人禽流感的防治

人禽流行性感冒（人禽流感）是由禽甲型流感病毒某些亚型中的一些毒株引起的急性呼吸道传染病。考虑到人类对禽流感病毒普遍缺乏免疫力，人类感染H5N1型禽流感病毒后的高病死率以及可能出现的病毒变异等，世界卫生组织（WHO）认为该疾病可能是对人类存在潜在威胁最大的疾病之一。本文从禽流感病原特征、人禽流感流行病学概况、临床特征、用药指导、疫情监测、医院感染的控制与防护、社会预防与控制等多方面论述人禽流感疾病。尽管禽流感病毒对人类的感染途径和传播方式还没完全明了，也没人类疫情爆发的报道，但医务工作者应当吸取2003年“传染性非典型肺炎疫情”给我们带来的深刻教训。贯彻卫生部提出的各项防控人间禽流感疫情的各种防控措施，并保证措施得到有效落实，防止禽流感疫情向人间扩散与传播。     

人禽流感诊疗方案(2005版修订版)

禽流感是由禽甲型流感病毒某些亚型毒株引起的急性呼吸遣传染病，人禽流感是当前我国和部分其他国家面临的重要公共卫生问题。为有效应对人禽流感疫情，国家卫生部和国家中医药管理局于2004年委托中华医学会等学会组织相关领域专家制订了《人禽流感诊疗方案（试行）》，供临床诊疗和医务人员培训时使用。随后，又于2005年进行了修订，新修订的《人禽流感诊疗方案（2005版修订版）》于2005年11月23日向社会发布。为协助卫生行政部门做好人禽流感的预防和治疗工作，我刊在本期全文刊登了谊方案。我们希望各级各类医疗机构和医药学工作者重点学习和掌握新旧人禽流感诊疗方案中诊断、治疗的差异及其临床意义，进一步做好人禽流感的预检分诊、诊断治疗、消毒、防护、疫情报告等工作。今后，我刊将继续密切关注有关人禽流感的诊治进展。同时，也希望广大医务工作者注意搜集总结防治人禽流感工作中的经验和遇到的问题，并及时向国家相关部门报告。[编者按]     

人禽流感疫情监测实施方案

为及时发现人间可能感染的禽流感病例，及时采取有效的控制策略和措施，特制订此监测方案，此项监测工作只在有动物禽流感疫情发生的省份开展。     

防制禽流感的公共卫生意义

禽流感是第一个实行全球性监测的传染病，且与人类流感关系密切，高致病性禽流感，已经且将可能给许多国家和我国养禽业造成巨大的损失，同时高致病性禽流感病毒作为人流感的最大基因库而间接威胁人类健康，并可作为人类的新病源而直接对人类构成威胁。     

禽流感疫苗研究进展

A型禽流感病毒（H5N1）带来了全球性的威胁，截止到2006年3月，世界卫生组织已报道了7个国家176例A型禽流感（H5N1）确诊病人，其中97人死亡，死亡率为55％。目前最大的担忧是，禽流感病毒（H5N1）继续进化成不同的抗基因突变体，感染除人之外的哺乳动物宿主，其传染范围扩大，从家禽至迁移鸟类，而通过鸟类传播，30多个国家暴发了禽流感。安全有效的疫苗很可能是减小大流行病的发病率、死亡率，从而维护公众健康的唯一手段。     

高致病性禽流感的流行病学特征

2004年禽流感突袭东南亚国家和我国部分地区,不仅造成数百万家禽染病,而且国外已有人因感染禽流感病毒而死亡。为了对高致病性禽流感有一个正确的认识,现将其流行病学特征介绍如下。1 禽流感概述禽流感是由禽流感病毒引起的一种动物间的急性传染病,最早于1878年暴发于意大利,它可发生于禽类,也可发生于哺乳动物。1900年,这种病毒被人类发现时命名为“真性鸡瘟病毒“,1955年正式命名为禽流感病毒。它与人类和其它动物的流感病毒同属正粘病毒科,俗称     

人类禽流感病毒感染的药物防控研究进展

禽流感病毒具有高致病性和高致死率，它不仅给养殖业造成很大的危害，而且对人类的健康和生命安全也构成了威胁。因此，研究抗禽流感病毒的药物势在必行。本文综述了目前抗禽流感病毒药物的研究现状和进展。     

防治跨种属的禽流感

易发于野生鸟类和家禽中流行的禽流感病毒可引起禽流感（avianin Quenza）。禽流感病毒属正粘病毒科甲型流感病毒属。预防禽流感要加强禽类疾病的监测。对疑似和确诊患者应进行隔离治疗和对症治疗，加强支持治疗，密切观察，监测并预防并发症的发生。     

