|Embryology - 17 Dec 2017 Expand to Translate|
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|Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.|
- 1 Introduction
- 2 Some Recent Findings
- 3 Rubella Virus
- 4 Cytomegalovirus
- 5 Hendra Virus
- 6 Herpes Simplex Virus
- 7 Human Papilloma Virus
- 8 Polio Virus
- 9 Human Immunodeficiency Virus
- 10 Hepatitis Virus
- 11 Influenza Virus
- 12 Measles
- 13 Rotavirus
- 14 Varicella Zoster Virus (chickenpox)
- 15 Swine Influenza Virus
- 16 Avian Influenza Virus
- 17 Lassa Virus
- 18 Ebola Virus
- 19 Ljungan virus
- 20 Adenovirus
- 21 Coxsackie
- 22 Echoviruses
- 23 Mumps
- 24 Marburg Virus
- 25 West Nile Virus
- 26 Zika Virus
- 27 Prevention
- 28 References
- 29 External Links
- 30 Glossary Links
Below is a list of some known maternal, then fetal and postnatal infections that impact upon development. Only a very brief overview is given for each virus for more specific details see the listed internal and external links.
Viruses cannot reproduce by themselves and therefore infect cells to use the cell machinery to produce more virus. Different viruses have genetic material as single- or double-stranded RNA or DNA. The infectious virus particle is called a "virion" and is the genetic material packed in a protein shell. Viruses come in many genetic sizes, as little as 4 proteins up to 200 proteins.
Viral infections can range in their effects from no discernable impact through to severe impacts on development. Furthermore this may occur either directly by the infection or indirectly by the associated maternal fever and other side-effects of the infection. (More? Abnormal Development - Maternal Hyperthermia)
Rubella virus "German Measles" infection during pregnancy is one of the most serious causing congenital rubella syndrome with serious malformations of the developing fetus.
Viral infections have also recently been in the news with the 2009 novel influenza A (H1N1) "Swine Flu" pandemic.
Some early postnatal viral infections can also impact upon development and have been the target for worldwide immunization and eradication.
Human Immunodeficiency Virus (HIV) leads to AIDS and according to United Nations 2005 data about 38.6 million people had HIV. Of the 17.3 million women infected with HIV, 3.28 million gave birth each year (mostly in sub-Saharan Africa), leading to 700,000 new infections of HIV in children each year.
Note also that many cancers can be caused by viruses (papilloma viruses, hepatitis B and C viruses, Epstein-Barr virus and human T-cell lymphotropic virus). Virus-induced cancers account for about 20% of worldwide cancer incidence.
In a few developing countries, and mainly in Africa, at least 3 viruses induce a hemorrhagic fever: Ebola hemorrhagic fever, Marburg virus disease, and Lassa fever.
|Viral Links: TORCH Infections | Cytomegalovirus | Hepatitis Virus | HIV | Parvovirus | Polio Virus | Rubella Virus | Chickenpox | Lymphocytic Choriomeningitis Virus | Zika Virus | Vaccination | Environmental|
Some Recent Findings
|More recent papers|
This table shows an automated computer PubMed search using the listed sub-heading term.
References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.
Thalia Velho Barreto de Araújo, Ricardo Arraes de Alencar Ximenes, Demócrito de Barros Miranda-Filho, Wayner Vieira Souza, Ulisses Ramos Montarroyos, Ana Paula Lopes de Melo, Sandra Valongueiro, Maria de Fátima Pessoa Militão de Albuquerque, Cynthia Braga, Sinval Pinto Brandão Filho, Marli Tenório Cordeiro, Enrique Vazquez, Danielle di Cavalcanti Souza Cruz, Claudio Maierovitch Pessanha Henriques, Luciana Caroline Albuquerque Bezerra, Priscila Mayrelle da Silva Castanha, Rafael Dhalia, Ernesto Torres Azevedo Marques-Júnior, Celina Maria Turchi Martelli, Laura Cunha Rodrigues, investigators from the Microcephaly Epidemic Research Group, Brazilian Ministry of Health, Pan American Health Organization, Instituto de Medicina Integral Professor Fernando Figueira, State Health Department of Pernambuco Association between microcephaly, Zika virus infection, and other risk factors in Brazil: final report of a case-control study. Lancet Infect Dis: 2017; PubMed 29242091
T Yanase, T Kato, Y Hayama, M Akiyama, N Itoh, S Horiuchi, Y Hirashima, H Shirafuji, M Yamakawa, S Tanaka, T Tsutsui Transition of Akabane virus genogroups and its association with changes in the nature of disease in Japan. Transbound Emerg Dis: 2017; PubMed 29193771
Yali Hu, Chenyu Xu, Biao Xu, Lingqing Hu, Qin Liu, Jie Chen, Jingli Liu, Lanhua Liu, Jishi Yang, Tingmei Chen, Jian Wen, Na Jiang, Yaguang Zhang, Minkai Cao, Jing Feng, Xiaoqian Lin, Zhiqun Wang, Biyun Xu, Yi-Hua Zhou Safety and efficacy of telbivudine in late pregnancy to prevent mother-to-child transmission of hepatitis B virus: a multicenter prospective cohort study. J. Viral Hepat.: 2017; PubMed 29193547
Cora Alexandra Voekt, Therese Rinderknecht, Hans Hellmuth Hirsch, Annette Blaich, Irene Mathilde Hösli Ultrasound indications for maternal STORCH testing in pregnancy. Swiss Med Wkly: 2017, 147;w14534 PubMed 29185251
Sarah B Mulkey, Gilbert Vezina, Dorothy I Bulas, Zarir Khademian, Anna Blask, Youssef Kousa, Caitlin Cristante, Lindsay Pesacreta, Adre J du Plessis, Roberta L DeBiasi Neuroimaging Findings in Normocephalic Newborns With Intrauterine Zika Virus Exposure. Pediatr. Neurol.: 2017; PubMed 29167058
Rubella virus (Latin, rubella = little red), also known as "German Measles" (due to early citation in German medical literature).
