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Complete summary Virology - Biomedische wetenschappen UA

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This document is a summary of the complete Virology course from 3rd bachelor Biomedical Sciences at the University of Antwerp, in the language it was taught in (English). The summary consists of all the learning material from the slides (including many pictures) as well as the information given during the lessons.

Voorbeeld van de inhoud

INHOUDSOPGAVE

H1: introduction to virology: what are viruses? where do they originate? – classification of viruses –
the virology toolbox – virus structures – replication cycles – virus evolution .................................... 9
what are viruses? ............................................................................................................................. 9
astonishing number of viruses on earth ............................................................................................. 9
all viruses are obligatory parasites .................................................................................................... 9

virus replication ..............................................................................................................................10
viruses have high genome evolution rates .........................................................................................11

are viruses dead or alive? ................................................................................................................11
origin of viruses? .............................................................................................................................12
a typical virus genome .....................................................................................................................12
a chimeric origin of viruses ..............................................................................................................12

five hallmark viral replication genes .................................................................................................13
cellular ancestry of capsids .............................................................................................................13
a brief history of virology ..................................................................................................................13
koch’s postulates to affirm the causes of infectious diseases........................................................ 14
21st century revised version of koch’s postulates .......................................................................... 14
virus classification ..........................................................................................................................14
definitions/rules underlying the Baltimore system......................................................................... 15
viruses with dna genomes ............................................................................................................ 16
viruses with rna genomes ............................................................................................................ 17
ambisense rna genomes .............................................................................................................. 19
summary of 7 genome classes according to baltimore .................................................................. 20
what information is encoded by the viral genome? ............................................................................21
what information is not encoded by the viral genome? ......................................................................21
summary (examen!) ........................................................................................................................21

the virology toolbox .........................................................................................................................21
virus diagnostic methods ............................................................................................................. 21

a typical virus genome .....................................................................................................................27
virus particles are made up from structural proteins ..................................................................... 27
virus structural ............................................................................................................................ 28
virus particles are metastable ...................................................................................................... 28
the viral replication cycle .................................................................................................................34
steps in virus replication .............................................................................................................. 34
step 1: binding to cell receptor ..................................................................................................... 34
step 2: entry and uncoating .......................................................................................................... 36
genome transcription & translation (step 3 and 5) .............................................................................41
some definitions.......................................................................................................................... 41
modifications to the central dogma of molecular biology............................................................... 41



1

, viral mrna’s are capped at the 5’ end ............................................................................................ 44
viral mrna’s are polyadenylated at the 3’ end (poly-a-tale) ............................................................. 45
monocistronic & polycistronic mrna’s .......................................................................................... 46
post-translational modifications .................................................................................................. 47
summary: genome transcription of eukaryotic viruses & transcriptases ......................................... 47
genome replication (step 4) .............................................................................................................49
why genome replication? ............................................................................................................. 49
locations of virus genome replication in eukaryotic cells ............................................................... 50
initiation of genome replication .................................................................................................... 50
dna strand displacement replication ............................................................................................ 51
key enzymes in rna virus genome replication ................................................................................ 51
reverse transcription ................................................................................................................... 52
genome replication according the baltimore classification ............................................................ 53

assembly & exit ...............................................................................................................................53
the structure of a virion determines how it is formed ..................................................................... 53
three strategies for making sub-assemblies .................................................................................. 55
genome packaging ...................................................................................................................... 56
virion exit from the cell ................................................................................................................. 58
virus evolution.................................................................................................................................61
phylogenetics.............................................................................................................................. 61
virus evolution and main drivers of evolution ................................................................................ 61
virus evolution ............................................................................................................................. 66
constraints on virus evolution ...................................................................................................... 67
next series of lectures .....................................................................................................................67
in summary .....................................................................................................................................67

H2: respiratory viral infections ..................................................................................................... 68
the importance of respiratory infections ...........................................................................................68
respiratory tract ..............................................................................................................................68
bronchitis/bronchiolitis ............................................................................................................... 68
pneumonia ................................................................................................................................. 69
other respiratory conditions ......................................................................................................... 69
viral cause of rti ...............................................................................................................................69
general overview .............................................................................................................................70
respiratory virus transmission ..........................................................................................................70
aerosol deposition....................................................................................................................... 71
respiratory virus seasonality ............................................................................................................71
humidity/temperature ................................................................................................................. 72
respiratory syncytial virus ................................................................................................................73
pneumoviridae ............................................................................................................................ 73
epidemiology .............................................................................................................................. 74
treatment .................................................................................................................................... 74
prevention................................................................................................................................... 75
human metapneumovirus ...............................................................................................................75