人禽流感诊疗方案（2005版修订版）

卫生部和国家中医药管理局组织专家对《人禽流感诊断方案（2005版）》进行了修订，于2005年11月23日发布了《人禽流感诊疗方案（2005版修订版）》，以指导医疗机构做好人禽流感的诊断和治疗工作。现搜集刊出，增加人们对人禽流感病医学、流行病学、临床特征、诊断鉴别和治疗的了解和认识，增强防治人禽流感的意识。     

禽流感病毒诊断进展

禽流感是由禽流感病毒（AIV）所致的一种人畜共患急性传染性疾病。自中国香港1997年发现第1例患者以来，世界各地都相继有病例报道，严重影响了人们的健康和经济发展。我国于1979年首次分离到AIV，1994年报道AI在鸡群中流行，1996年在广东地区的鹅群中首次分离到H5亚型AIV。1997年，我国香港首次发生H5N1亚型AIV感染人并致人死亡的事件。     

高致病性H7N9禽流感病毒研究进展

摘要：H7N9禽流感病毒在中国出现以来共造成5次流行。在第5次流行中出现了高致病性H7N9变异株,该病 毒株的HA链接肽位置发生了基因插入性突变,导致该病毒对家禽毒力的增强。同时在人感染H7N9禽流感病例中 也相继分离到了该病毒。因此,对高致病性H7N9禽流感病毒病原学及流行病学研究对于该疾病的预防和控制具有 重要意义。本文从高致病性H7N9禽流感病毒的变异来源、流行病学特征及防治措施等方面进行综述,为高致病性 H7N9禽流感的有效防治提供科学策略。     

2014～2015年南充市禽流感职业暴露人群及环境监测结果分析

目的 了解南充市禽流感职业暴露人群H5N1感染及环境禽流感病毒污染状况.方法 2014～2015年采集南充市禽类职业暴露人群血清标本,用红细胞凝集抑制试验(HI)检测H5N1抗体;对城乡活禽市场、家禽规模养殖、野鸟禽鸟栖息地以及禽类宰杀市场等场所的笼子、粪便以及污水标本采用实时荧光定量PCR法检测禽流感病毒(甲型流感病毒,即FluA)核酸.结果 共采集职业暴露人群160份血清标本,H5N1抗体结果均为阴性采集环境标本160份进行禽流感病毒核酸检测,FluA核酸阳性31份,总检出率为16.32％.其中H5、H7、H9核酸阳性分别是18份、0份、10份,H5、H7、H9检出率分别是9.47％、0％、5.26％,FluA核酸阳性未分型3份,未分型检出率为1.58％,不同类型标本、不同监测点环境、不同监测场所及不同季节监测结果比较差异有统计学意义(x2值分别是37.43、8.67、30.57和30.44,P＜0.05).结论 禽流感H5亚型在南充市职业暴露人群中未发现隐性感染,南充市各类型标本、各监测场所、各监测点环境及各季节均存在禽流感病毒,建议各相关政府部门加强对禽流感相关知识的宣传,加强交易以及宰杀市场等的监管,加强对外环境的监测,必要时采取短期关闭活禽交易、禽类宰杀市场,季节性休市等措施,降低禽流感病毒感染的风险.     

人感染甲型H7N9禽流感病毒致病性研究进展

人感染甲型H7N9禽流感病毒（human-infecting H7N9 avian influenza A virus，hH7N9 AIAV）已跨越禽类与人类之间的宿主屏障而感染人类。2013年至今，hH7N9 AIAV已在中国引起5次大的流行。虽然到目前为止仅存在有限的hH7N9 AIAV感染人际传播病例，但hH7N9 AIAV的高突变率特征似存在引发大流行的可能。此文就hH7N9 AIAV的来源、致病性和抗原分子基础，以及人感染H7N9禽流感的临床特征进行综述，以为hH7N9 AIAV防控提供参考。     

Characterization of a trypsin-dependent avian influenza H5N1-pseudotyped HIV vector system for high throughput screening of inhibitory molecules

In this study, we have generated and characterized an avian influenza H5N1 hemagglutinin (HA), neuraminidase (NA) and M2 ion channel pseudotyped HIV-based vector system (HaNaM-pseudotyped HIV vector). The cleavage site of the HA protein was modified to necessitate trypsin-dependent maturation of the glycoprotein. HA, NA and M2 were efficiently incorporated in HIV vector particles which could transduce different cell lines in a trypsin-dependent manner. Results also showed that the presence of avian influenza M2 and NA proteins maximized both vector production and transduction and that transduction was highly sensitive to the specific NA inhibitor oseltamivir (Tamiflu). H5N1 HaNaM-pseudotyped HIV vector system was also adapted for cell-based high throughput screening of drug candidates against influenza virus infection, and its high sensitivity to the specific oseltamivir validates its potential utility in the identification of new influenza inhibitors. Overall, the trypsin-dependent H5N1-pseudotyped HIV vector can mimic avian influenza virus infection processes with sufficient precision to allow for the identification of new antivirals and to study avian influenza virus biology in a lower biosafety level laboratory environment.     

