裂谷热病毒TaqMan荧光定量PCR检测方法的建立

目的根据裂谷热病毒(Rift Valley Fever Virus,RVFV)M片段的保守序列设计并合成特异性引物和TaqMan探针,建立鉴定裂谷热病毒的TaqMan实时荧光定量PCR检测方法。方法合成裂谷热病毒M片段基因,PCR扩增后将其连入pMD18-T载体,构建重组质粒作为阳性标准品,以10倍系列稀释的标准品进行荧光定量PCR扩增,并绘制标准曲线。结果所绘制标准曲线的相关系数为0.999,该检测方法的灵敏度达40copies/μL,特异性好,对除裂谷热病毒外其他病毒(PPRV、HFV、RV、SPPV和GIPV)检测均为阴性。该方法重复性好,批内重复和批间重复的变异系数均小于1%。结论裂谷热病毒TaqMan荧光定量PCR检测方法的建立为裂谷热病毒的快速准确诊断及流行病学调查提供了有效的手段。     

埃及尖音库蚊和触角库蚊吸血宿主的选择方式

1977年首次在埃及发现裂谷热(Riftvalley fever)病毒,它导致了大量动物和人的死亡。该病毒的流行很大程度上受蚊选择宿主吸血的影响。本文作者研究了与裂谷热流行有关的蚊对吸血宿主的选择行为。 在距开罗西北约70公里的Abu Heif村,从94户村民中随机选10户,每户都有一个卧室和畜厩,或有夜间圈养家畜的庭院。从1983年8月到1984年7月,在这10户居民     

与人类疾病相关的布尼安病毒研究进展

近几年,布尼安病毒的研究进展较快,新的布尼安病毒不断被发现。布尼安病毒科（Bunyauiridne）至少包括350种病毒,被分为5个属：Orthobunyavirus、Hantanvirus、Nairovirus、Phlebovirus、Tospovirus（见表1）,是动物病毒家族中最大的一个病毒科。至少有60种布尼安病毒可引起人类或家畜的疾病,其中对人类健康及社会经济生活产生严重威胁的病毒主要有裂谷热病毒（RVFV）、Lacrosse脑炎病毒（LACV）、奥罗普切热病毒（OROV）、白蛉热病毒（SFV）、克里米亚一刚果出血热病毒（CCHFV）和汉坦病毒属成员等。     

裂谷热病毒实时荧光定量PCR检测方法的建立

目的建立一种快速、敏感、特异的RealtimePCR（实时荧光定量PCR）方法,用于裂谷热病毒（RVFV）的检测。方法根据裂符热病毒N蛋白基因的保守序列设计并合成一对引物及特异性TaqMan探针。通过条件优化,以10倍系列稀释重组质粒为标准品,进行Real-timePCR扩增,绘制标准曲线,并进行重复性、准确性、特异性及敏感性检测。结果建立的Real-timePCR方法检测裂谷热病毒所绘制标准曲线的相关系数大于0．99,灵敏度为1．0×10^1拷贝,高于常规PCR方法（1．0×10^3拷贝）;除裂谷热病毒外的其他7种对照烈性病病原体基因检测均呈阴性;批内重复和批问重复的变异系数均小于1％。结论建立的裂谷热病毒Real-timePCR检测方法敏感性和特异性较高,可用于裂谷执病毒感染懊涑诊眯斤殛流行病学谰杏．     

当前传入我国风险较大的几种新发传染病

近年来,国际新发、烈性传染病疫情发生的频率大大加快,对我国的影响也日益加大。西尼罗病毒、马尔堡病毒、拉沙病毒、委内瑞拉马脑炎病毒、尼帕病毒、布氏锥虫、裂谷热病毒等多种人兽共患病原体均曾引起过人间或动物间较大规模的暴发流行。随着我国对外经贸、人员往来的日趋频繁,上述传染病疫情存在传入我国并引起国内地方性流行的巨大风险,应引起我国高度关注。     

人类病毒性出血热

病毒引起的出血热不是新近才认识的现象,天花和黄热为人们所熟知已有若干世纪。但是,许多其它病毒引起的出血热,只是近30年才了解的。虽然这些病毒常常称之为“新”病毒,但很可能早已“无声无息”存在于动物疫源地多年。Casals 等根据病毒性出血热传播途径加以分类(表1)。通过接触患病动物感染(如裂谷燕),或接触病人感染(如拉沙热和马尔堡病)。在缺乏病毒学诊断设备的情况下,依靠临床观察作出确诊极为困难,许多感染的早期症     

