2015年中国大陆流行性感冒流行特征分析

【摘要】 目的  对2015年流行性感冒的监测结果及流行特征进行分析总结,对2016的流行趋势进行预判。 方法  统计中国流感监测信息系统以及突发公共卫生事件信息管理系统2015年全年中国大陆地区的流感样病例（ILI）监测数据以及流感样病例爆发疫情数据。 结果  2015年夏季南方出现了流行高峰,北方维持在低水平,均为A（H3N2）亚型占绝对优势。南北方省份均在12月份开始相继进入2015~2016冬春季流感流行季节,甲型H1N1、A（H3N2）和B型共同流行。 结论  预计2016年2月下旬,流感活动水平将达到峰值,春夏季中国大陆省份将以甲型H1N1、 A（H3N2）和B型流感共同流行,但以甲型H1N1流感为主要流行株。     

Infectivity and pathogenicity of canine H3N8 influenza A virus in horses

Please cite this paper as: Yamanaka et al. (2010) Infectivity and pathogenicity of canine H3N8 influenza A virus in horses. Influenza and Other Respiratory Viruses 4(6), 345–351. Background  Equine H3N8 influenza A viruses (EIVs) cause respiratory disease in horses and circulate among horses worldwide. In 2004, an outbreak of canine H3N8 influenza A virus (CIV) occurred among dogs in Florida and has spread among dogs in the United States (US). Genetic analyses revealed that this CIV is closely related to the recent EIVs. Although CIV‐infected dogs could be the source of H3N8 influenza A virus for horses, it remains unclear whether the CIV circulating in the United States still maintains its infectivity and/or pathogenicity in horses. To address this, we investigated the infectivity and pathogenicity of CIV in horses and the receptor binding specificity of CIV. Materials and methods  Three horses were inoculated with A/canine/Colorado/30604/2006 (CO06, H3N8). Clinical signs and nasal swabs were recorded or collected every day. We also evaluated the virus binding to α2‐3‐linked 5‐N‐acetylneuraminic acid (NeuAcα2‐3Gal) and 5‐N‐glycolylneuraminic acid (NeuGcα2‐3Gal) receptor analogues. Results  Although all the three horses inoculated with CO06 seroconverted, they showed only mild clinical signs and two of them showed no virus shedding. CO06 had reduced binding to NeuGcα2‐3Gal. Discussion  Our results demonstrated that CO06 had reduced proliferation ability and pathogenicity in horses. As the recognition of NeuGcα2‐3Gal by EIV is known to be essential for binding to the equine respiratory system, the decreased binding of CO06 to NeuGcα2‐3Gal may be one of the important factors that reduces the proliferation ability and pathogenicity of CO06 in horses.     

Inter‐ and intraspecies transmission of canine influenza virus (H3N2) in dogs,cats, and ferrets

Background The emergence of zoonotic viruses in domestic animals is a significant public health concern. Canine influenza virus (CIV) H3N2 is a virus that can infect companion animals and is, therefore, a potential public health concern. Objective This study investigated the inter‐ and intraspecies transmission of CIV among dogs, cats, and ferrets, under laboratory conditions, to determine whether transmission of the virus was possible between as well as within these domestic animal species. Method The transmission routes for inter‐ and intraspecies transmission were airborne and direct contact, respectively. Transmission was conducted through intranasal infection of dogs followed by exposure to either cats or ferrets and by comingling infected and naïve animals of the same species. Results The interspecies transmission of CIV H3N2 via airborne was only observed from dogs to cats and not from dogs to ferrets. However, direct intranasal infection of either cats or ferrets with CIV could induce influenza‐like clinical signs, viral shedding, and serological responses. Additionally, naïve cats and ferrets could be infected by CIV via direct contact with infected animals of the same species. Conclusion Cats appear to be another susceptible host of CIV H3N2, whereas ferrets are not likely natural hosts. The molecular‐based mechanism of interspecies and intraspecies transmission of CIV H3N2 should be further studied.     

