virologija_Layout 1 23.6.2011 13:00 Page I
MEDICINSKA VIROLOGIJA
Urednika
Prof. dr. Mario Poljak, dr. med.
Doc. dr. Miroslav Petrovec, dr. med.
medicinski razgledi
2011
virologija_Layout 1 23.6.2011 13:00 Page II
Medicinski razgledi 2011
MEDICINSKA VIROLOGIJA
Urednika
Prof. dr. Mario Poljak, dr. med.
Doc. dr. Miroslav Petrovec, dr. med.
Uredni{ka ekipa Medicinskih razgledov
Petra Bav~ar
Sa{a Ilovar
Sara Mugerli
Katja Stopar
Bogdan Vidmar
Klemen @iberna
Ilustrator
Jure Triglav
Lektorja
Mateja Ho~evar Gregori~
Matej Klemen
Stvarno kazalo
Sa{a Ilovar
Ra~unalni{ki prelom
SYNCOMP d. o. o.
Tisk
TISKARNA PLE[KO d. o. o.
CIP − Katalo`ni zapis o publikaciji
Narodna in univerzitetna knji`nica, Ljubljana
578.7(075.8)
616.9(075.8)
MEDICINSKA virologija / urednika Mario Poljak, Miroslav
Petrovec. − Ljubljana : Medicinski razgledi, 2011
ISBN 978-961-6260-18-3
1. Poljak, Mario
256037888
Uredni{tvo Medicinskih razgledov
Glavni urednik
Bogdan Vidmar
Odgovorna urednica
Petra Bav~ar
Tehni~ni urednici
Sara Mugerli, Nena Golob
Uredni{ki odbor
Alenka Biteznik, Ana Dov~, Jernej Drobe`, Sa{a Ilovar, Kaja
Jam{ek, Grega Kragelj, Sandra Mlakar, Sara Mugerli, Ma{a
Prelec, Toma` Rus, Katja Stopar, Ana [ubic, [pela Tev`i~,
^rt Zavrnik, Sonja @arkovi~, Klemen @iberna
Naslov uredni{tva
Medicinski razgledi, Korytkova 2, 1000 Ljubljana
Tel., faks: (01) 52 42 356
http://www.medrazgl.si
E-po{ta: infoamedrazgl.si
Copyright © Medicinski razgledi 2011
Vse pravice pridr`ane. Razmno`evanje ali raz{irjanje posameznih
delov ali celote te publikacije s katerimkoli sredstvom brez pisnega
privoljenja zalo`be je prepovedano.
virologija_Layout 1 23.6.2011 13:00 Page III
Predgovor
Medicinska virologija je razmeroma mlada, hitro razvijajo~a se veda, ki preu~uje viruse in virusne bolezni od
navadnega prehlada do smrtonosnega aidsa. Medicinska
virologija obravnava osnovne in posebne lastnosti za
medicino pomembnih virusov, opisuje z virusi povzro~ene bolezni in predstavlja na~ine za njihovo prepoznavanje, zdravljenje, prepre~evanje in nadzor.
Pri~ujo~a knjiga je nastala na podlagi dolgoletnih prakti~nih in teoreti~nih izku{enj avtorjev predvsem z diagnostiko virusnih oku`b. Opisuje in pojasnjuje zgradbo in
razmno`evanje virusnih povzro~iteljev bolezni, patogenezo in imunost, epidemiologijo, klini~no sliko, sodobne
diagnosti~ne postopke za spoznavo virusnih oku`b in podaja kratek pregled zdravljenja, prepre~evanja ter nadzora
virusnih oku`b.
Knjiga je prvenstveno namenjena {tudentom Medicinske fakultete Univerze v Ljubljani kot pomo~ pri u~enju medicinske mikrobiologije in imunologije, pa tudi
infektologije, patologije in epidemiologije. Prepri~ani
smo namre~, da brez podrobnega poznavanja virusov ni
mogo~e razumeti posameznih virusnih bolezni. V knjigi
bodo na{li veliko koristnih podatkov tudi zdravniki in
drugi strokovnjaki, ki `elijo obnoviti ali dopolniti svoje
znanje o virusih in virusnih boleznih.
