respiratory viruses infection-八年制掌握流感病毒結(jié)構(gòu)、主要表面抗原HA NA

徐霖 大綱要 熟悉：呼吸 常 的種類及其所致主要疾。流 致病與免疫的特點、檢查方法和預(yù)防原。SARS冠 的防治原則 esassociatedwithrespiratory MeaslesMumpsParainfluenzaRubella“commonSARSApproxApprox15respiratoryrespiratorytractgrowsgrowssalivaryglandsandlocallymphoidtissue7-10spreadspleenanddistantlymphoidtissuethroughoutthroughoutbodytotestes,ovary,pancreas,18daysand esthathavehighaffinitytomucinoncellsurface. , ,genomeconsistsofsegments,highaffinitytomucin ,withhemagglutinin(HA)andneuraminidase(NA) :human,Humaninfluenza 3types,A,B,andCNeedhost“m7GpppXm”primertotranscriptionTypeAundergoesantigenicshiftandTypeBundergoesantigenicdriftonlyTypeCisrelativelyCompositionofRNA:-ssRNA,7～8fragmentsNP:nucleoprotein

RNAdependantRNApolymerase(PB1,PB2,Mprotein:M1,M2Lipidenvelope Enveloped,Fragmented-RNACore:Polymerase: PB2, Matrixproteinmembranefrom:M1andLipidbilayerfromhostcellHA,NS1andNS2

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Trimericprotein,rod-Notinfectiousbeforeclearagebyprotease:HA0→HA1+HA2Hemagglutinin enttothecellmembrane:sialicacid,α(2,6)or(2,3)-linkageAbcanpreventinfection:neutralizationCombinewithspecificreceptors,causeFunctionsofAgglutinationofRBC.Bindtohostcells:HA1Fusewithcellmembrane:HA2formingafusionpore.Foursphericalsubunits,mushroom-Enzymeactivity:liquefymucusFacilitatesthelocalspreadofvirionsAbcan’tpreventinfectionbutcanreduceseverity.FunctionsofHelpthe topermeatemucin.Importantinthefinalstagesofrelease. spreadfromtheoriginalsiteofinfection.Replicationof andType:NPandMprotein(A,BandC).SubtypeoftypeA:HA(H1~H18)andNA(N1~N10).Nomenclature:influenzatype/host(omitifhuman)/locationofisolation/strainno./year/HAandNAsubtypee.g.A/Guangdong/01/2006Pandemics:influenzaA,newhemagglutininsubtype,antigenicshift.PopulationhasnoAntigenicshiftshadoccurred4timesinthe20thcentury.Epidemics:influenzaAandB,antigenicAntigenicMinorchangesinAg:genemutation.HAandNAaccumulatemutations.AbnolongerSporadicoutbreaks,limitedAntigenicMajorchangesinAg:gene“new”HAorPre-existingAbdonotprotectMaycausepandemics.TheoriesBehindAntigenicReassortment:HandNgenes,betweenhumanandavian,throughathirdhost.1957H2N2andthe1968H3N2Recycling:pre-existing Gradualadaptation:avian MechanismsofInfluenzaAntigenic“Shift”?AvianWildbirdsaretheLowpathogenic →mutationsindomesticpoultry→highlypathogenicCo-infection→genetic→highlypathogenicSubtypesinfectedhuman: ,H5N1,H7N1,H7N2,H7N3,H7N7,H7N9,H9N2,andH10N8Chickembryo:mostcommonly hemagglutinationtestCellculture:kidneycelllines.Animal:ferret,mouseSensitivetoheat,dry,UVlight,Inactivateat56℃30min.QuicklylosinginfectivityatroomCauseSeasonandarea:winterinnorthernChina,summerandwinterinsouthernChina.TypeAinfectdifferentanimalsincludinghuman,birds,pigs,horses,etc.Pandemic.TypeBinfecthumanandpigs,localepidemic.TypeConlyinfecthuman,mainlyinfantsandchildren.Seldom/notepidemic.Infectionpatients,subclinicalinfected Transmission:respiratory,aerosol,18-72hrincubationPathogenicPropagateinrespiratoryepithelium,causedirect/indirectcelldamage,noviremiaNAhelpthe topermeatemucinandHighmorbility,lowSeverity:veryyoung,elderly, promised,orpeoplewithheart/lungLocalsymptoms:cough,rhinitis,ocularGeneralsymptoms:fever,headache,myalgiaAvianinfluenza:immunopathologicdamage,“Cytokinestorm”Protectionagainstre-sIgAprotectsmucusIgGlessefficientbutlastslonger.Ab:HAandNA,HA-Ab(neutralize).MicrobiologicalNose,throatswab,tissuecultureorErythrocyteagglutinationtest;HI,Acutestage(<5days)andconvalescencestage(2-4weeks)Rapidtests:IMF,ELISA,RT-PCRProvisional:clinicalpicture+outbreakAvoidcrowdduringpandemicperiod,airInactivated,split,subunitvaccinesareavailableagainstinfluenzaAandB.IndividualswhoareatriskofsevereinfluenzaTrivalent:A/H3N2, andBAntiviralAmantadine 烷胺Rimantadine 乙胺 Tamiflu?(oseltamivir)(達菲)Relenza?(zanamivir)(瑞樂砂) RecentFound(SwineA“quadruplereassortant” AsianandAfricanswine,avianandhumanflu),2009to2010.H5N1(AvianHighpathogenic(death394/667from2003toSpreadbycloseH7N9(AvianNewestavianflu,highpathogenic(death205/652from2013to2015) (副流 (麻 Respiratorysyncytial 毒,RSV) (腮腺 Humanmetap (尼 Sphericalorpleomorphic-ssRNA,nosegments,HN(orHorG)andF es,M,NP,PandLFprotein(fusionandhemolysis),HNprotein(hemagglutininandneuraminidase)Agstable,buthighlyinfectious Enveloped,80-120nm,sphericalor

