2009年贵州省流行性感冒监测结果分析

流行性感冒（Influenza ）简称流感,是由流感病毒引起的一种急性呼吸道传染病,流感病毒分甲、乙、丙三型,其中甲型流感病毒经常发生抗原变异,传染性强,传播迅速,极易发生大范围流行。2009年4月新甲型H1N1流感病毒出现,由于此次疫情是由一个新型H1N1病毒亚型引起的,人群没有天然免疫力［1］,疫情迅速在全球范围传播,W H O在6月11日将大流行警戒级别提高至6级,宣布了新甲型 H1N1流感的世界大流行［2］。我国迅速启动应急工作机制,贵州省按照国家要求迅速扩大监测点,及时监测流感疫情,现将2009年贵州省流感监测情况报告如下。     

2012-2013年北半球流感流行季节使用流感疫苗成分的建议

2011年9月-2012年1月,全球分离到2009大流行甲型H1N1(甲型H1 N1 pdm09)、甲型H5N1、甲型H3N2变异株(v)、甲型H1N1v、甲型H1N2v和乙型流感病毒.北半球甲型H1N1pdm09流感病毒以很低水平传播,流感疫情较轻.对流感病毒分离株的抗原性和遗传学分析表明,甲型H1N1pdm09流感病毒呈抗原同质性,并与疫苗病毒A/California/7/2009密切相关.甲型H1N1pdm09流感病毒血凝素基因的序列分析表明,病毒属于抗原性不能区别的至少8个基因群.大多数新近分离的甲型H3N2病毒的抗原性和遗传性与类A/Victoria/361/2011参考病毒密切相关.大多数B/Yamagata/16/88谱系病毒的抗原性与类B/Wisconsin/1/2010病毒密切相关.     

重症甲型H1N1流感患者1例在负压病房的护理管理体会

甲型H1N1流感是一种由变异后的新型流感病毒一甲型H1N1病毒引起的急性呼吸道传染病．可通过近距离飞沫和接触传播,临床表现为流感样症状,少数病例病情重,进展迅速,可出现病毒性肺炎,合并呼吸衰竭、多脏器功能损伤。严重者可以导致死亡。由于其传播快、发病率高,传染率可达50％,容易引起暴发或流行,故在病房内的感染控制尤为重要,现将成功抢救重症甲型H1N1流感患者负压病房管理体会报道如下。     

甲型H1N1流行性感冒患者淋巴细胞亚群与血常规检测结果相关性分析

<正>甲型H1N1流行性感冒(甲流)是甲型(A型)流感病毒引起的猪或人的一种急性、人畜共患呼吸道传染性疾病。传染源主要为病猪和携带病毒的猪,感染甲型H1N1流感病毒的人也可以传播病毒,其主要通过呼吸道传播,临床表现为流感样症状。我们对甲流患者外周血细胞计数与淋巴     

大学校园内甲型H1N1流感的护理及预防

甲型H1N1流感是一种由新的甲型H1N1流感病毒引起的急性呼吸道传染病,其病原体是一种新型的甲型H1N1流感病毒,在人群中传播。与以往或目前的季节性流感病毒不同,该病毒毒株包含有猪流感、禽流感和人流感3种流感病毒的基因片段。人群对甲型H1N1流感病毒普遍易感,并可以人传染人,人感染甲型H1N1流感后的早期症状与普通流感相似,包括发热、咳嗽、喉痛、身体疼痛、头痛、发冷和疲劳等,有些还会出现腹泻或呕吐、肌肉痛或疲倦、眼睛发红等^[1]。     

甲型H1N1流感诊疗方案

2009年3月墨西哥暴发“人感染猪流感”疫情,造成人员死亡。4月30日世界卫生组织（以下简称WHO）宣布将流感大流行警告级别提高为5级。研究发现,此次疫情的病原为变异后的新型甲型H1N1流感病毒,该毒株包含有猪流感、禽流感和人流感3种流感病毒的基因片段,可以在人间传播。WHO初始将此次流感疫情称为“人感染猪流感”,但随着对疫情性质的深入了解,现已将其重新命名为“甲型H1N1流感”。我国卫生部于4月30日宣布将其纳入《中华人民共和国传染病防治法》规定的乙类传染病,依照甲类传染病采取预防、控制措施。     

九八年冬季流感的临床特点

流行性感冒(influenza简称流感)是由流感病毒引起的急性呼吸道传染病,病原体为甲、乙、丙三型流行性感冒病毒,多经飞沫传播,临床上有急性起病、高烧、乏力、全身肌肉酸痛、咳嗽等呼吸道症状,病程短,老年人和伴有慢性呼吸道疾病、心脏病、脑血管病后遗症卧床患者易并发肺炎等特点.流感病毒,尤以甲型极易变异,往往造成暴发、流行或大流行.自本世纪以来已有五次世界性大流行的记载,死亡率高.我国从1953至1976年已有12次中等或中等以上的流感流行,每次流行均由甲型为主的流感病毒所引起.     