Zelo dolgo (verjetno predolgo) smo odla{ali s pisanjem
te knjige. Vzrokov za to je ve~, osnovni je dejstvo, da
vodilni svetovni u~benik na podro~ju medicinske mikrobiologije (Jawetz) `e ve~ kot polovico stoletja vsaka tri
leta poskrbi tudi za zgo{~en in posodobljen pregled snovi na podro~ju medicinske virologije v obsegu, ki naj bi
ga obvladal {tudent medicine. Knjige zagotovo {e ne bi
bilo, ~e nekaj slovenskih avtorjev leta 2008 ne bi k pisanju
u~benika »Medicinska mikrobiologija« v bosanskem jeziku
povabila doc. dr. Selma Uzunovi} - Kamberovi}, dr. med.,
z Univerze v Zenici. Ob pripravi bosanskega u~benika se
je tudi porodila ideja o pisanju slovenske medicinske virologije in posodobljena poglavja, pripravljena originalno
za bosanski u~benik (poglavja 1, 2, 4–7, 17 in 21), so
predstavljala dovolj trdno opori{~e za za~etek pisanja te
knjige. Zato – hvala Selmi.
Zahvaljujemo se recenzentoma, prof. dr. Adriani Vince,
dr. med., in prof. dr. Bo{tjanu Luzarju, dr. med., za strokovne nasvete in koristne predloge za izbolj{ave.
Posebna zahvala je namenjena {tudentom medicine iz
uredni{tva Medicinskih razgledov, ki so prizadevno in
skrbno sodelovali pri za~etnih recenzijah in oblikovanju
knjige. Jure Triglav je narisal ve~ino originalnih shem in
slik v tem u~beniku. Sa{a Ilovar, Petra Bav~ar, Sara Mugerli
in Katja Stopar so pregledale besedilo s {tudentskega zornega kota in s tehtnimi pripombami omogo~ile prenekatero izbolj{avo teksta, Bogdan Vidmar je poskrbel za
brezhibno tehni~no urejanje besedila in Klemen @iberna
za usklajevanje.
Upamo, da boste u`ivali v branju in s pridom uporabljali pridobljeno znanje.
Ljubljana, maj 2011
Urednika:
prof. dr. Mario Poljak, dr. med.
doc. dr. Miroslav Petrovec, dr. med.
III
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IV
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MEDICINSKA VIROLOGIJA
Seznam avtorjev
1. Prof. dr. Tatjana Av{i~ - @upanc, univ. dipl. biol.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
Specialistka medicinske mikrobiologije, redna profesorica mikrobiologije in imunologije, vodja Laboratorija za diagnostiko zoonoz,
In{titut za mikrobiologijo in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
@eljka Bogovac, univ. dipl. mikr.
Nacionalni forenzi~ni laboratorij, Ministrstvo za notranje zadeve, Ljubljana.
Luka Fajs, univ. dipl. mikr.
Mladi raziskovalec, Laboratorij za diagnostiko zoonoz, In{titut za mikrobiologijo in imunologijo, Medicinska fakulteta, Univerza
v Ljubljani.
Mateja Jelen, univ. dipl. mikr.
Mlada raziskovalka, Laboratorij za molekularno mikrobiologijo in diagnostiko hepatitisov in aidsa, In{titut za mikrobiologijo
in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Asist. Samo Jeverica, dr. med.
Specialist klini~ne mikrobiologije, vodja Laboratorija za diagnostiko aerobnih in anerobnih infekcij, In{titut za mikrobiologijo
in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Asist. Monika Jev{nik, univ. dipl. mikr.
Laboratorij za diagnostiko virusnih infekcij, In{titut za mikrobiologijo in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Dr. Bo{tjan J. Kocjan, univ. dipl. mikr.
Laboratorij za molekularno mikrobiologijo in diagnostiko hepatitisov in aidsa, In{titut za mikrobiologijo in imunologijo, Medicinska
fakulteta, Univerza v Ljubljani.
Prof. dr. Sre~ko Koren, dr. med.
Specialist klini~ne mikrobiologije, redni profesor mikrobiologije in imunologije, predstojnik In{tituta za mikrobiologijo in imunologijo,
Medicinska fakulteta, Univerza v Ljubljani.
Anja Kovanda, univ. dipl. mikr.
Mlada raziskovalka, Laboratorij za molekularno mikrobiologijo in diagnostiko hepatitisov in aidsa, In{titut za mikrobiologijo
in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Polona Maver, dr. med.