人畜共患的蚊传裂谷热

裂谷热是由裂谷热病毒(rift valley fever virus,RVFV)感染引起的人畜共患传染病,蚊叮咬或者通过接触病畜体液传播,通常为亚临床表现或仅有自限性发热,严重者可出现脑膜炎、视网膜炎、肝炎、肾功能损伤,重症者有出血倾向及肝肾功能衰竭,死亡率10%～12%.主要流行于非洲,但WHO警告旅游业的发展使之有可能传播至各地[1].目前,我国尚无确诊病例报道.     

裂谷热病毒Gn蛋白主要抗原区的表达、纯化及抗原性分析

目的 通过原核表达系统制备裂谷热病毒Gn片段主要抗原区蛋白,获取纯化蛋白,并分析抗原性。方法 将合成的裂谷热Gn基因用PCR的方法扩增具有保护性抗原表位的两段Gn1和Gn2,并将其定向插入原核表达质粒pColdⅠ中,构建重组表达质粒pColdⅠ-Gn1和pColdⅠ-Gn2,并将重组质粒转化到BL21(DE3)感受态中,以IPTG诱导表达,SDS-PAGE分析表达蛋白和表达量,并利用His-tag Ni柱进行亲和层析纯化,Western-blot鉴定表达蛋白。结果 所构建的质粒pColdⅠ-Gn1和pColdⅠ-Gn2序列正确,SDS-PAGE检测到目的蛋白,Western-blot显示截断的Gn蛋白具有很好反应原性。结论 成功纯化了裂谷热病毒Gn主要抗原区的表达蛋白。     

裂谷热病毒Gn蛋白主要抗原区的表达、纯化及抗原性分析北大核心CSCD

目的通过原核表达系统制备裂谷热病毒Gn片段主要抗原区蛋白,获取纯化蛋白,并分析抗原性。方法将合成的裂谷热Gn基因用PCR的方法扩增具有保护性抗原表位的两段Gn1和Gn2,并将其定向插入原核表达质粒pColdⅠ中,构建重组表达质粒pColdⅠ-Gn1和pColdⅠ-Gn2,并将重组质粒转化到BL21(DE3)感受态中,以IPTG诱导表达,SDS-PAGE分析表达蛋白和表达量,并利用His-tag Ni柱进行亲和层析纯化,Western-blot鉴定表达蛋白。结果所构建的质粒pColdⅠ-Gn1和pColdⅠ-Gn2序列正确,SDS-PAGE检测到目的蛋白,Western-blot显示截断的Gn蛋白具有很好反应原性。结论成功纯化了裂谷热病毒Gn主要抗原区的表达蛋白。     

裂谷热

裂谷热(Rift Valley Fever)是节肢动物携带由裂谷热病毒引起的人畜共患急性出血性传染病。主要侵害家畜,人类也可流行。临床主要特征为发热,出血倾向,并发肝炎、脑膜脑炎或视网膜损伤等,肝组织中出现广泛的、非化脓性改变为其特点。 1912年首次在非洲的肯尼亚立夫特山谷(Rift     

Virus isolations and high population density implicate Culex antennatus (Becker) (Diptera: Culicidae) as a vector of Rift Valley Fever virus during an outbreak in the Nile Delta of Egypt

In June, 2003, Egypt's hospital-based electronic disease surveillance system began to record increased cases of acute febrile illness from governorates in the Nile Delta. In response to a request for assistance from the Egyptian Ministry of Health and the World Health Organization (WHO), the U.S. Naval Medical Research Unit No. 3 (NAMRU-3) provided assistance in identifying the cause and extent of this outbreak. Testing of human clinical samples (n=375) from nine governorates in Egypt identified 29 cases of RVF viremia that spanned the period of June to October, and a particular focus of disease in Kafr el Sheikh governorate (7.7% RVF infection rate). Veterinary samples (n=101) collected during this time in Kafr el Sheikh and screened by immunoassay for RVFV-specific IgM identified probable recent infections in cattle (10.4%) and sheep (5%). Entomologic investigations that focused in rural, rice growing villages in the Sidi Salim District of Kafr el Sheikh during August-September, 2003, collected, identified, and tested host-seeking female mosquitoes for the presence of pathogenic viruses. Three isolates of RVF virus (RVFV) were obtained from 297 tested pools of female mosquitoes and all three RVFV isolates came from Cx. antennatus (Becker). While Cx. pipiens has been considered the primary vector of RVF virus in Egypt and is often the most common man-biting species found, Cx. antennatus was the dominant species captured at the 2003 outbreak location in Kafr el Sheikh governorate. This is the first time that Cx. antennatus has been found naturally infected with RVFV in Egypt.     