2

, pneumoviridae ............................................................................................................................ 75
adenovirus ......................................................................................................................................75
adenoviridae ............................................................................................................................... 75
epidemiology .............................................................................................................................. 77
vaccines ..................................................................................................................................... 77
parainfluenzavirus...........................................................................................................................77
paramyxoviridae .......................................................................................................................... 77
epidemiology .............................................................................................................................. 78
treatment and prevention ............................................................................................................ 79

rhinovirus – respiratory enterovirus ..................................................................................................79
picornaviridae ............................................................................................................................. 79
epidemiology .............................................................................................................................. 80
treatment & prevention ................................................................................................................ 81

non-rhinovirus enteroviruses ...........................................................................................................81
taxonomy .................................................................................................................................... 81
EnteroVirus D68 .......................................................................................................................... 81
impact of covid-19 NPI on epidemiology of respiratory viruses ...........................................................81
respiratory syncytial virus ................................................................................................................84

H3: herpesviruses ....................................................................................................................... 85

main characteristics .......................................................................................................................85
classification ..................................................................................................................................85
subfamilies ................................................................................................................................. 85
human herpesviruses .................................................................................................................. 86
viral structure..................................................................................................................................87
genome ..........................................................................................................................................87
hsv-1 – human herpesvirus 1 (hhv-1) ............................................................................................ 87
replication cycle .............................................................................................................................88
entry ........................................................................................................................................... 89
nuclear pore transport ................................................................................................................. 90
assembly & exit ........................................................................................................................... 90
hhv-1 ..............................................................................................................................................91
herpes simplex virus type 1 – HSV-1 – HHV1 ................................................................................. 91
hhv-2 ..............................................................................................................................................92
herpes simplex virus type 2 – HSV-2 – HHV2 ................................................................................. 92

HHV-3 ............................................................................................................................................93
varicella zoster virus – VZV ........................................................................................................... 93
hhv-5 ..............................................................................................................................................94
cytomegalovirus – cmv ................................................................................................................ 94
hhv-4 ..............................................................................................................................................95
epstein barr virus – ebv – hhv-4 ..................................................................................................... 95

hhv6A/B hhv7 ..................................................................................................................................96



3

, rash causing viruses – viral exanthema ......................................................................................... 96
hhv-8 ..............................................................................................................................................97
kaposi sarcoma associated herpes virus (kshv) – HHV-8 ............................................................... 97

H1: emerging & re-emerging viruses: emerging viruses – arboviruses – HIV .................................... 98
who pathogen priority list.................................................................................................................98
major drivers of virus emergence & spread .......................................................................................98
1. demographic changes & urbanisation ................................................................................ 98
2. globalisation of travel & trade ............................................................................................ 98
3. intense agriculture & livestock ........................................................................................... 98
4. bushmeat & animal trade .................................................................................................. 98
5. climate change ................................................................................................................. 98
6. biodiversity loss & habitat destruction (also caused by 3, 4 and 5) ....................................... 98
7. intrinsic viral property of rapid genome evolution................................................................ 99

obligate intracellular parasites with small genomes & high mutation rates .........................................99
zoonotic origin ................................................................................................................................99

major agents of viral hemorrhagic fevers (VHFs).............................................................................. 100
ebola virus ................................................................................................................................ 100
marburg virus: another filovirus causing sporadic outbreaks in humans ....................................... 109
arboviruses ................................................................................................................................... 112
global map of emerging infections in humans since 1998 ............................................................ 112
arboviruses cycle between insects & vertebrate hosts ................................................................ 112
arboviruses in a highly connected, urbanising & warming world ................................................... 112
clinically indistinguishable febrile syndrome & co-circulation ...................................................... 112
classification ............................................................................................................................ 113
risk of aedes albopictus-borne chikungunya virus in europe ........................................................ 113
environmental suitability for dengue occurrence worldwide ........................................................ 113
epidemic drivers ........................................................................................................................ 114
dengue virus.............................................................................................................................. 114
zika virus ................................................................................................................................... 122
other (re)emerging flaviviruses ................................................................................................... 125
(re)emerging neutotropic flaviviruses.......................................................................................... 128
chikungunya ............................................................................................................................. 129
oropouche ................................................................................................................................ 134
why is there a need to diagnose? ................................................................................................ 136

summary ...................................................................................................................................... 139

h2: the human immunodeficiency virus (hiv) ............................................................................... 140
baltimore classification ................................................................................................................. 140
hiv – more than just one virus ......................................................................................................... 140
zoonotic origin of hiv-1 groups m, n, o and p ............................................................................... 140
zoonotic origin of hiv-2 ............................................................................................................... 140

hiv particle .................................................................................................................................... 141
hiv genomic structure .................................................................................................................... 141