Specializantka klini~ne mikrobiologije, Laboratorij za molekularno mikrobiologijo in diagnostiko hepatitisov in aidsa, In{titut
za mikrobiologijo in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Dr. Karmen Me{ko Megli~, dr. med.
Laboratorij za klini~no imunologijo in molekularno genetiko, Bolni{nica Golnik, Klini~ni oddelek za plju~ne bolezni in alergijo, Golnik.
Doc. dr. Miroslav Petrovec, dr. med.
Specialist klini~ne mikrobiologije, docent mikrobiologije in imunologije, vodja Laboratorija za diagnostiko virusnih infekcij, In{titut
za mikrobiologijo in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Prof. dr. Mario Poljak, dr. med.
Specialist klini~ne mikrobiologije, redni profesor mikrobiologije in imunologije, vodja Laboratorija za molekularno mikrobiologijo in
diagnostiko hepatitisov in aidsa, In{titut za mikrobiologijo in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Asist. str. svet. dr. Mateja Polj{ak Prijatelj, univ. dipl. biol.
Vodja Laboratorija za elektronsko mikroskopijo in diagnostiko gastroenteriti~nih virusov, In{titut za mikrobiologijo in imunologijo,
Medicinska fakulteta, Univerza v Ljubljani.
Dr. Ana Saksida, univ. dipl. mikr.
Laboratorij za diagnostiko zoonoz, In{titut za mikrobiologijo in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Izr. prof. dr. Katja Seme, dr. med.
Specialistka klini~ne mikrobiologije, izredna profesorica mikrobiologije in imunologije, vodja Laboratorija za bakteriolo{ko diagnostiko
respiratornih infekcij, In{titut za mikrobiologijo in imunologijo, Medicinska fakulteta, Univerza v Ljubljani.
Znan. sod. dr. Andrej Steyer, univ. dipl. mikr.
Laboratorij za elektronsko mikroskopijo in diagnostiko gastroenteriti~nih virusov, In{titut za mikrobiologijo in imunologijo, Medicinska
fakulteta, Univerza v Ljubljani.
Tina Ur{i~, univ. dipl. mikr.
Mlada razsikovalka, Laboratorij za diagnostiko virusnih infekcij, In{titut za mikrobiologijo in imunologijo, Medicinska fakulteta,
Univerza v Ljubljani.
Dr. Janet Zim{ek Mijovski, univ. dipl. mikr.
Laboratorij za elektronsko mikroskopijo in diagnostiko gastroenteriti~nih virusov, In{titut za mikrobiologijo in imunologijo, Medicinska
fakulteta, Univerza v Ljubljani.
V
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Kazalo
UVODNIK .......................................................................................................................................................... III
SEZNAM AVTORJEV .......................................................................................................................... V
KAZALO ................................................................................................................................................................ VI
Poglavje 1. Par vovirusi ...................................................................................................... 1
UVOD ............................................................................................................................................................................ 1
ZGRADBA IN POMNO@EVANJE ...................................................................................... 2
PATOGENEZA IN IMUNOST ................................................................................................ 4
EPIDEMIOLOGIJA .................................................................................................................................. 5
KLINI^NA SLIKA ...................................................................................................................................... 5
MIKROBIOLO[KA DIAGNOSTIKA .............................................................................. 6
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ............ 7
OKU@BE S PARVOVIRUSI V SLOVENIJI .............................................................. 7
POVZETEK .......................................................................................................................................................... 8
VIRI ZA DODATNI [TUDIJ ...................................................................................................... 8
Poglavje 2. Adenovirusi .................................................................................................... 9
UVOD ............................................................................................................................................................................ 9
ZGRADBA IN POMNO@EVANJE ...................................................................................... 9
PATOGENEZA IN IMUNOST .............................................................................................. 10
EPIDEMIOLOGIJA .............................................................................................................................. 10
KLINI^NA SLIKA .................................................................................................................................. 10
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 12
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 13
OKU@BE Z ADENOVIRUSI V SLOVENIJI ...................................................... 13
POVZETEK ...................................................................................................................................................... 14
VIRI ZA DODATNI [TUDIJ .................................................................................................. 14
Poglavje 3. Herpesvirusi .............................................................................................. 15
UVOD ........................................................................................................................................................................ 15
ZGRADBA IN POMNO@EVANJE .................................................................................. 16
Virus herpesa simpleksa 1 in virus herpesa simpleksa 2 ........ 16
PATOGENEZA IN IMUNOST .............................................................................................. 17
EPIDEMIOLOGIJA .............................................................................................................................. 17
KLINI^NA SLIKA .................................................................................................................................. 18
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 19
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 20
OKU@BE Z VIRUSI HERPESA SIMPLEKSA 1
IN 2 V SLOVENIJI ............................................................................................................................ 20
Virus vari~ele zostra ........................................................................................................................ 20
PATOGENEZA IN IMUNOST .............................................................................................. 20
EPIDEMIOLOGIJA .............................................................................................................................. 21
KLINI^NA SLIKA .................................................................................................................................. 21
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 22
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 22