2016年全球传染病热点回顾

经历了2014—2015年全球埃博拉恐怖疫情后,2016年寨卡疫情由南美洲迅速向北美洲、亚洲、欧洲等地区扩散,疫情在下半年有所缓和,但目前已经扩大到69个国家和地区.得益于国际社会的通力合作,黄热病疫情没有在非洲继续扩大.2016年底H5N3禽流感在亚洲局部地区禽间暴发,中国H7N9禽流感在人间散发病例数有突然增多的趋势.在埃博拉病毒病、中东呼吸综合征、疟疾、AIDS以及丙型肝炎等传染病基础研究、治疗和预防方面,2016年继续有许多重大突破.     

H7N9禽流感及相关疫情分析评估

2016年10月起至今发生的第5波人感染H7N9禽流感疫情比前4波严重,截止至2017年3月8日,本波疫情感染者数量已达历年累积报告数的40.00%。病原学研究发现最近广东分离的两株H7N9病毒在HA的链接肽位置发生插入性变异导致对禽致病性有所增强,但绝大多数分离株与前4波疫情中H7N9病毒病原学特征无明显区别;流行病学调查研究显示,除有3起可能人传人事件外,与前4波比较,患者之间也没有明显的流行病学关联。因此,基于疫情分析及风险评估认为H7N9禽流感仍会扩散传播并继续发生新发病例,但流行病学和病原学分析认为该病毒在人际间持续传播的可能性低。本综述认为加强H7N9禽流感病原学与流行病学的研究具有重要的公共卫生意义。     

The avian‐origin H3N2 canine influenza virus that recently emerged in the United States has limited replication in swine

Equine‐origin H3N8 has circulated in dogs in the United States since 1999. A genetically and antigenically distinct avian‐origin H3N2 canine influenza was detected in March of 2015 in Chicago, Illinois. Subsequent outbreaks were reported with over 1000 dogs in the Midwest affected followed by 23 additional states with detections within 5 months. The potential for canine‐to‐swine transmission was unknown. Experimental infection in pigs showed this virus does not replicate efficiently in swine.     

2016-2017年度中国大陆流行性感冒监测分析

目的 对2016-2017监测年度中国内地流行性感冒的监测结果及流行形势进行分析总结。方法 统计“中国流感监测信息系统”以及“突发公共卫生事件信息管理系统”2016-2017监测年度全年中国内地的ILI监测数据以及流感样病例暴发疫情数据。结果 2016-2017监测年度,南方省份流感活动未出现明显的夏季活动高峰,南、北方省份2017年秋冬流感流行季节均早于上一个监测年度,但流行高峰水平低于2015-2016监测年度。整个年度全国的流感流行优势病毒分别就经历了B型、A(H3N2)和甲型H1N1的交替。全国报告的ILI暴发疫情总起数低于2015-2016年度,南方片区高于北方片区。结论 各地继续高度重视近期流感病毒活动情况,密切关注全球及我国疫情形势,加强监测数据的分析和利用,跟踪流感病毒的活动水平、变异和耐药性变化,及时开展流感暴发疫情的调查处置和应对工作。     

2017-2018年陕西省H7N9禽流感病毒流行特征及基因进化分析

目的 整理和分析2017-2018年陕西省H7N9禽流感病毒流行分布和基因特性,为防控决策提供实证依据。方法 采集陕西省外环境样本、H7N9病例及关联样本,用荧光定量PCR检测H7N9亚型流感病毒,H7N9 阳性标本的病毒分离和基因测序分析由国家流感中心完成。结果 2017年5月至2018年3月,陕西省142个监测点外环境外环境H7N9核酸阳性率仅4.91‰。同时,本省共报告7例H7N9病例和2起禽间疫情。病毒序列分析发现:部分H7N9病毒中HA蛋白裂解位点插入“KRTA”氨基酸基序,具有对禽类高致病性的分子特征。血凝素(HA)和神经氨酸酶(NA)基因进化树分析结果显示陕西省H7N9禽流感病毒与长三角来源的H7N9序列高度同源。结论 陕西H7N9病毒流行株具有遗传多样性,同时存在低致病性和高致病性两个变种。今后应继续做好禽流感病原学监测和遗传变异分析,为防控工作提供依据。     