4

Inhoudsopgave

  1. 01 the virology toolbox – virus structures – replication cycles – virus evolution 9
  2. 02 what are viruses? 9
  3. 03 astonishing number of viruses on earth 9
  4. 04 all viruses are obligatory parasites 9
  5. 05 virus replication 10
  6. 06 viruses have high genome evolution rates 11
  7. 07 are viruses dead or alive? 11
  8. 08 origin of viruses? 12
  9. 09 a typical virus genome 12
  10. 10 a chimeric origin of viruses 12
  11. 11 five hallmark viral replication genes 13
  12. 12 cellular ancestry of capsids 13
  13. 13 a brief history of virology 13
  14. 14 koch’s postulates to affirm the causes of infectious diseases 14
  15. 15 21st century revised version of koch’s postulates 14
  16. 16 virus classification 14
  17. 17 definitions/rules underlying the Baltimore system 15
  18. 18 viruses with dna genomes 16
  19. 19 viruses with rna genomes 17
  20. 20 ambisense rna genomes 19
  21. 21 summary of 7 genome classes according to baltimore 20
  22. 22 what information is encoded by the viral genome? 21
  23. 23 what information is not encoded by the viral genome? 21
  24. 24 summary (examen!) 21
  25. 25 the virology toolbox 21
  26. 26 virus diagnostic methods 21
  27. 27 a typical virus genome 27
  28. 28 virus particles are made up from structural proteins 27
  29. 29 virus structural 28
  30. 30 virus particles are metastable 28
  31. 31 the viral replication cycle 34
  32. 32 steps in virus replication 34
  33. 33 step 1: binding to cell receptor 34
  34. 34 step 2: entry and uncoating 36
  35. 35 genome transcription & translation (step 3 and 5) 41
  36. 36 some definitions 41
  37. 37 modifications to the central dogma of molecular biology 41
  38. 38 viral mrna’s are capped at the 5’ end 44
  39. 39 viral mrna’s are polyadenylated at the 3’ end (poly-a-tale) 45
  40. 40 monocistronic & polycistronic mrna’s 46
  41. 41 post-translational modifications 47
  42. 42 summary: genome transcription of eukaryotic viruses & transcriptases 47
  43. 43 genome replication (step 4) 49
  44. 44 why genome replication? 49
  45. 45 locations of virus genome replication in eukaryotic cells 50
  46. 46 initiation of genome replication 50
  47. 47 dna strand displacement replication 51
  48. 48 key enzymes in rna virus genome replication 51
  49. 49 reverse transcription 52
  50. 50 genome replication according the baltimore classification 53
  51. 51 assembly & exit 53
  52. 52 the structure of a virion determines how it is formed 53
  53. 53 three strategies for making sub-assemblies 55
  54. 54 genome packaging 56
  55. 55 virion exit from the cell 58
  56. 56 virus evolution 61
  57. 57 phylogenetics 61
  58. 58 virus evolution and main drivers of evolution 61
  59. 59 virus evolution 66
  60. 60 constraints on virus evolution 67
  61. 61 next series of lectures 67
  62. 62 in summary 67
  63. 63 H2: respiratory viral infections 68
  64. 64 the importance of respiratory infections 68
  65. 65 respiratory tract 68
  66. 66 bronchitis/bronchiolitis 68
  67. 67 pneumonia 69
  68. 68 other respiratory conditions 69
  69. 69 viral cause of rti 69
  70. 70 general overview 70
  71. 71 respiratory virus transmission 70
  72. 72 aerosol deposition 71
  73. 73 respiratory virus seasonality 71
  74. 74 humidity/temperature 72
  75. 75 respiratory syncytial virus 73
  76. 76 pneumoviridae 73
  77. 77 epidemiology 74
  78. 78 treatment 74
  79. 79 prevention 75
  80. 80 human metapneumovirus 75
  81. 81 pneumoviridae 75
  82. 82 adenovirus 75
  83. 83 adenoviridae 75
  84. 84 epidemiology 77
  85. 85 vaccines 77
  86. 86 parainfluenzavirus 77
  87. 87 paramyxoviridae 77
  88. 88 epidemiology 78
  89. 89 treatment and prevention 79
  90. 90 rhinovirus – respiratory enterovirus 79
  91. 91 picornaviridae 79
  92. 92 epidemiology 80