OKU@BE Z VIRUSOM VARI^ELE ZOSTRA V SLOVENIJI ........ 23
Virus citomegalije .............................................................................................................................. 23
PATOGENEZA IN IMUNOST .............................................................................................. 23
EPIDEMIOLOGIJA .............................................................................................................................. 23
KLINI^NA SLIKA .................................................................................................................................. 23
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 24
VI
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 25
OKU@BE Z VIRUSOM CITOMEGALIJE V SLOVENIJI .................. 25
Humani herpesvirus 6 in humani herpesvirus 7 .......................... 25
PATOGENEZA IN IMUNOST .............................................................................................. 25
EPIDEMIOLOGIJA .............................................................................................................................. 25
KLINI^NA SLIKA .................................................................................................................................. 25
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 26
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 26
Virus Epstein-Barr ............................................................................................................................ 26
PATOGENEZA IN IMUNOST .............................................................................................. 26
EPIDEMIOLOGIJA .............................................................................................................................. 27
KLINI^NA SLIKA .................................................................................................................................. 27
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 27
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 28
Humani herpesvirus 8 ................................................................................................................ 28
PATOGENEZA IN IMUNOST .............................................................................................. 28
EPIDEMIOLOGIJA .............................................................................................................................. 28
KLINI^NA SLIKA .................................................................................................................................. 28
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 28
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 28
Opi~ji herpesvirus B ...................................................................................................................... 29
POVZETEK ...................................................................................................................................................... 29
VIRI ZA DODATNI [TUDIJ .................................................................................................. 30
Poglavje 4. Poksvirusi ........................................................................................................ 31
UVOD ........................................................................................................................................................................ 31
ZGRADBA IN POMNO@EVANJE .................................................................................. 31
PATOGENEZA IN IMUNOST .............................................................................................. 33
EPIDEMIOLOGIJA .............................................................................................................................. 33
KLINI^NA SLIKA .................................................................................................................................. 34
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 35
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 35
OKU@BE Z DRUGIMI ORTOPOKSVIRUSI .................................................. 36
OKU@BE S POKSVIRUSI V SLOVENIJI .............................................................. 38
POVZETEK ...................................................................................................................................................... 38
VIRI ZA DODATNI [TUDIJ .................................................................................................. 39
Poglavje 5. Papilomavirusi .................................................................................... 41
UVOD ........................................................................................................................................................................ 41
ZGRADBA IN POMNO@EVANJE .................................................................................. 42
PATOGENEZA IN IMUNOST .............................................................................................. 44
EPIDEMIOLOGIJA .............................................................................................................................. 50
KLINI^NA SLIKA .................................................................................................................................. 51
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 54
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ...... 57
OKU@BE S HUMANIMI PAPILOMA VIRUSI V SLOVENIJI .... 58
POVZETEK ...................................................................................................................................................... 59
VIRI ZA DODATNI [TUDIJ .................................................................................................. 60
Poglavje 6. Poliomavirusi .......................................................................................... 61
UVOD ........................................................................................................................................................................ 61
ZGRADBA IN POMNO@EVANJE .................................................................................. 64
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MEDICINSKA VIROLOGIJA
PATOGENEZA IN IMUNOST .............................................................................................. 66
EPIDEMIOLOGIJA .............................................................................................................................. 68
KLINI^NA SLIKA .................................................................................................................................. 69
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 70
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ...... 72
OKU@BE S HUMANIMI PAPILOMA VIRUSI V SLOVENIJI ...... 72
POVZETEK ...................................................................................................................................................... 73
VIRI ZA DODATNI [TUDIJ .................................................................................................. 74
Poglavje 7. Virusi hepatitisa
..............................................................................