慢性乙型肝炎防治指南(2019年版)

为了实现世界卫生组织提出的“2030年消除病毒性肝炎作为重大公共卫生威胁”的目标,中华医学会感染病学分会和肝病学分会于2019年组织国内有关专家,以国内外慢性乙型肝炎病毒感染的基础和临床研究进展为依据,结合现阶段我国的实际情况,更新形成了《慢性乙型肝炎防治指南(2019年版)》,为慢性乙型肝炎的预防、诊断和治疗提供重要依据。     

Case Report: Severe Rift Valley Fever May Present with a Characteristic Clinical Syndrome

Rift Valley fever (RVF) virus is an emerging pathogen that is transmitted in many regions of sub-Saharan Africa, parts of Egypt, and the Arabian peninsula. Outbreaks of RVF, like other diseases caused by hemorrhagic fever viruses, typically present in locations with very limited health resources, where initial diagnosis must be based only on history and physical examination. Although general signs and symptoms of human RVF have been documented, a specific clinical syndrome has not been described. In 2007, a Kenyan outbreak of RVF provided opportunity to assess acutely ill RVF patients and better delineate its presentation and clinical course. Our data reveal an identifiable clinical syndrome suggestive of severe RVF, characterized by fever, large-joint arthralgia, and gastrointestinal complaints and later followed by jaundice, right upper-quadrant pain, and delirium, often coinciding with hemorrhagic manifestations. Further characterization of a distinct RVF clinical syndrome will aid earlier detection of RVF outbreaks and should allow more rapid implementation of control.     

Transmission of Rift Valley fever virus by the sand fly, Phlebotomus duboscqi (Diptera: Psychodidae)

Studies were conducted to determine if the sand fly Phlebotomus duboscqi could serve as a vector of Rift Valley fever (RVF) virus. When 145 P. duboscqi were fed on a hamster with RVF viremia (approximately 10(9) PFU/ml of blood), 72 (50%) became infected. Of 5 with disseminated infections (i.e., virus recovered from their legs) 4 transmitted virus to hamsters by bite. Sand flies were uniformly infected when RVF virus was inoculated by the intrathoracic route, and each of 31 sand flies so inoculated that fed on a hamster transmitted virus. None of 331 progeny of inoculated sand flies or 230 progeny of orally exposed sand flies contained virus. Sand flies could serve as vectors of RVF virus.     

World Health Assembly Resolution 60.22 and its importance as a health care policy tool for improving emergency care access and availability globally

The recent adoption of World Health Assembly Resolution 60.22, titled "Health Systems: Emergency Care Systems," has established an important health care policy tool for improving emergency care access and availability globally. The resolution highlights the role that strengthened emergency care systems can play in reducing the increasing burden of disease from acute illness and injury in populations across the socioeconomic spectrum and calls on governments and the World Health Organization to take specific and concrete actions to make this happen. This resolution constitutes recognition by the World Health Assembly of the growing public health role of emergency care systems and is the highest level of international attention ever devoted to emergency care systems worldwide. Emergency care systems for secondary prevention of acute illnesses and injury remain inadequately developed in many low- and middle-income countries, despite evidence that basic strategies for improving emergency care systems can reduce preventable mortality and morbidity and can in many cases also be cost-effective. Emergency care providers and their professional organizations have used their comprehensive expertise to strengthen emergency care systems worldwide through the development of tools for emergency medicine education, systems assessment, quality improvement, and evidence-based clinical practice. World Health Assembly 60.22 represents a unique opportunity for emergency care providers and other advocates for improved emergency care to engage with national and local health care officials and policymakers, as well as with the World Health Organization, and leverage the expertise within the international emergency medicine community to make substantial improvements in emergency care delivery in places where it is most needed.     

First isolation of the Rift Valley fever virus from Culex poicilipes (Diptera: Culicidae) in nature

Following the reemergence of Rift Valley fever (RVF) virus in southeastern Mauritania in 1998, an entomological survey was undertaken in the boundary area in Senegal to assess the extent of the virus circulation. During this study, RVF virus (36 strains) was isolated for the first time from Culex poicilipes in nature. The possible role of Cx. poicilipes as an RVF vector is discussed regarding its biology and ecology.     