甲型流感病毒致病机制的研究进展

甲型流感的爆发给人类健康带来了重大威胁,近年来对甲型流感病毒致病机制的研究已取得了一定进展。本文从甲型流感病毒基因编码的蛋白质方面简述病毒致病性的研究进展。     

流感疫苗的接种反应及处理

流行性感冒（流感）病毒属于正黏病毒科,根据其核蛋白可分成甲型、乙型和丙型,甲型病毒极易变异,可引起反复流行或大流行。流感是由流感病毒引起的一种急性呼吸道传染病,其传染源主要是流感患者和病毒携带者,动物特别是禽类可作为流感病毒中间或贮存宿主。流感主要通过空气经飞沫传播,也可以通过接触被污染的物品而感染。流感的临床表现为急起高热、头痛、乏力、全身肌肉酸痛等中毒症状,但呼吸道症状轻微。流感发病后虽可产生一定的免疫力,但不同型别的病毒之间没有交叉免疫力,变异后的病毒可导致人群反复感染而发病,并在人群中广泛传播,甚至形成世界性大流行^[1]。接种流感疫苗是预防流感的有效方法。     

颅底骨折口鼻大出血用导尿管气囊压迫止血一例

甲型H1N1流感为一种新型呼吸道传染病，其病原为新甲型H1N1流感病毒株，病毒基因中包含有猪流感、禽流感和人流感病毒的基因片段，自2009年3月以来，此病毒迅速在全球范围内蔓延，其传播力之强、传播速度之快，在历史上比较少见，现将预防感染及感染的控制体会介绍如下。     

Neuraminidase inhibitor susceptibility of porcine H3N2 influenza A viruses isolated in Germany between 1982 and 1999

As an intermediate host of avian and human influenza A viruses (FLUAV) pigs may play a potential role in interspecies virus transmission and reassortment of viral genes including those conferring antiviral drug resistance. Porcine FLUAV isolated in Germany between 1989 and 2001 contains mutations in the M2 gene inducing amantadine resistance. No data exist on neuraminidase inhibitor (NAI) susceptibility of these porcine FLUAV. We studied the antiviral activity of NAI against seven selected H3N2 FLUAV isolated from pigs in Germany between 1982 and 1999. All isolates were susceptible towards oseltamivir and zanamivir in neuraminidase enzyme-inhibition assays. Both compounds inhibited virus spreading and reduced the virus yields and plaque size at low concentrations. Higher concentrations were necessary to reduce the plaque number. Two isolates that differed in glycosylation pattern of viral hemagglutinin (HA) showed markedly reduced drug susceptibility in cell culture-based assays.     

Packaging signals in the 5'-ends of influenza virus PA, PB1, and PB2 genes as potential targets to develop nucleic-acid based antiviral molecules

In a previous study a 15-mer phosphorothioate oligonucleotide (S-ON) derived from the packaging signal in the 5′ end of segment 1 (PB2) of influenza A virus (designated 5–15b) proved markedly inhibitory to virus replication. Here we investigated whether analogous inhibitory S-ONs targeting the 5′ end of segments 2 (PB1) and 3 (PA) could be identified and whether viral resistance to S-ONs can be developed. Similar to our earlier result, 20-mer S-ONs reproducing the 5′ ends of segments 2 or 3 (complementary to the 3′-coding regions of PB1 and PA, respectively) exerted a powerful antiviral activity against a variety of influenza A virus subtypes in MDCK cells. Serial passage of the A/Taiwan/1/86 H1N1 strain in the presence of S-ON 5–15b or its antisense as5–15b analogue showed that mutant viruses with reduced susceptibility to the S-ON could indeed be generated, although the resistant viruses displayed reduced replicative fitness. Sequencing the resistant viruses identified mutations in the PB1, PB2, PA and M1 genes. Introduction of these changes into the A/PR/8/34 H1N1 strain by reverse genetics, suggested that alterations to RNA function in the packaging regions of segments 2 and 3 were important in developing resistance to S-ON inhibition. However, many of the other sequence changes induced by S-ON treatment were markedly deleterious to virus fitness. We conclude that packaging signals in the influenza A virus polymerase segments provide feasible targets for nucleic acid-based antivirals that may be difficult for the virus to evade through resistance mutations.     