Infection during pregnancy can cause congenital rubella syndrome (CRS) with serious malformations of the developing fetus. The type and degree of abnormality relates to the time of maternal infection.
Immunoflourescent detection of Cytomegalovirus
(Image: CDC USA)
|Viral infection causes systemic infection and extensive brain damage and cell death by necrosis. Cytomegalovirus infection can also occur in the human placenta.|
- Links: Cytomegalovirus | Medical Microbiology- Cytomegalovirus | Search Medical Microbiology "Cytomegalovirus"
Australia map - hendra virus outbreaks (1994-2008)
| Hendra virus is a paramyxoviridae (ssRNA negative-strand virus) that mainly infects large fruit bats (flying foxes) which can be passed on to horses. The infection has occasionally been passed onto people who have been in close contact with an infected horse. There is evidence of fetal and placental infection in flying fox and animal models. There is currently insufficient information to determine whether there are developmental effects in humans.
Named after the Brisbane suburb where in 1994 the first outbreak was detected. Recently a vaccine for horses has been developed.
Herpes Simplex Virus
NCBI Bookshelf (external link) Search Medical Microbiology "Herpes Simplex Virus"
Human Papilloma Virus
Human papilloma virus
| (HPV) A group of more that 118 identified viral strains about 40 infect the genital tract and 12 are known to be cancer-causing. Just eight HPV types 16, 18, 45, 33, 31, 52, 58, and 35 in descending order of frequency are responsible for more than 90 percent of cervical cancer cases. (Lancet 2010)
Infection can be detected by pap smear and at least 2 available vaccines, Cervarix (GSK) and Gardasil (Merck). Gardasil protects against HPV types 16 and 18, which cause 70% of cervical cancers in women and 90% of all HPV-related cancers in men. Also against two low-risk HPV types (types 6 and 11), which cause 90% of genital warts. through cross-protection also partially against HPV types 31 and 45.
Poliomyelitis (polio) is a highly infectious viral disease, affecting only humans of any age, but mainly children under the age of 3 (> 50% cases) causing paralysis and death. There are three types (type 1, type 2, and type 3) of wild poliovirus which can invade the nervous system and can cause total paralysis in several hours. Polio cases have decreased by more than 99% since 1988.
A bivalent oral polio vaccine (BOPV) is presently being used in countries with high existing polio rates, India and Nigeria. A recent WHO release has shown the largest ever year-to-year drop in polio cases following the use of BOPV:
Human Immunodeficiency Virus
Hepatitis (inflammation of the liver) is caused in humans by one of 7 viruses (A, B, C, D, E) with the 2 additional F has not been confirmed as a distinct genotype; and G is a newly described flavivirus.
"All of these viruses can cause an acute disease with symptoms lasting several weeks including yellowing of the skin and eyes (jaundice); dark urine; extreme fatigue; nausea; vomiting and abdominal pain. It can take several months to a year to feel fit again." (CDC text).
Virus particles measure 42nm in overall diameter and contain a 27nm diameter DNA-based core.
Hepatitis Transmission Risk to the Fetus
Hepatitis E virions (CDC)
Flu is the general term and abbreviation of influenzaviral infections and the possible teratogenic effect of influenza viruses (orthomyxoviruses, "flu") is unclear, with very little evidence directly linking the two events. A relatively recent study was unable to identify any placental transmission of influenza virus during the second and third trimester. Severe maternal infection though may lead to hyperthermia, which has been demonstrated to be teratogenic, particularly in early neural development. (More? [hyperthermia.htm Maternal Hyperthermia])
Influenza virus infection in the second and third trimesters of pregnancy: a clinical and seroepidemiological study. "We found no evidence for transplacental transmission of influenza virus or auto-antibody production in pregnancies complicated by influenza infections. There was an increase in the complications of pregnancy in our influenza cohort."
Postnatally, the suggested initial limited neonatal immune system makes postnatal infection dangerous.
See also: Transmission of influenza A in human beings.