Comment on review article: Chronic hepatitis C virus infection cascade of care in pediatric patients

An enhanced cascade of care should include a younger population, helping to achieve the goal of the World Health Organization with a focus on elimination in the pediatric population. Furthermore, enhanced screening and awareness efforts and continued education of health care providers will improve the outcomes of chronic hepatitis C virus (HCV) infection in the pediatric population. The present work discusses and comments on the topic "cascade of care in HCV chronic pediatric patients".     

Rift Valley fever surveillance in mobile sheep flocks in the Nile Delta

Rift Valley fever (RVF) surveillance was carried out in the Nile Delta by monitoring mobile and stationary sheep flocks for antibodies to RVF virus. Sheep are known to be susceptible to RVF virus infection and experienced severe morbidity in 1977 and 1978 when RVF was epidemic in Egypt. Four hundred six sheep in 32 flocks were surveyed during 1984. Twenty-four sheep from 7 flocks had antibodies to RVF virus detected by hemagglutination inhibition and plaque reduction neutralization tests. Antibodies were found primarily in sheep greater than 3 years of age, although 1- and 2-year-old sheep were included in the sample. No seroconversion was observed among 177 seronegative sheep that were bled successively for a period of 10 months. These results indicate that epizootic RVF was probably not present in the Nile Delta during 1984.     

Primary health care as a practical means for measles control

In 1977 the 30th World Health Assembly affirmed that the main social target of governments and the World Health Organization in the coming decades should be "the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life." The International Conference on Primary Health Care in Alma-Ata, USSR in 1978 identified primary health care as the fundamental approach for attaining this social target. What relevance do these pronouncements have concerning the worldwide control of measles? Is primary health care a prerequisite to control? Is it sufficient? It is concluded that little chance for global measles control exists unless national policy makers and health workers at all levels adopt the general approach of primary health care but that it is unlikely this approach, by itself, will assure measles control. Special efforts to reduce or stop measles transmission will also be required. In most developing countries at least, the goal of measles control can best be pursued as part of a broader program to reduce morbidity and mortality from several diseases of children preventable by immunization.     

Being Ready to Treat Ebola Virus Disease Patients

As the outbreak of Ebola virus disease (EVD) in West Africa continues, clinical preparedness is needed in countries at risk for EVD (e.g., United States) and more fully equipped and supported clinical teams in those countries with epidemic spread of EVD in Africa. Clinical staff must approach the patient with a very deliberate focus on providing effective care while assuring personal safety. To do this, both individual health care providers and health systems must improve EVD care. Although formal guidance toward these goals exists from the World Health Organization, Medecin Sans Frontières, the Centers for Disease Control and Prevention, and other groups, some of the most critical lessons come from personal experience. In this narrative, clinicians deployed by the World Health Organization into a wide range of clinical settings in West Africa distill key, practical considerations for working safely and effectively with patients with EVD.An unprecedented number of health care professionals from a variety of clinical settings, in a wide range of countries are thinking about, preparing for and caring for Ebola virus disease (EVD) patients. Guidance documents on infection prevention and control (IPC) practice and clinical care have been produced by organizations with EVD experience.^1–3 The World Health Organization (WHO) produces guidance for implementation across a wide range of resource settings. Medecin Sans Frontières produces guidance for medical team activities across the outbreak. The Centers for Disease Control and Prevention (CDC) focus on measures which can be taken by the United States health system and extrapolated by others involved in preparedness and response. There are no short cuts to clinical preparedness for EVD. These documents and their revisions should be reviewed carefully.As important as guidance documents are, many lessons must be learned from specific hands-on experience. The WHO has mobilized clinical consultants in support of EVD response in each of the affected countries in West Africa. This short list of key points attempts to consolidate practical lessons learned that do not always percolate into technical documents. Having landed in unconstrained, resource-limited settings at the start of local EVD clinical operations in an outbreak, and more established EVD care centers, we hope that others might adopt some of these lessons and avoid some of the risks inherent to the steep learning curve associated with delivering EVD care. The points are geared toward the daily care of patients as opposed to the critical mechanics of establishing a care center and developing its procedures. They are focused on the outbreak setting and also have relevance to the referral hospital setting.