75
UVOD ........................................................................................................................................................................ 75
Virus hepatitisa A ................................................................................................................................ 75
ZGRADBA IN POMNO@EVANJE .................................................................................. 76
PATOGENEZA IN IMUNOST .............................................................................................. 77
EPIDEMIOLOGIJA .............................................................................................................................. 78
KLINI^NA SLIKA .................................................................................................................................. 78
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 78
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 79
OKU@BE Z VIRUSOM HEPATITISA A V SLOVENIJI .................... 79
Virus hepatitisa E ................................................................................................................................ 80
ZGRADBA IN POMNO@EVANJE .................................................................................. 80
PATOGENEZA IN IMUNOST .............................................................................................. 80
EPIDEMIOLOGIJA .............................................................................................................................. 81
KLINI^NA SLIKA .................................................................................................................................. 81
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 82
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 83
OKU@BE Z VIRUSOM HEPATITISA E V SLOVENIJI .................... 83
Virus hepatitisa B ................................................................................................................................ 84
ZGRADBA IN POMNO@EVANJE .................................................................................. 84
PATOGENEZA IN IMUNOST .............................................................................................. 87
EPIDEMIOLOGIJA .............................................................................................................................. 89
KLINI^NA SLIKA .................................................................................................................................. 90
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 91
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ........ 94
OKU@BE Z VIRUSOM HEPATITISA B V SLOVENIJI .................... 96
Virus hepatitisa D ................................................................................................................................ 96
ZGRADBA IN POMNO@EVANJE .................................................................................. 96
PATOGENEZA IN IMUNOST .............................................................................................. 97
EPIDEMIOLOGIJA .............................................................................................................................. 97
KLINI^NA SLIKA .................................................................................................................................. 97
MIKROBIOLO[KA DIAGNOSTIKA .......................................................................... 98
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ...... 99
OKU@BE Z VIRUSOM HEPATITISA D V SLOVENIJI .................. 99
Virus hepatitisa C ................................................................................................................................ 99
ZGRADBA IN POMNO@EVANJE .................................................................................. 99
PATOGENEZA IN IMUNOST .......................................................................................... 100
EPIDEMIOLOGIJA ............................................................................................................................ 101
KLINI^NA SLIKA .............................................................................................................................. 101
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 103
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 104
OKU@BE Z VIRUSOM HEPATITISA C V SLOVENIJI ................ 105
Virusi hepatitisa ne-A, ne-E ............................................................................................ 106
POVZETEK .................................................................................................................................................... 107
VIRI ZA DODATNI [TUDIJ .............................................................................................. 109
Poglavje 8. Pikornavirusi ........................................................................................ 111
UVOD .................................................................................................................................................................... 111
ZGRADBA IN POMNO@EVANJE .............................................................................. 113
Rod Enterovirus .................................................................................................................................. 114
PATOGENEZA IN IMUNOST .......................................................................................... 114
EPIDEMIOLOGIJA ............................................................................................................................ 116
KLINI^NA SLIKA .............................................................................................................................. 116
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 119
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 120
Rod Kobuvirus ...................................................................................................................................... 120
Rod Parechovirus ............................................................................................................................ 121
Rod Aphtovirus .................................................................................................................................... 121
OKU@BE S PIKORNAVIRUSI V SLOVENIJI .............................................. 122
POVZETEK .................................................................................................................................................... 123
VIRI ZA DODATNI [TUDIJ .............................................................................................. 124
Poglavje 9. Ortomiksovirusi ............................................................................ 125
UVOD .................................................................................................................................................................... 125
ZGRADBA IN POMNO@EVANJE .............................................................................. 125
PATOGENEZA IN IMUNOST .......................................................................................... 128
EPIDEMIOLOGIJA ............................................................................................................................ 128
KLINI^NA SLIKA .............................................................................................................................. 131
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 132
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 133
OKU@BE Z VIRUSI INFLUENCE V SLOVENIJI .................................. 135
POVZETEK .................................................................................................................................................... 135
VIRI ZA DODATNI [TUDIJ .............................................................................................. 136
Poglavje 10. Paramiksovirusi ...................................................................... 137
UVOD .................................................................................................................................................................... 137
ZGRADBA IN POMNO@EVANJE .............................................................................. 137
Virus o{pic .................................................................................................................................................... 139
PATOGENEZA IN IMUNOST .......................................................................................... 139
EPIDEMIOLOGIJA ............................................................................................................................ 139
KLINI^NA SLIKA .............................................................................................................................. 139
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 140
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 141