Segmented polyurethane intravaginal rings for the sustained combined delivery of antiretroviral agents dapivirine and tenofovir

Dual segment polyurethane intravaginal rings (IVRs) were fabricated to enable sustained release of antiretroviral agents dapivirine and tenofovir to prevent the male to female sexual transmission of the human immunodeficiency virus. Due to the contrasting hydrophilicity of the two drugs, dapivirine and tenofovir were separately formulated into polymers with matching hydrophilicity via solvent casting and hot melt extrusion. The resultant drug loaded rods were then joined together to form dual segment IVRs. Compression testing of the IVRs revealed that they are mechanically comparable to the widely accepted NuvaRing^® IVR. Physical characterization of the individual IVR segments using wide angle X-ray scattering and differential scanning calorimetry determined that dapivirine and tenofovir are amorphous and crystalline within their polymeric segments, respectively. In vitro release of tenofovir from the dual segment IVR was sustained over 30 days while dapivirine exhibited linear release over the time period. A 90 day accelerated stability study confirmed that dapivirine and tenofovir are stable in the IVR formulation. Altogether, these results suggest that multisegment polyurethane IVRs are an attractive formulation for the sustained vaginal delivery of drugs with contrasting hydrophilicity such as dapivirine and tenofovir.     

Targeting Influenza A Virus RNA Promoter

The emergence of drug‐resistant strains of influenza virus makes exploring new classes of inhibitors that target universally conserved viral targets a highly important goal. The influenza A viral genome is made up of eight single‐stranded RNA‐negative segments. The RNA promoter, consisting of the conserved sequences at the 3′ and 5′ end of each RNA genomic segment, is universally conserved among influenza A virus strains and in all segments. Previously, we reported on the identification and NMR structure of DPQ (6,7‐dimethoxy‐2‐(1‐piperazinyl)‐4‐quinazolinamine) (compound 1 ) in complex with the RNA promoter. Here, we report on additional screening and SAR studies with compound 1 , including ex vivo anti‐influenza activity assays, resulted in improved cellular activity against influenza A virus in the micromolar range.     

Doing things together? Analysis of health education materials to inform hepatitis C prevention among couples

Considerable effort has been expended in developing health education materials and programmes aimed at reducing transmission of hepatitis C virus (HCV) among people who inject drugs. Health education is considered more likely to be effective when it is targeted to defined segments of the population and when people actively identify with the messages presented. In this context, it is important to understand the health messages on offer in these materials. This article conducts a discourse analysis of an extensive corpus of Australian heath education literature on HCV to explore the kinds of messages these materials attempt to present. It questions the unexamined assumptions they include and it considers how effectively these materials address the social context of HCV transmission. It focuses on issues of individual and group conduct: in particular, because HCV transmission occurs commonly between sexual partners, on the place of couples who inject together in prevention education. The article concludes by arguing that these materials pay insufficient attention to couples, relying almost without exception, and despite a longstanding critique recommending new approaches, on the individual as the core unit of agency in HCV transmission and in turn prevention.     

Avian influenza: a review.

PURPOSE: A review of the avian influenza A/H5N1 virus, including human cases, viral transmission, clinical features, vaccines and antivirals, surveillance plans, infection control, and emergency response plans, is presented. SUMMARY: The World Health Organization (WHO) considers the avian influenza A/H5N1 virus a public health risk with pandemic potential. The next human influenza pandemic, if caused by the avian influenza A/H5N1 virus, is estimated to have a potential mortality rate of more than a hundred million. Outbreaks in poultry have been associated with human transmission. WHO has documented 258 confirmed human infections with a mortality rate greater than 50%. Bird-to-human transmission of the avian influenza virus is likely by the oral-fecal route. The most effective defense against an influenza pandemic would be a directed vaccine to elicit a specific immune response toward the strain or strains of the influenza virus. However, until there is an influenza pandemic, there is no evidence that vaccines or antivirals used in the treatment or prevention of such an outbreak would decrease morbidity or mortality. Surveillance of the bird and human populations for the highly pathogenic H5N1 is being conducted. Infection-control measures and an emergency response plan are discussed. CONCLUSION: Avian influenza virus A/H5N1 is a public health threat that has the potential to cause serious illness and death in humans. Understanding its pathology, transmission, clinical features, and pharmacologic treatments and preparing for the prevention and management of its outbreak will help avoid its potentially devastating consequences.     