Human influenza

Human influenza is one of the most common human infectious diseases, contributing to approximately one million deaths every year. In Germany, each year between 5.000 and 20.000 individuals die from severe influenza infections. In several countries, the morbidity and mortality of influenza is greatly underestimated. This is reflected by general low immunization rates. The emergence of avian influenza against the background of the scenario of a human influenza pandemic has revived public interest in the disease. According to the World Health Organisation, it is only the question on the beginning of a new influenza pandemic. The virus type of the new pandemic is still uncertain and it is also unclear, if a pandemic spread of the virus may be prevented by consistent controlling of avian influenza.     

四价流感病毒裂解疫苗生产用毒种传代稳定性研究

目的  研究四价流感病毒裂解疫苗生产用毒种的传代稳定性,确保毒种适用于疫苗生产。方法  将WHO推荐的季节性流感疫苗甲型H1N1和H3N2、乙型BV和BY病毒株（原始种子批）在鸡胚中传代扩增,制备生产用主种子批和工作种子批毒种。按中国药典2015年版三部的要求对毒种进行检定,包括鉴别试验、病毒滴度和血凝滴度测定、外源微生物检查等。将毒种连续传10代,用反转录PCR扩增第2、3、4、5、10代病毒鸡胚尿囊液中的血凝素（hemagglutinin,HA）和神经氨酸酶（neuraminidase,NA）基因片段,并进行序列测定,分析传代过程中HA和NA的核苷酸和氨基酸序列同源性。结果  主种子批和工作种子批毒种的抗原性均与推荐的病毒株一致。各型病毒滴度均>6.5 lg半数鸡胚感染量/ml,血凝滴度均≥1：160。2个种子批的支原体和无菌检查结果均为阴性,主种子批外源性禽白血病病毒和禽腺病毒检查结果亦为阴性。毒种在鸡胚中连续传代后,各型病毒株HA和NA的核苷酸序列同源性均>99%,氨基酸序列同源性均为100%。结论  本研究的四价流感病毒裂解疫苗生产用毒种具有良好的传代稳定性,可用于疫苗生产。     

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.     

Alternative routes of influenza vaccine delivery

The global emergence of virulent avian influenza and the concomitant raised threat of an influenza pandemic has increased interest in the development of improved influenza vaccines. Whereas conventional influenza vaccines are delivered by parenteral injection, an intranasal influenza vaccine has been marketed since 2003. Many other technologies are in development for intranasal, oral, epidermal and topical influenza vaccines. This editorial summarises the advances in clinical development of technologies for needle-free influenza vaccine delivery.     

Antiviral agents active against influenza A viruses

The recent outbreaks of avian influenza A (H5N1) virus, its expanding geographic distribution and its ability to transfer to humans and cause severe infection have raised serious concerns about the measures available to control an avian or human pandemic of influenza A. In anticipation of such a pandemic, several preventive and therapeutic strategies have been proposed, including the stockpiling of antiviral drugs, in particular the neuraminidase inhibitors oseltamivir (Tamiflu; Roche) and zanamivir (Relenza; GlaxoSmithKline). This article reviews agents that have been shown to have activity against influenza A viruses and discusses their therapeutic potential, and also describes emerging strategies for targeting these viruses.     

Vaccines against epidemic and pandemic influenza

Background: Preventative vaccination is the most effective way to control epidemic and, perhaps, pandemic influenza viral infections. However, the immunogenicity and efficacy of influenza vaccines against epidemic strains are suboptimal among older adults. The risk of serious complications from influenza viral infection is compounded by co-morbid conditions among older adults. Furthermore, despite annual influenza vaccination campaigns, the vaccination rates in high risk populations range from 60.5 – 79.2% only . In addition, H5N1 avian influenza viruses have the potential to cause a pandemic. However, H5N1 vaccines currently licensed in the US are poorly immunogenic in high doses in the absence of an adjuvant even in healthy adults. Objectives: In this review, we address the current status of vaccines against epidemic and avian influenza viruses of pandemic potential. Methods: We have limited the review to the discussion of technologies and strategies that have progressed to human clinical trials and/or licensure for seasonal and pandemic influenza. Results/conclusion: Improving the immunogenicity of vaccines against avian influenza viruses, as well as aggressive programs to vaccinate high risk populations against seasonal and pandemic influenza, are crucial for our public health efforts in minimizing the impact of influenza epidemics or pandemics.