Mumps ................................................................................................................................................................ 141
PATOGENEZA IN IMUNOST .......................................................................................... 141
EPIDEMIOLOGIJA ............................................................................................................................ 141
KLINI^NA SLIKA .............................................................................................................................. 141
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 142
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 142
Virusi parainfluence 1, 2, 3, 4 ...................................................................................... 142
PATOGENEZA IN IMUNOST .......................................................................................... 142
EPIDEMIOLOGIJA ............................................................................................................................ 143
KLINI^NA SLIKA .............................................................................................................................. 143
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 143
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ...... 143
Respiratorni sincicijski virus ...................................................................................... 143
PATOGENEZA IN IMUNOST .......................................................................................... 144
EPIDEMIOLOGIJA ............................................................................................................................ 144
KLINI^NA SLIKA .............................................................................................................................. 144
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 145
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 145
^love{ki metapnevmovirus ............................................................................................ 146
PATOGENEZA IN IMUNOST .......................................................................................... 146
EPIDEMIOLOGIJA ............................................................................................................................ 146
KLINI^NA SLIKA .............................................................................................................................. 146
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 146
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 146
VII
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KAZALO
Virusa Hendra in Nipah ........................................................................................................ 146
Rod Orthobunyavirus .............................................................................................................. 171
PATOGENEZA IN IMUNOST .......................................................................................... 147
EPIDEMIOLOGIJA ............................................................................................................................ 147
KLINI^NA SLIKA .............................................................................................................................. 147
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 147
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .. 147
OKU@BE S PARAMIKSOVIRUSI V SLOVENIJI .................................. 147
POVZETEK .................................................................................................................................................... 149
VIRI ZA DODATNI [TUDIJ .............................................................................................. 150
PATOGENEZA IN IMUNOST .......................................................................................... 171
EPIDEMIOLOGIJA ............................................................................................................................ 171
KLINI^NA SLIKA .............................................................................................................................. 172
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 172
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 172
Rod Hantavirus .................................................................................................................................... 172
PATOGENEZA IN IMUNOST .......................................................................................... 173
EPIDEMIOLOGIJA ............................................................................................................................ 173
KLINI^NA SLIKA .............................................................................................................................. 174
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 175
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 175
OKU@BE S HANTAVIRUSI V SLOVENIJI .................................................... 175
Rod Phlebovirus ................................................................................................................................ 175
PATOGENEZA IN IMUNOST .......................................................................................... 176
EPIDEMIOLOGIJA ............................................................................................................................ 176
KLINI^NA SLIKA .............................................................................................................................. 177
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 177
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 177
OKU@BE S FLEBOVIRUSI V SLOVENIJI ...................................................... 178
Rod Nairovirus .................................................................................................................................... 178
PATOGENEZA IN IMUNOST .......................................................................................... 178
EPIDEMIOLOGIJA ............................................................................................................................ 178
KLINI^NA SLIKA .............................................................................................................................. 179
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 179
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 180
Rod Tospovirus .................................................................................................................................... 180
POVZETEK .................................................................................................................................................... 180
VIRI ZA DODATNI [TUDIJ .............................................................................................. 181
Poglavje 11. Flavivirusi .............................................................................................. 151
UVOD .................................................................................................................................................................... 151
ZGRADBA IN POMNO@EVANJE .............................................................................. 151
Virus denga ................................................................................................................................................ 152
PATOGENEZA IN IMUNOST .......................................................................................... 153
EPIDEMIOLOGIJA ............................................................................................................................ 154
KLINI^NA SLIKA .............................................................................................................................. 154
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 155
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B ...... 155
OKU@BE Z VIRUSI DENGA V SLOVENIJI ................................................ 155
Virus rumene mrzlice .............................................................................................................. 155
PATOGENEZA IN IMUNOST .......................................................................................... 156
EPIDEMIOLOGIJA ............................................................................................................................ 156
KLINI^NA SLIKA .............................................................................................................................. 156
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 157
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 157
Virus japonskega encefalitisa ...................................................................................... 158
PATOGENEZA IN IMUNOST .......................................................................................... 158
EPIDEMIOLOGIJA ............................................................................................................................ 158
KLINI^NA SLIKA .............................................................................................................................. 158