Minimal molecular constraints for respiratory droplet transmission of an avian–human H9N2 influenza A virus

Pandemic influenza requires interspecies transmission of an influenza virus with a novel hemagglutinin (HA) subtytpe that can adapt to its new host through either reassortment or point mutations and transmit by aerosolized respiratory droplets. Two previous pandemics of 1957 and 1968 resulted from the reassortment of low pathogenic avian viruses and human subtypes of that period; however, conditions leading to a pandemic virus are still poorly understood. Given the endemic situation of avian H9N2 influenza with human-like receptor specificity in Eurasia and its occasional transmission to humans and pigs, we wanted to determine whether an avian–human H9N2 reassortant could gain respiratory transmission in a mammalian animal model, the ferret. Here we show that following adaptation in the ferret, a reassortant virus carrying the surface proteins of an avian H9N2 in a human H3N2 backbone can transmit efficiently via respiratory droplets, creating a clinical infection similar to human influenza infections. Minimal changes at the protein level were found in this virus capable of respiratory droplet transmission. A reassortant virus expressing only the HA and neuraminidase (NA) of the ferret-adapted virus was able to account for the transmissibility, suggesting that currently circulating avian H9N2 viruses require little adaptation in mammals following acquisition of all human virus internal genes through reassortment. Hemagglutinin inhibition (HI) analysis showed changes in the antigenic profile of the virus, which carries profound implications for vaccine seed stock preparation against avian H9N2 influenza. This report illustrates that aerosolized respiratory transmission is not exclusive to current human H1, H2, and H3 influenza subtypes.     

Avian influenza virus infections in humans

Seroepidemiologic and virologic studies since 1889 suggested that human influenza pandemics were caused by H1, H2, and H3 subtypes of influenza A viruses. If not for the 1997 avian A/H5N1 outbreak in Hong Kong of China, subtype H2 is the likely candidate for the next pandemic. However, unlike previous poultry outbreaks of highly pathogenic avian influenza due to H5 that were controlled by depopulation with or without vaccination, the presently circulating A/H5N1 genotype Z virus has since been spreading from Southern China to other parts of the world. Migratory birds and, less likely, bird trafficking are believed to be globalizing the avian influenza A/H5N1 epidemic in poultry. More than 200 human cases of avian influenza virus infection due to A/H5, A/H7, and A/H9 subtypes mainly as a result of poultry-to-human transmission have been reported with a > 50% case fatality rate for A/H5N1 infections. A mutant or reassortant virus capable of efficient human-to-human transmission could trigger another influenza pandemic. The recent isolation of this virus in extrapulmonary sites of human diseases suggests that the high fatality of this infection may be more than just the result of a cytokine storm triggered by the pulmonary disease. The emergence of resistance to adamantanes (amantadine and rimantadine) and recently oseltamivir while H5N1 vaccines are still at the developmental stage of phase I clinical trial are causes for grave concern. Moreover, the to-be pandemic strain may have little cross immunogenicity to the presently tested vaccine strain. The relative importance and usefulness of airborne, droplet, or contact precautions in infection control are still uncertain. Laboratory-acquired avian influenza H7N7 has been reported, and the laboratory strains of human influenza H2N2 could also be the cause of another pandemic. The control of this impending disaster requires more research in addition to national and international preparedness at various levels. The epidemiology, virology, clinical features, laboratory diagnosis, management, and hospital infection control measures are reviewed from a clinical perspective.     

