H5N1禽流感疫苗的研究进展

在亚洲、欧洲、非洲,高致病性禽流感（H5N1株）不断的在家禽和迁徙鸟类中爆发,最近人类在感染这种高致病禽流感（HPAI）病毒和因HPAI病毒的病死率都在增加,暗示着流感大流行仍威胁着人类,诸如神经氨酸酶抑制剂等抗病毒药对预防和治疗H5NI感染是有价值的。但供应有限和耐药性限制其发展。疫苗作为控制流感大流行的一种主要手段,受到各个国家的重视。因此,发展H5N1疫苗被认为是主要的策略,保护人类避免一个可能的H5N1的流感大流行大体上建立的普通人流感疫苗的原则也被应用到大流行H5N1的流感疫苗的发展上。     

甲型H1N1流感的抗病毒治疗

2009年4月初,甲型H1N1流感开始在墨西哥和美国出现,2009年6月11日WHO将甲型H1N1流感大流行警告级别提升至6级,表明此次流感疫情已经进入大流行阶段,目前,甲型H1N1流感正在令球流行.     

昆明地区无偿献血者血清甲型H1N1流感病毒抗体调查

2009年3月,墨西哥爆发＂人感染猪流感＂疫情,并迅速在全球范围内蔓延。世界卫生组织（WHO）初始将此型流感称为＂人感染猪流感＂,后将其更名为＂甲型H1N1流感＂。2009年6月11日,WHO宣布将甲型H1N1流感大流行警告级别提升为6级,全球进入流感大流行阶段[1]。     

甲型H1N1流感诊疗方案(2009年试行版第一版)

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     

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。     

甲型H1N1流感诊疗方案 (2009年试行版第一版)

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.     

甲型H1N1流感的流行病学与预防控制

2009年3月暴发于墨西哥的甲型H1N1流感传播迅速,目前已呈现全球蔓延之势,防控形势十分严峻。2009—04—30世界卫生组织（WHO）宣布将流感大流行警告级别提高为5级。我国卫生部同日宣布将其纳入《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。截至2009—05—25,中国内地已发现11例输人性甲型H1N1流感确诊病例。由输入性病例引起的本地流行,甚至引起较大规模的暴发或流行的风险进一步加大。     

警惕甲型禽流感病毒

目前亚洲流行的禽流感病毒是1997年香港出现的H5N1型病毒后代，曾在鸡鸭中流行。H5N1，其中H为红细胞凝集素，N是神经氨酸苷酶，它们都是糖蛋白分布在病毒表面，H有1—15个亚型，N有1—9个亚型(在甲型病毒情况下)。由于H和N的组合不同，病毒的毒性与传播速度也不同。其中3个亚型(H1-H3)与人流感病毒相关，N1-N2为人流感病     

我国人间禽H5N1流感特点、态势及防控策略

虽然国际社会进行全力阻击,但2003年底发生在东南亚地区的高致病性禽H5N1流感仍扩散到欧洲、非洲和北美洲的禽。人间禽流感病/死病例也不断出现。全球从1997年5月～2006年10月20日,人间共发生病例达266例,死亡151例。发生的国家和地区有:中国香港特区、越南、印度尼西亚、泰国、中国、埃及、土耳其、阿塞拜疆、柬埔寨、伊拉克和吉布提。其中发生病/死病例最多的国家为越南和印度尼西亚。根据WHO估计,由于目前禽H5N1流感仍在世界上一些国家禽中流行,同时流行的区域正逐步扩大,因此,今冬明春人间禽流感病例会明显增加。我国地处北半球,每年…     

有效预防人类禽流感H5N1感染的疫苗研制

本文介绍了世界卫生组织(WHO)流感大流行准备计划中预防人类禽流感H5N1感染疫苗的研制步骤.     

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.     

季节性流感疫苗接种对大流行流感的影响研究

加拿大研究发现,季节性流感疫苗接种增加2009年大流行甲型流感(H1N1)感染的危险性,而澳大利亚研究未能证实这个发现.雪貂实验结果表明,以前的季节性流感感染能防御大流行甲型流感(H1N1),但以前的季节性流感疫苗接种则不能.模型研究显示,流感感染可导致对不同亚型的暂时性免疫.这些观察可以解释加拿大和澳大利亚的不一致发...     