The molecular epidemiology of rotavirus infection in Ga-Rankuwa, southern Africa.

Rotaviruses were detected in 32.8 pc (96/292) of stool specimens collected from infants and young children with gastroenteritis attending the rehydration unit at Ga-Rankuwa Hospital between January and December 1989. A seasonal distribution was observed with an increase in numbers shedding the virus during the colder months of the year. Based on variations in the migration pattern of the RNA genome segments when passed through polyacrylamide gels, seven different RNA electrophoretypes were identified; 82 pc of the patients had virus with long patterns and 17 pc with short patterns. A mixed infection was observed in one case with both a long and a short virus. A single dominant long electrophoretype persisted throughout the 12 month study period, whereas the other minor types co-circulated at varying intervals.     

Pandemic influenza: preventing the emergence of novel strains and countermeasures to ameliorate its effects

Influenza is a seasonal disease that peaks every year in the winter months. Antigenic drift of the viral surface proteins, particularly the hemagglutinin (HA), is responsible for the virus's ability to evading the host's immune system, and for the severity of the disease. Pandemic influenza arises when an influenza virus carrying a novel HA gene enters into the naive human population, resulting in excess morbidity and mortality. Three major influenza pandemics were experienced in the last century and the emergence of a new pandemic strain is considered a matter of time. Our current understanding suggests that pandemic influenza strains arise from influenza viruses circulating in the natural reservoir, although the presence of intermediate hosts is considered essential in this process. Pigs and land-based birds have been shown to play a major role in the ecology of influenza viruses by providing an environment in which influenza viruses can change their phenotype, expand their host range, and eventually transmit to humans. In recent years, a great detail of attention has been placed on understanding the epidemiological and molecular factors that can lead to interspecies transmission of influenza viruses. In this review we will discuss the ecological and molecular aspects that lead to pandemic influenza as well as the intervention strategies at our disposal that can reduce the emergence of pandemic influenza strains and/or minimize their effects.     

乙型肝炎病毒性传播的研究现状

慢性乙型肝炎的发病率高,乙型肝炎病毒的相关疾病预后差,致死率高.随着新生儿乙肝疫苗注射的普及,青少年人群乙型肝炎病毒的携带率偏低,而中青年乙型肝炎病毒的携带率却偏高,提示目前性传播途径已逐渐成为重要的传播途径,而乙型肝炎病毒的性传播尚未受到足够重视.本研究综述了乙型肝炎病毒性传播的机制,夫妻间、男同性恋、女同性恋间乙型肝炎病毒性传播的现状,防控情况,危险因素,并初步探讨乙型肝炎病毒性传播的阻断措施,以期提高对乙型病毒性肝炎性传播的认识并帮助指导临床及预防工作.     

Origins and evolutionary genomics of the novel swine-origin influenza A (H1N1) virus in humans--past and present perspectives

Swine influenza viruses cause annual epidemics and occasional pandemics claiming the lives of millions from the early history up to the present days. This virus has drawn on a bag of evolutionary tricks to survive in one or another form in both humans and pigs with novel gene constellations through the periodic importation or exportation of viral genes. A prime example is emergence of pandemic novel swine-origin influenza A (H1N1) virus (S-OIV) in 2009 that have transmitted to and spread among humans, resulting in outbreaks internationally. The phylogenetic analysis of sequences of all genes of the S-OIV, showed that its genome contained six gene segments that were similar to ones previously found in triple-reassortant swine influenza viruses circulating in pigs in North America. The genes encoding neuraminidase and M protein were most closely related to those in influenza A viruses circulating in swine populations in Eurasia. This unique genetic combination of influenza virus gene segments leading to the emergence of novel S-OIV that had not been seen before in the world. Here, it has been used evolutionary analysis to estimate the timescale of the origins and the early development of the S-OIV epidemic. This paper shows that it was derived from several viruses circulating in swine and makes a briefly review over the origins and evolutionary genomics of current S-OIV in humans with historical perspectives with a view to exhibition of evolutionary relationship between past and present origins of swine influenza viruses.