Establishment of multiple sublineages of H5N1 influenza virus in Asia: implications for pandemic control

Preparedness for a possible influenza pandemic caused by highly pathogenic avian influenza A subtype H5N1 has become a global priority. The spread of the virus to Europe and continued human infection in Southeast Asia have heightened pandemic concern. It remains unknown from where the pandemic strain may emerge; current attention is directed at Vietnam, Thailand, and, more recently, Indonesia and China. Here, we report that genetically and antigenically distinct sublineages of H5N1 virus have become established in poultry in different geographical regions of Southeast Asia, indicating the long-term endemicity of the virus, and the isolation of H5N1 virus from apparently healthy migratory birds in southern China. Our data show that H5N1 influenza virus, has continued to spread from its established source in southern China to other regions through transport of poultry and bird migration. The identification of regionally distinct sublineages contributes to the understanding of the mechanism for the perpetuation and spread of H5N1, providing information that is directly relevant to control of the source of infection in poultry. It points to the necessity of surveillance that is geographically broader than previously supposed and that includes H5N1 viruses of greater genetic and antigenic diversity.     

Compatibility of H9N2 avian influenza surface genes and 2009 pandemic H1N1 internal genes for transmission in the ferret model

In 2009, a novel H1N1 influenza (pH1N1) virus caused the first influenza pandemic in 40 y. The virus was identified as a triple reassortant between avian, swine, and human influenza viruses, highlighting the importance of reassortment in the generation of viruses with pandemic potential. Previously, we showed that a reassortant virus composed of wild-type avian H9N2 surface genes in a seasonal human H3N2 backbone could gain efficient respiratory droplet transmission in the ferret model. Here we determine the ability of the H9N2 surface genes in the context of the internal genes of a pH1N1 virus to efficiently transmit via respiratory droplets in ferrets. We generated reassorted viruses carrying the HA gene alone or in combination with the NA gene of a prototypical H9N2 virus in the background of a pH1N1 virus. Four reassortant viruses were generated, with three of them showing efficient respiratory droplet transmission. Differences in replication efficiency were observed for these viruses; however, the results clearly indicate that H9N2 avian influenza viruses and pH1N1 viruses, both of which have occasionally infected pigs, have the potential to reassort and generate novel viruses with respiratory transmission potential in mammals.     

Genetic Characterization and Pathogenesis of Three Novel Reassortant H5N2 Viruses in South Korea, 2018

The outbreaks of H5N2 avian influenza viruses have occasionally caused the death of thousands of birds in poultry farms. Surveillance during the 2018 winter season in South Korea revealed three H5N2 isolates in feces samples collected from wild birds (KNU18-28: A/Wild duck/South Korea/KNU18-28/2018, KNU18-86: A/Bean Goose/South Korea/KNU18-86/2018, and KNU18-93: A/Wild duck/South Korea/KNU18-93/2018). Phylogenetic tree analysis revealed that these viruses arose from reassortment events among various virus subtypes circulating in South Korea and other countries in the East Asia–Australasian Flyway. The NS gene of the KNU18-28 and KNU18-86 isolates was closely related to that of China’s H10N3 strain, whereas the KNU18-93 strain originated from the H12N2 strain in Japan, showing two different reassortment events and different from a low pathogenic H5N3 (KNU18-91) virus which was isolated at the same day and same place with KNU18-86 and KNU18-93. These H5N2 isolates were characterized as low pathogenic avian influenza viruses. However, many amino acid changes in eight gene segments were identified to enhance polymerase activity and increase adaptation and virulence in mice and mammals. Experiments reveal that viral replication in MDCK cells was quite high after 12 hpi, showing the ability to replicate in mouse lungs. The hematoxylin and eosin-stained (H&E) lung sections indicated different degrees of pathogenicity of the three H5N2 isolates in mice compared with that of the control H1N1 strain. The continuing circulation of these H5N2 viruses may represent a potential threat to mammals and humans. Our findings highlight the need for intensive surveillance of avian influenza virus circulation in South Korea to prevent the risks posed by these reassortment viruses to animal and public health.     