Protective immunity elicited by a pseudotyped baculovirus-mediated bivalent H5N1 influenza vaccine

The development of novel H5N1 influenza vaccines to elicit a broad immune response is a priority in veterinary and human public health. In this report, a baculovirus vector was used to construct bivalent recombinant baculovirus vaccine encoding H5N1 influenza virus hemagglutinin proteins (BV-HAs) from clade 2.3.4 and clade 9 influenza viruses. Mice immunized with 5 × 10⁷ IFU BV-HAs developed significantly high levels of H5-specific neutralizing antibodies and cellular immunity that conferred 100% protection against infection with H5N1 influenza viruses. This study suggests that baculovirus-delivered multi-hemagglutinin proteins might serve as a candidate vaccine for the prevention of pre-pandemic and pandemic H5N1 influenza viruses.     

Genotypic and phenotypic resistance of pandemic A/H1N1 influenza viruses circulating in Germany

In response to the rapid global spread of an antigenically novel A/H1N1 influenza virus in 2009, the World Heath Organization (WHO) recommended surveillance and monitoring for antiviral resistance of influenza viruses. We designed and evaluated pyrosequencing (PSQ)-based genotypic assays for high-throughput analysis of the susceptibility of pandemic A/H1N1 influenza viruses to neuraminidase (NA) inhibitors. A total of 1570 samples circulating in Germany between April 2009 and April 2010 were tested for determination of molecular markers of resistance to the NA inhibitors oseltamivir and zanamivir, and 635 of them were evaluated by phenotypic fluorescence-based assay with MUNANA substrate. Eight (0.5%) viruses were resistant to oseltamivir due to the H274Y NA substitution (N2 numbering). Six of these oseltamivir-resistant cases were treatment-related; four of them were selected in immunocompromised patients, two in patients suffered from chronic diseases. The two remaining oseltamivir-resistant viruses seem to have evolved in the absence of drug treatment and were isolated from immunocompetent healthy patients. All tested A/H1N1 pandemic viruses were sensitive to zanamivir. In addition, analysis of 1011 pandemic A/H1N1 virus samples by a PSQ-based assay according to the WHO protocol revealed the presence of mutation S31N in the M2 protein that conferred resistance to M2 ion channel inhibitors. Our data demonstrate a low incidence of oseltamivir-resistant pandemic A/H1N1 influenza variants isolated under drug selection pressure as well as community-acquired or naturally evolving viruses.     

大流行流感与甲型H1N1流感

目的对大流行流感和甲型H1N1进行综述。方法参考国内外近期的有关文献和WHO的相关报道,介绍了流感病毒的基本知识、大流行流感的定义和发展,以及甲型H1N1流感的特点和流行现状等。结果与结论大流行流感具有传播性强、危害大等特点,2009年的甲型H1N1流感为21世纪的第1次大流感,应加以重视。     

甲流记忆与思考——历史上的流感大流行

早在2400年前,希腊名医希波克拉底（Hippocrates）就描述过人类流感的症状。但由于流感的症状与白喉、肺炎、伤寒、登革热以及斑疹伤寒等其他一些流行疾病的症状非常相似,当时的技术水平还不足以将这些流行性疾病鉴别开来,因此,19世纪以前关于流感的记录都不够确切和详尽。     

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 [1] . 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.     

Grippe A (H1N1) 2009. Revue générale

Influenza A(H1N1) 2009 is an acute contagious respiratory infection caused by influenza A virus subtype H1N1 appeared in 2009 and responsible for a pandemic. The new virus, different from the avian virus H5N1, is a variant containing genes from several known viruses from porcine, avian and human origin. Appeared originally in the northern hemisphere, the epidemic wave reached early most countries, and up to 24% of the population in metropolitan France. It is characterized by a low mortality estimated at 0.04 to 0.2%, and by a benign, or even asymptomatic presentation. However, more severe clinical expression has been observed in some subgroups, carrying or not risk factors (young, pregnant women). The preexisting immunity in a significant proportion of the population, the remarkable stability of the virus, determination of early antigenic characteristics of the virus, the development and rapid availability of suitable vaccines, the efficacy of antiviral drugs, and health care system contributed to the control the morbidity and mortality of the first pandemic wave. Other virological, clinical and epidemiological investigations, are needed to identify all potential risk factors for severity and determine the role of mutation and the diffusion of pandemic and seasonal viruses, which may alter the virulence and transmissibility of influenza A(H1N1)v 2009.     

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。     

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.