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 159
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .. 159
Virus encefalitisa St. Louis ................................................................................................ 159
PATOGENEZA IN IMUNOST .......................................................................................... 159
EPIDEMIOLOGIJA ............................................................................................................................ 160
KLINI^NA SLIKA .............................................................................................................................. 160
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 160
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 160
Virus Zahodnega Nila .............................................................................................................. 161
PATOGENEZA IN IMUNOST .......................................................................................... 161
EPIDEMIOLOGIJA ............................................................................................................................ 161
KLINI^NA SLIKA .............................................................................................................................. 161
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 162
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .. 162
OKU@BE Z VIRUSI ZAHODNEGA NILA V SLOVENIJI ........ 162
Virus klopnega meningoencefalitisa .............................................................. 162
PATOGENEZA IN IMUNOST .......................................................................................... 163
EPIDEMIOLOGIJA ............................................................................................................................ 163
KLINI^NA SLIKA .............................................................................................................................. 164
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 164
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 165
OKU@BE Z VIRUSI KLOPNEGA
MENINGOENCEFALITISA V SLOVENIJI ............................................ 165
POVZETEK .................................................................................................................................................... 166
VIRI ZA DODATNI [TUDIJ .............................................................................................. 167
Poglavje 12. Bunjavirusi .......................................................................................... 169
UVOD .................................................................................................................................................................... 169
ZGRADBA IN POMNO@EVANJE .............................................................................. 169
VIII
Poglavje 13. Togavirusi .............................................................................................. 183
UVOD .................................................................................................................................................................... 183
ZGRADBA IN POMNO@EVANJE .............................................................................. 183
Rod Alphavirus .................................................................................................................................... 185
PATOGENEZA IN IMUNOST .......................................................................................... 186
EPIDEMIOLOGIJA ............................................................................................................................ 186
KLINI^NA SLIKA .............................................................................................................................. 187
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 188
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 188
OKU@BE Z ALFAVIRUSI V SLOVENIJI ............................................................ 188
Rod Rubivirus ........................................................................................................................................ 188
PATOGENEZA IN IMUNOST .......................................................................................... 188
EPIDEMIOLOGIJA ............................................................................................................................ 189
KLINI^NA SLIKA .............................................................................................................................. 189
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 190
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .. 191
OKU@BE Z RUBIVIRUSI V SLOVENIJI ............................................................ 191
POVZETEK .................................................................................................................................................... 191
VIRI ZA DODATNI [TUDIJ .............................................................................................. 192
Poglavje 14. Arenavirusi ........................................................................................ 193
UVOD .................................................................................................................................................................... 193
ZGRADBA IN POMNO@EVANJE .............................................................................. 194
PATOGENEZA IN IMUNOST .......................................................................................... 195
EPIDEMIOLOGIJA ............................................................................................................................ 195
KLINI^NA SLIKA .............................................................................................................................. 196
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 197
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .. 197
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MEDICINSKA VIROLOGIJA
OKU@BE Z ARENAVIRUSI V SLOVENIJI .................................................... 198
POVZETEK .................................................................................................................................................... 198
VIRI ZA DODATNI [TUDIJ .............................................................................................. 199
Poglavje 15. Filovirusi
..................................................................................................
201
UVOD .................................................................................................................................................................... 201
ZGRADBA IN POMNO@EVANJE .............................................................................. 201
PATOGENEZA IN IMUNOST .......................................................................................... 203
EPIDEMIOLOGIJA ............................................................................................................................ 204
KLINI^NA SLIKA .............................................................................................................................. 204
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 205
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 206
OKU@BE Z FILOVIRUSI V SLOVENIJI ............................................................ 206
POVZETEK .................................................................................................................................................... 207
VIRI ZA DODATNI [TUDIJ .............................................................................................. 207
Poglavje 16. Reovirusi .................................................................................................. 209
UVOD .................................................................................................................................................................... 209
Rod Rotavirus ........................................................................................................................................ 210
ZGRADBA IN POMNO@EVANJE .............................................................................. 210
PATOGENEZA IN IMUNOST
EPIDEMIOLOGIJA ............................................................................................................................ 214
KLINI^NA SLIKA .............................................................................................................................. 214
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 215
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 216
OKU@BE Z ROTAVIRUSI V SLOVENIJI .......................................................... 216
Rod Orthoreovirus ........................................................................................................................ 216
Rod Orbivirus ........................................................................................................................................ 217