No evidence for zoonotic transmission of H3N8 canine influenza virus among US adults occupationally exposed to dogs

Objectives

The zoonotic potential of H3N8 canine influenza virus (CIV) has not been previously examined; yet considering the popularity of dogs as a companion animal and the zoonotic capabilities of other influenza viruses, the public health implications are great. This study aimed to determine the seroprevalence of antibodies against CIV among a US cohort.

Design

A cross-sectional seroepidemiological study was conducted between 2007 and 2010.

Setting

Recruitments primarily occurred in Iowa and Florida. Participants were enrolled at dog shows, or at their home or place of employment.

Sample

Three hundred and four adults occupationally exposed to dogs and 101 non-canine-exposed participants completed a questionnaire and provided a blood sample.

Main outcome measures

Microneutralization and neuraminidase inhibition assays were performed to detect human sera antibodies against A/Canine/Iowa/13628/2005(H3N8). An enzyme-linked lectin assay (ELLA) was adapted to detect antibodies against a recombinant N8 neuraminidase protein from A/Equine/Pennsylvania/1/2007(H3N8).

Results

For all assays, no significant difference in detectable antibodies was observed when comparing the canine-exposed subjects to the non-canine-exposed subjects.

Conclusion

While these results do not provide evidence for cross-species CIV transmission, influenza is predictably unpredictable. People frequently exposed to ill dogs should continually be monitored for novel zoonotic CIV infections.     

2016-2019年深圳口岸入境人群感染甲型流感的流行病学特征分析

目的 分析深圳各口岸近4年入境人群感染甲型流感的流行病学特征,为口岸监测和防控甲型流感疫情提供科学依据。方法 收集2016年1月至2019年12月来自深圳各口岸发热入境人员的鼻咽拭子标本,利用实时荧光定量PCR进行甲型流感病毒检测及分型,通过Excel 2003、SPSS 20.0对不同型别的流感阳性病例的流行情况进行分析。结果 共收集104 115例发热入境人员鼻咽拭子标本,从中检出甲型流感病毒14 026例,检出率为13.5%,其中男女比例为1.75:1,甲型流感病毒检出率在51~60岁、60岁以上人群中检出率最高,分别为18.5%、18.9%。2016-2019年共出现3次甲型流感高峰,分别为2016年2-3月,以甲型H1N1为主;2017年7月,H3亚型病例激增,成为主要流行株;2018年12月,以H1N1亚型为主。结论 2016-2018年期间深圳口岸入境人员感染甲型流感病例中同时有H1N1亚型、甲型H3亚型的流行,呈现为相互交替的流行特征。发病以51岁以上人群为主,不同性别、不同年龄层流感病毒亚型检出率有差异。     

2014-2018年中山市人感染H7N9禽流感病例特征分析

目的 了解2014年1月至2018年5月中山市人感染H7N9禽流感病例临床特征并分析其流行病学特征。方法 收集整理2014年1月至2018年5月中山市H7N9病例个案调查资料。结果 中山市累计报告15例H7N9病例,其中3岁以下女童3人,临床表现为上呼吸道感染,预后良好。12例成人病例,年龄34-78岁(中位数54岁),男性占58.3%(7/12)。成人病例发病后4-8 d(中位数5 d)均出现呼吸困难、严重低氧血症等重症肺炎表现,需要呼吸机辅助通气治疗措施。4例(26.7%)死亡,其中3例为50岁以上且有高血压等基础疾病。60.0%(9/15)发病时间集中于1月下旬至2月上旬。10例可能传播途径为禽类接触传播,其中6例从市场购买活禽回家并亲自宰杀。2例有活禽市场暴露但无活禽直接接触史,可能传播途径为禽类市场空气传播。共发现3起聚集性疫情,其中2起发生人传人的可能性大。结论 在H7N9流行季节,尤其是1月下旬至2月上旬疫情高发期,中山市应采取综合措施,降低居民,尤其是50岁以上有基础疾病者,从市场购买活禽回家及宰杀活禽等高风险行为。     