Measles (rubeola) is a paramyxovirus appearing mainly as a respiratory viral infection, clinically different from Rubella. A single-stranded RNA virus which is highly contagious. Before measles vaccination (USA 1963) more than 90% of children had an infection before puberty and in developing countries it is still a common and often fatal childhood disease. Childhood immunisation and immunity persists in only about 80% of adults.
Pregnancy effects of measles results in a higher risk of premature labor, spontaneous abortion, low-birth-weight, and possibly rare cases of birth defects with no definable pattern of malformation.
In terms of the immune response to post-natal infection, a monkey model has shown that the virus is initially regulated by T cells, but require an antibody response to eliminate the viral RNA.
A type of virus that is a common cause of diarrhoea and vomiting (viral gastroenteritis) in infants and young children. The live attenuated rotavirus vaccine is contraindicated in pregnancy, but can be safely administered to household contacts of pregnant women. There is only a very small risk of transmission of the rotavirus vaccine virus to a susceptible pregnant woman and there is no evidence of risk to the fetus if pregnant women are in contact with recently vaccinated individuals.
(data based on: The Australian Immunisation Handbook 9th Edition 2008 2.3.2 Vaccination of women planning pregnancy, pregnant or breastfeeding women, and preterm infants - updated July 2009 )
Varicella Zoster Virus (chickenpox)
Fetal varicella syndrome (FVS) is caused by transplacental infection by the varicella zoster (chickenpox) virus following maternal infection.
Fetal and neonatal risks are dependent on infection timing.
Swine Influenza Virus
In 2009 a global pandemic of the novel influenza A (H1N1) or Swine Flu has occurred. At this stage the possible teratogenic effect of this influenza virus should be considered the same as those described for the influenza virus above. The term "Pandemic" refers only to the spread of the virus, not the severity of the infection or potential developmental outcomes. This virus has also been spreading in an unseasonable pattern, that is in the northern hemisphere summer, when typically viral infections increase in the winter period.
H1 refers to one of the hemagglutinin subtypes (H1, H2 or H3) and N1 refers to one of the two neuraminidase subtypes (N1 or N2). Over the last century there have been at least three different human viral pandemic circulating strains H1N1 (1918, 1977), H2N2 (1957) and H3N2 (1968).
A study of the perinatal outcomes after maternal 2009/H1N1 infection: national cohort study.
(Table data source: BMJ 2009;339:b2840)
Confirmed infections per million population (July 2009)
Australia - H1N1 Influenza 09 (Human Swin Flu) Facts
Australian State Information
(Facts from: Australian Commonwealth Department of Health and Ageing H1N1 Influenza 09 (Human Swine influenza) ‚Äì Summary Sheet for General Practitioners Current as of 24 May 2009)
20 July 2009: Chief Medical Officer's advice to pregnant women"Some pregnant women who catch the H1N1 (swine) ‚Äòflu virus will develop complications of the infection (including pneumonia) that could put their own and their baby‚Äôs health at risk. The risks are greatest in the second and third trimesters of pregnancy. It is too early in the pandemic of influenza to be able to quantify these risks for the individual but most pregnant women who catch the disease are likely to make an uncomplicated recovery...."
Avian Influenza Virus
Ebola virus disease (EVD, Ebola hemorrhagic fever, or EHF) is caused by three of the four species of “Ebola-like viruses” that appear to be maintained in a natural reservoir in the rain forests of Africa.
Zoonotic Ljungan virus associated with central nervous system malformations in terminated pregnancy.
1953 - Human adenovirus was first isolated. This virus family is the causative agent of membrane infections in: respiratory tract, eyes, gastrointestinal tract, and urinary tract.
Modified adenovirus is currently used as a research tool to introduce genes into cells in vitro and in animal systems.
Echoviruses are RNA viruses found in the gastrointestinal tract that belongs to the genus Enterovirus of the Picornaviridae family. These viruses do not seem to damage the fetus.
West Nile Virus
Karin A Fox, Regan Theiler Vaccination in pregnancy. Curr Pharm Biotechnol: 2011, 12(5);789-96 PubMed 21480828
Asher Ornoy, Alexander Tenenbaum Pregnancy outcome following infections by coxsackie, echo, measles, mumps, hepatitis, polio and encephalitis viruses. Reprod. Toxicol.: 2006, 21(4);446-57 PubMed 16480851
J M Best, J E Banatvala Congenital virus infections. BMJ: 1990, 300(6733);1151-2 PubMed 2189514
A P Waterson Virus infections (other than rubella) during pregnancy. Br Med J: 1979, 2(6190);564-6 PubMed 227524
R D Oberst Viruses as teratogens. Vet. Clin. North Am. Food Anim. Pract.: 1993, 9(1);23-31 PubMed 8384522
E Pandolfi, G Chiaradia, M Moncada, L Rava, A E Tozzi Prevention of congenital rubella and congenital varicella in Europe. Euro Surveill.: 2009, 14(9);16-20 PubMed 19317971
D M Horstmann Viral infections in pregnancy. Yale J Biol Med: 1969, 42(2);99-112 PubMed 4317516
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Cite this page: Hill, M.A. 2017 Embryology Abnormal Development - Viral Infection. Retrieved December 17, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Viral_Infection