Enveloped,150-300nm,sphericalorpleomorphic

7-8

No High Low

HAand

HN(Paramyxo HA(measles NoHAandNA(RSV)Pathogenofmeasles:HAandHLproteinon CatarrhasymptomsandKoplik infection:SSPE(subacutesclerosingVeryrarely(7in1,000,000cases)1-10yearsafterinitialinfection.Progressive,fatalDefectiveformsof intheLongimmunityafter KoplikPathogenofmumps(epidemicH,NandFproteinon MMRLongRespiratory Ball-shaped,120-200nm,10genes:G(adherereceptor),F(fusion),SH,M1,M2,N,P,L,NS1,NS2GiantmultinucleatedcellsOnlyoneserotypeSeriousrespiratoryinfectionsYoungchildrenNoCellmembraneGiantmultinucleatedcellsandinclusionbodiesRespiratoryClinicalWinterandspring,aerosol/contactInfantileacuteasthmatic ImmunopathologicNo5serotypes:PIV1-human:PIV1,2,3,4CloselyrelatedtoMumpsNocommongroupantigenNoviremia,weakimmunityCommoncold+ssRNA,enveloped,pleomorphicmorphologyserogroups:OC43,229E,NL63,HKU1,SARS-CoV,MERS-CoVCancausecommoncoldSARS-CoVcausesevereacuterespiratorySevereacutesyndrome(SARS)SevereAcuteRespiratorySyndrome2002,Guangdong,droplettransmission,winterandspring,incubation4-5days.Highmortalityin>40ypeoplewithheart/lungMiddleEastRespiratorySyndrome Newcorona ,theMiddleEast(96.7%),death421/1106from2012.9to2015.42015.6-7,Korea, esAssociatedWithRespiratoryInfections (dsDNA,non-enveloped) (ssRNA):causefetal (ssRNA):adultcommoncold (dsRNA,segmented,non-大綱要 脊髓灰質(zhì) 的致病特點和預(yù)防原則。輪生物學(xué)性狀、致病性與免 estransmittedbyfecal-oral

Nucleic New

Enteric CommonPicornaviridae,+ssRNA,naked infectiousnucleicacidVPg:combinewithRNA5’end,22-24aa,IRES:RNA5’end,IRES-dependantTranslatedintoapolyprotein,cleavedintoenzymaticandstructuralproteins CommonIcosahedralsymmetryReplicateinthecytoplasm Common4structuralproteins:VP1,VP2,VP3,:StableinacidpH(pH3-5);Survivelongtimeinwater>100serotypes,dividedintoHEV-1-Coxsackie1-22,Coxsackie1-1-9,11-27,29-Other68-EnteroCommonReplicateinsusceptiblecells,andquicklyinduceCPE.Transmission:fecal-oralroute.Humansaretheonlyknownreservoir.Majorityinapparentinfection.Propagateintheintestine,butusuallyinducediseasesoutofintestine.Neurologicasepticmeningitis,paralysis,Cardiacandmuscularmyocarditis,Infectionofskinandhand-foot-and-mouthRespiratoryinfection:commoncoldsAlimentaryinfection:diarrheainPathogenof3serotypes(type1,2,3):Type1causesmostepidemics(85%).Receptor:CD155.Incubation1-2w.presentinstoolfor3-Reservoir:Transmission:fecal-Replicationinpharynx,GItract,locallymphaticsBloodBlood(primaryAbortive(0.1

CentralnervousCentralnervous

FatalillnessFatalillness

Salk(inactivated)vaccine:IPV(inactivatedpoliovaccine)byJonasSalk,safe,nosIgASabin(attenuated)vaccine:OPV(oralpoliovaccine)byAlbertSabin,inducesIgA,lessstable,VAPPrisk ,Myocarditis:CAVgroupBHand-foot-mouth(HFMD):CAV16andEV71,months-3yearsoldchildren.Fever,blistersonthehands,palateandfeet.AsepticAcute (輪 es 杯 (諾 Entericadeno Acutegastroenteritiswithsimilarsymptoms,suchasdiarrheaandvomitingHuman Reovirudae,60-80nm,icosahedral,nakedCapsid:twoconcentriccapsidss,icosahedralCore:dsRNA,11segmentedRNAgenomeReoviridae(RespiratoryEntericOrphan Latinword“rota”,meaning“wheel”HRV7groupsGroupsA~C:humanandanimalGroupA:infantileacutegastroenteritisGroupB:outbreaksinadultsGroupC:onlysporadicGroupD-G:animalDifferentrotagroupsandRNALaneA:agroupA LaneB:agroupAhuman LaneC:agroupBhumanadultdiarrhea LaneD:agroupArabbitthatexhibitsa"short”RNAInfectscolu