Avian Influenza a H9N2 Viruses in Morocco, 2018–2019

Low pathogenic H9N2 avian influenza (LPAI H9N2) is considered one of the most important diseases found in poultry (broiler, laying hens, breeding chickens, and turkeys). This infection causes considerable economic losses. The objective of this work was to monitor and assess the presence of avian influenza virus (AIV) H9N2 in eight different regions of Morocco using real-time RT-PCR, and to assess the phylogenetic and molecular evolution of the H9N2 viruses between 2016 and 2019. Field samples were collected from 108 farms suspected of being infected with LPAI H9N2 virus. Samples were analyzed using H9N2-specific real-time RT-PCR. Highly positive samples were subjected to virus isolation and seven isolates were fully sequenced. Low pathogenic H9N2 avian influenza virus was introduced in Morocco in 2016. We show that in 2018–2019, the virus was still present irrespective of vaccination status. Phylogenetic and molecular analyses showed mutations related to virulence, although our viruses were related to 2016 Moroccan viruses and grouped in the G1 lineage. Specific amino acid substitutions were identified in Moroccan H9N2 viruses that are believed to lead to increased resistance to antiviral drugs.     

H7N9亚型禽流感病毒研究进展

H7N9亚型禽流感病毒(H7N9 AIV)是危害家禽养殖的主要病原体之一,其不仅制约家禽养殖业的健康发展,而且表现出对人类较强的传染性和较高的致死率,严重威胁公共卫生安全。2013年我国首次报道人类感染H7N9 AIV事件,病毒溯源发现家禽体内存在H7N9 AIV,但无明显症状。2017年,H7N9 AIV出现变异株,表现出对家禽的高致病性,随后我国推出H5/H7二价苗,并在全国实施家禽强制免疫接种,有效控制了H7N9 AIV在我国家禽中的流行以及人类感染事件的发生,成为我国控制人兽共患传染病的成功案例。由于我国家禽养殖和AIV的复杂性,全面和持续的流行病学监测对于H7N9禽流感的防控仍然至关重要。本文针对2013年至今H7N9 AIV的流行特征、遗传变异特点及疫苗研究等内容作简要论述,以期为禽流感的预防和控制提供参考。     

安徽省人感染H7N9禽流感病毒基因组特征分析

目的 分析安徽省2013年分离的5株人感染H7N9禽流感病毒全基因组特征。方法 从美国国家生物技术信息中心(NCBI)和全球禽流感基因共享数据库(GISAID)中下载具有代表性的H7N9、H7N3、H7N7和H9N2等毒株序列,运用分子生物信息学软件分析病毒全基因组特征。结果 我省流行的H7N9病毒HA基因与A/duck/Fujian/6390/2010(H7N3)相似度最高,NA基因与A/northern shoveler/Hong Kong/MPL133/2010(H2N9)株相似度最高,6个内部基因片段与中国北京、香港、湖南、江苏地区分离的H9N2毒株相似度接近。氨基酸序列比对发现NS1蛋白218~230位氨基酸缺失、M2蛋白的N31S突变、HA蛋白的G186V 、Q226L突变以及NA蛋白69~73位的删除,并且我省人感染H7N9病毒均带有PB2的E627K突变,同时PA-100A、PA-356R、PA-409N这些易感人类的特征氨基酸也在本次流行的H7N9病毒中发现;此外HA蛋白裂解位点仅有1个碱性氨基酸、糖基化位点高度保守以及未发现NA蛋白R294K突变也是我省H7N9病毒主要特征。结论 我省人感染H7N9病毒与中国其他省份流行株高度同源,该病毒获得跨种传播、毒力增强、耐药等能力均与病毒蛋白功能域有关。