Rod Coltivirus ........................................................................................................................................ 217
POVZETEK .................................................................................................................................................... 218
VIRI ZA DODATNI [TUDIJ .............................................................................................. 218
PATOGENEZA IN IMUNOST .......................................................................................... 255
EPIDEMIOLOGIJA ............................................................................................................................ 256
KLINI^NA SLIKA .............................................................................................................................. 257
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 257
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 258
OKU@BE S KALICIVIRUSI V SLOVENIJI .................................................... 258
POVZETEK .................................................................................................................................................... 259
VIRI ZA DODATNI [TUDIJ .............................................................................................. 260
Poglavje 19. Astrovirusi ............................................................................................ 261
UVOD .................................................................................................................................................................... 261
ZGRADBA IN POMNO@EVANJE .............................................................................. 262
PATOGENEZA IN IMUNOST .......................................................................................... 263
EPIDEMIOLOGIJA ............................................................................................................................ 263
KLINI^NA SLIKA .............................................................................................................................. 263
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 264
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 264
OKU@BE Z ASTROVIRUSI V SLOVENIJI .................................................... 264
POVZETEK .................................................................................................................................................... 265
VIRI ZA DODATNI [TUDIJ .............................................................................................. 266
Poglavje 20. Koronavirusi .................................................................................... 267
UVOD .................................................................................................................................................................... 267
ZGRADBA IN POMNO@EVANJE .............................................................................. 268
PATOGENEZA IN IMUNOST .......................................................................................... 270
EPIDEMIOLOGIJA ............................................................................................................................ 270
KLINI^NA SLIKA .............................................................................................................................. 270
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 271
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 271
OKU@BE Z KORONAVIRUSI V SLOVENIJI .............................................. 272
POVZETEK .................................................................................................................................................... 272
VIRI ZA DODATNI [TUDIJ .............................................................................................. 273
Poglavje 17. Retrovirusi ............................................................................................ 219
UVOD .................................................................................................................................................................... 219
^love{ki virus imunske pomanjkljivosti .................................................. 221
ZGRADBA IN POMNO@EVANJE .............................................................................. 221
PATOGENEZA IN IMUNOST .......................................................................................... 228
EPIDEMIOLOGIJA ............................................................................................................................ 233
KLINI^NA SLIKA .............................................................................................................................. 234
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 235
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 238
^love{ki T-celi~ni limfotropni virus .............................................................. 240
ZGRADBA IN POMNO@EVANJE .............................................................................. 241
PATOGENEZA IN IMUNOST .......................................................................................... 243
EPIDEMIOLOGIJA ............................................................................................................................ 244
KLINI^NA SLIKA .............................................................................................................................. 245
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 246
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 247
MuLV-soroden ksenotropni virus ........................................................................ 247
OKU@BE Z RETROVIRUSI V SLOVENIJI .................................................... 248
POVZETEK .................................................................................................................................................... 249
VIRI ZA DODATNI [TUDIJ .............................................................................................. 250
Poglavje 18. Kalicivirusi
..........................................................................................
251
UVOD .................................................................................................................................................................... 251
ZGRADBA IN POMNO@EVANJE .............................................................................. 253
Poglavje 21. Rabdovirusi
......................................................................................
275
UVOD .................................................................................................................................................................... 275
ZGRADBA IN POMNO@EVANJE .............................................................................. 275
PATOGENEZA IN IMUNOST .......................................................................................... 276
EPIDEMIOLOGIJA ............................................................................................................................ 277
KLINI^NA SLIKA .............................................................................................................................. 277
MIKROBIOLO[KA DIAGNOSTIKA ...................................................................... 278
ZDRAVLJENJE, PREPRE^EVANJE IN NADZOR OKU@B .... 279
OKU@BE Z RABDOVIRUSI V SLOVENIJI .................................................. 280
POVZETEK .................................................................................................................................................... 280
VIRI ZA DODATNI [TUDIJ .............................................................................................. 281
Poglavje 22. Mimivirusi in drugi gigantski virusi .... 283
UVOD .................................................................................................................................................................... 283
Mimivirusi .................................................................................................................................................. 283
Drugi gigantski virusi .............................................................................................................. 284
POVZETEK .................................................................................................................................................... 285
VIRI ZA DODATNI [TUDIJ .............................................................................................. 285
AVTORSTVO SLIK ............................................................................................................................ 287
STVARNO KAZALO ........................................................................................................................ 293
RAZLAGA KRATIC .......................................................................................................................... 301
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