  93. 93 treatment & prevention 81
  94. 94 non-rhinovirus enteroviruses 81
  95. 95 taxonomy 81
  96. 96 EnteroVirus D68 81
  97. 97 impact of covid-19 NPI on epidemiology of respiratory viruses 81
  98. 98 respiratory syncytial virus 84
  99. 99 H3: herpesviruses 85
  100. 100 main characteristics 85
  101. 101 classification 85
  102. 102 subfamilies 85
  103. 103 human herpesviruses 86
  104. 104 viral structure 87
  105. 105 genome 87
  106. 106 hsv-1 – human herpesvirus 1 (hhv-1) 87
  107. 107 replication cycle 88
  108. 108 entry 89
  109. 109 nuclear pore transport 90
  110. 110 assembly & exit 90
  111. 111 hhv-1 91
  112. 112 herpes simplex virus type 1 – HSV-1 – HHV1 91
  113. 113 hhv-2 92
  114. 114 herpes simplex virus type 2 – HSV-2 – HHV2 92
  115. 115 HHV-3 93
  116. 116 varicella zoster virus – VZV 93
  117. 117 hhv-5 94
  118. 118 cytomegalovirus – cmv 94
  119. 119 hhv-4 95
  120. 120 epstein barr virus – ebv – hhv-4 95
  121. 121 hhv6A/B hhv7 96
  122. 122 rash causing viruses – viral exanthema 96
  123. 123 hhv-8 97
  124. 124 kaposi sarcoma associated herpes virus (kshv) – HHV-8 97
  125. 125 H1: emerging & re-emerging viruses: emerging viruses – arboviruses – HIV 98
  126. 126 who pathogen priority list 98
  127. 127 major drivers of virus emergence & spread 98
  128. 128 demographic changes & urbanisation 98
  129. 129 globalisation of travel & trade 98
  130. 130 intense agriculture & livestock 98
  131. 131 bushmeat & animal trade 98
  132. 132 climate change 98
  133. 133 biodiversity loss & habitat destruction (also caused by 3, 4 and 5) 98
  134. 134 intrinsic viral property of rapid genome evolution 99
  135. 135 obligate intracellular parasites with small genomes & high mutation rates 99
  136. 136 zoonotic origin 99
  137. 137 major agents of viral hemorrhagic fevers (VHFs) 100
  138. 138 ebola virus 100
  139. 139 marburg virus: another filovirus causing sporadic outbreaks in humans 109
  140. 140 arboviruses 112
  141. 141 global map of emerging infections in humans since 1998 112
  142. 142 arboviruses cycle between insects & vertebrate hosts 112
  143. 143 arboviruses in a highly connected, urbanising & warming world 112
  144. 144 clinically indistinguishable febrile syndrome & co-circulation 112
  145. 145 classification 113
  146. 146 risk of aedes albopictus-borne chikungunya virus in europe 113
  147. 147 environmental suitability for dengue occurrence worldwide 113
  148. 148 epidemic drivers 114
  149. 149 dengue virus 114
  150. 150 zika virus 122
  151. 151 other (re)emerging flaviviruses 125
  152. 152 (re)emerging neutotropic flaviviruses 128
  153. 153 chikungunya 129
  154. 154 oropouche 134
  155. 155 why is there a need to diagnose? 136
  156. 156 summary 139
  157. 157 h2: the human immunodeficiency virus (hiv) 140
  158. 158 baltimore classification 140
  159. 159 hiv – more than just one virus 140
  160. 160 zoonotic origin of hiv-1 groups m, n, o and p 140
  161. 161 zoonotic origin of hiv-2 140
  162. 162 hiv particle 141
  163. 163 hiv genomic structure 141
  164. 164 hiv transcrips & proteins 141
  165. 165 hiv replication cycle 142
  166. 166 hiv membrane glycoprotein 142
  167. 167 cd4-induced conformational change 143
  168. 168 hiv gp120 – receptor & co-receptor interaction 143
  169. 169 hiv fusion (gp42 fusion peptide) 143
  170. 170 hiv entry 143
  171. 171 hiv uses chemokine receptors as co-receptors 144
  172. 172 hiv replication cycle – reverse transcription 144
  173. 173 RT occurs in the pre-integration complex in the cytoplasm 144
  174. 174 hiv rt – a heterodimeric enzyme 144
  175. 175 genome evolution rates 145
  176. 176 hiv mutation rates 145
  177. 177 intra-patient hiv evolution 145
  178. 178 hiv replication cycle – integration 145
  179. 179 modes of nuclear entry 146
  180. 180 model for hiv nuclear import 146
  181. 181 hiv integrase (in) enzyme 146
  182. 182 hiv replication cycle – transcription & budding 147
  183. 183 tat and rev regulatory proteins 147
  184. 184 hiv accessory proteins 148
  185. 185 proteolytic cleavage of hiv polyproteins 148
  186. 186 hiv budding at the cell membrane 149
  187. 187 hiv transmission 149
  188. 188 modes of transmission & epidemiology 150
  189. 189 probabilities of sexual transmission & relative risk 150
  190. 190 hiv mucosal transmission & systemic dissemination 150
  191. 191 genetic bottleneck during (sexual) transmission 151
  192. 192 biological properties of the ‘transmitted virus’ 151
  193. 193 biological factors that reduce risk of hiv transmission 151
  194. 194 hiv disease course 152
  195. 195 acute phase of hiv infection 152
  196. 196 chronic hiv infection 152
  197. 197 hiv profoundly affects the immune system 152
  198. 198 prevention & treatment 153
  199. 199 anti(retro) viral treatment 153
  200. 200 human immunodeficiency virus (hiv) 159
  201. 201 H1: Viral hepatitis 160
  202. 202 what is hepatitis? 160
  203. 203 central role of the liver in metabolism 160
  204. 204 what does the liver do? 500 vital functions 160
  205. 205 liver anatomy & histology 161
  206. 206 symptoms of acute hepatitis 161
  207. 207 course of non-complicated acute hepatitis 162
  208. 208 general course of viral hepatitis 162
  209. 209 pathogenesis of acute hepatitis 162
  210. 210 clinically useful liver function tests 163
  211. 211 hemoglobin metabolism 163
  212. 212 chronic hepatitis (in hepatitis b and c) 165
  213. 213 histology of cirrhosis 165
  214. 214 ascites = blood in peritoneum 165
  215. 215 portal hypertension & esophageal varices 165
  216. 216 hyper-nh3 and hepatic encepahlopathy 165
  217. 217 other signs of chronic hepatitis 166
  218. 218 pathogenesis hepato-cellular carcinoma (hcc) 166
  219. 219 etiology hepatitis 167
  220. 220 hepatitis viruses belong to very different classes/ families and transmission pathways 168
  221. 221 hepatitis a virus 168
  222. 222 structure 168
  223. 223 Geographic distribution 169
  224. 224 pathogenesis 169
  225. 225 evolution of hepatitis A after vaccination us 170
  226. 226 hepatitis e virus 170
  227. 227 structure 170
  228. 228 cycle 170
  229. 229 epidemiology 171
  230. 230 characteristics of hev genotypes 172
  231. 231 overview of clinical manifestations 172
  232. 232 clinical course 172
  233. 233 zoonotic risks in belgium: ‘pig belt’ 173
  234. 234 pregnancy 173
  235. 235 rare extrahepatic complications 173
  236. 236 some of the neurological complications of hev 173
  237. 237 hepatitis b virus 174
  238. 238 class VII: dna genome replication via rna intermediair 174
  239. 239 genome 174
  240. 240 structure 175
  241. 241 epidemiology 176
  242. 242 pathogenesis 176
  243. 243 typical course of self-limiting hbv: evidence in serum 177
  244. 244 different profiles between self-limiting and chronic hbv infection 177
  245. 245 transmission 177
  246. 246 outcome of hepatitis b virus infection by age at infection 177
  247. 247 prevention 178
  248. 248 treatment 178
  249. 249 hepatitis d virus 178
  250. 250 geographic distribution of hdv infection 178
  251. 251 structure = hybrid virus 178
  252. 252 hepatitis delta cycle (informative!!) 179
  253. 253 hepatitis c virus 179
  254. 254 structure 179
  255. 255 genomic structure 180
  256. 256 variability 180
  257. 257 genotypes 180
  258. 258 Viral cycle 180
  259. 259 transmission 181
  260. 260 clinical course 182
  261. 261 beneficial evolution without vaccine 182
  262. 262 symptoms 182
  263. 263 blood parameters 183
  264. 264 hbv versus hcv: clinical characteristics 183
  265. 265 hbv versus hcv: treatment 183
  266. 266 hepatitis c potential targets for drug development 184
  267. 267 contemporary hepatitis c treatment 184
  268. 268 overview hepatitis viruses 184
  269. 269 H2: SARS-CoV-2: Human COVID virology, clinic, immunology and vaccination 186
  270. 270 epidemiology of sars-cov-2, influenza and respiratory syncytial virus (rsv) in belgium 186
  271. 271 virology 186
  272. 272 coronaviruses were discovered in 1960 by a female scientist 186
  273. 273 class IV: positive single stranded (+ss) rna viruses 186
  274. 274 emerging human coronavirus infections since the sixties 186
  275. 275 the zoonotic origin of human sars-like coronaviruses 187
  276. 276 coronavirus subfamilies, their mammal hosts & associated diseases 187
  277. 277 viral cycle & function of viral proteins 187
  278. 278 evolution of SARS-CoV-2s 191
  279. 279 headlines virology sars-cov-2 193
  280. 280 clinical aspects 193
  281. 281 disease course and pathogenesis 193
  282. 282 risk factors 195
  283. 283 treatment 196
  284. 284 misc and long covid 196
  285. 285 diagnosis 197
  286. 286 overview sars-cov-2 diagnostic methods 197
  287. 287 technique to take a nasopharyngeal & throat swab for pcr diagnosis of sars-cov-2 197
  288. 288 principle of ‘real time pcr’ 198
  289. 289 faecal rna remains positive in many patients after resolution of symptoms & negative throat swabs 198
  290. 290 principle of rapid test kit 198
  291. 291 infection 199
  292. 292 immunology 199
  293. 293 key components of antiviral immunity 199
  294. 294 sars-cov-2 clinical immunology 199
  295. 295 key conclusions on immunity during & after covid 202
  296. 296 vaccination 202
  297. 297 vaccine platforms used for sars-cov-2 vaccine development 202
  298. 298 success of mrna vaccination: trick 1 modifications 204
  299. 299 success of mrna vaccination: trick 2 formulation 204
  300. 300 immune responses to mrna vaccines 205
  301. 301 various adenoviruses in clinical trial 205
  302. 302 principle of adenovirus vector vaccines (see notes) 205
  303. 303 viral pathway of adenoviruses 206
  304. 304 testing neutralizing antibodies by plaque reduction neutralization test (prnt) 206
  305. 305 infection 207
  306. 306 effect of degree of vaccination on death rate by early omicron variant 207
  307. 307 waning vaccine efficiency in california against delta & omicron infection 207
  308. 308 rapidly waning efectiveness of the xbb.1.5 vaccine in the 2023-2024 season 208
  309. 309 vaccine effectiveness against covid & flu in the 2024-2025 season in us 208
  310. 310 imprinting (original antigenic sin) hampers recognition of new epitopes 209
  311. 311 serious adverse effects of covid vaccines 210
  312. 312 thrombosis & thrombocytopenia syndrome tts (after adeno vector vaccine) 210
  313. 313 conclusion vaccines 211
  314. 314 novel vaccine concepts: nucleoprotein, nasal administration, pan-sarbeco 211
  315. 315 is a pan-sarbeco vaccine possible? 212
  316. 316 general conclusion 212
  317. 317 H3: poxviruses: variola or smallpox – monkeypox or mpx – varicella zoster or herpes 3 213
  318. 318 smallpox or variola 213
  319. 319 history 213
  320. 320 virology 214
  321. 321 clinical aspects 215
  322. 322 vaccines against smallpox 218
  323. 323 some conclusions on smallpox 220
  324. 324 monkeypox or mpow or MPX 221
  325. 325 history & epidemiology 221
  326. 326 clinical aspects 223
  327. 327 vaccines efficacy 225
  328. 328 summary of characteristics of mpox clades 226
  329. 329 varicell-zoster or hhv3 227
  330. 330 virology & pathogenesis 227
  331. 331 clinical signs & complications 229
  332. 332 treatment 232
  333. 333 vaccines 232
  334. 334 some conclusions on varicella-zoster 234
  335. 335 monkeypox, chickenpox & smallpox compared 235
  336. 336 Helps bind to specific proteins & delivers genome into cell 10

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