outline 2009 2009 4 24 - PowerPoint PPT Presentation

outline

2009 甲流疫情发生概况 2009 年 4 月 24 日：墨西哥出现 “ 猪流感 ” 患者约 800 例， 包括 60 例死亡病例 美国出现 7 例确诊病例 世卫组织要求各国卫生部门提高警惕 4 月 25 日：世卫组织确认该病毒属 H1N1 毒株族， 具有 “ 潜在大流行 ” 能力 4 月 27 日：世卫组织宣布将警戒级别从 3 级提升至 4 级。欧洲证 实出现最早 3 例确诊病例

4 月 28 日：拉丁美洲和中东地区证实出现确 诊病例 4 月 29 日：美国出现首例死亡病例 同日，世卫组织宣布再次提升警戒级别 4 月 30 日：世卫组织采用 “ 甲型 H1N1 流感病毒 ” 替代 原有猪流感一说 6 月 11 日：世卫组织宣布流感大流行，提升警戒级别至 最高一级的 6 级水平

� The pandemic phase is characterized by community level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. A global pandemic is under way.

在中国 截止到 2010 年 3 月 31 日，全国累计报告确诊甲流病 例 12.7 万余例，其中境内感染 12.6 万余例，境外输入 1228 例；已治愈 12.2 万余例，在院治疗 4859 例，居家 治疗 46 例，死亡病例 800 例。

1.1 H1N1 � Swine influenza virus ( SIV) is a kind of pigs’ orthomyxoviridae which can cause local influenza . � World Health Organization renamed this new type of deadly swine flu as H1N1 influenza virus (influenza A (H1N1))on April 30 ,2009.

� Influenza A ( H1N1 ) virus is a kind of influenza virus type A, carrying the H1N1 subtype swine influenza virus strains which contains gene fragments of avian flu, swine flu and human influenza virus. It also carries the characteristics of influenza viruses of pigs in Asia and Africa . � Medical tests show that the current mainstream of antiviral drugs effective against this strain.

� Antigenic shift is the process by which at least two different strains of a virus (or different viruses), especially influenza, combine to form a new subtype having a mixture of the surface antigens of the two original strains. The term antigenic shift is more often applied specifically (but is not limited) to the influenza literature, as it is the best known example (e.g. visna virus in sheep). Antigenic shift is a specific case of reassortment or viral shift that confers a phenotypic change.

1.2 symptoms of H1N1 flu � fever � diarrhea � Cough � Vomiting � Sore throat � Symptoms last from a few days to up to a week � Body aches or more � headache � chills � runny nose � feeling very tired

1.3 High risk groups for severe illness � Children younger than 2 � Persons with medical years old condition including asthma, neurological and � Pregnant woman up to 2 neurodevelopmental weeks post partum conditions (including (regardless how the disorder of the brain, spinal pregnancy ended) cord, peripheral nerve, and � Adult, 65 years of age or muscle such as cerebral palsy) older chronic obstructive lung � Persons younger than 19 disease, cardiac disease, years who are receiving long ‐ diabetes mellitus, term aspirin therapy. immunosuppressive conditions (including HIV/AIDS, and cancer)

1.4 How does H1N1 flu spread? wet spray (droplets of saliva and mucous) that comes out of the nose and mouth of someone who coughs or sneezes. The virus can also live for a short time on things you touch like doorknobs, phones and toys.

2 Pre-existing immunity against swine-origin H1N1 influenza viruses in the general human population 5/25/2010

� there is concern that little protective immune memory exists in the general human population. this concern was confirmed by reports that neutralizing antibodies against S-OIV are found nearly exclusively in persons born before 1957 � together with reports of differences in athogenicity of the virus in animal models compared with seasonal human H1N1 strains 5/25/2010

the incidence of clinically severe cases so far appears to be similar to that experienced for seasonal flu why? the possibility that some level of immunity against S-OIV sequences might exist in the general population 5/25/2010

5/25/2010

The experiments demonstrate that a significant level of T-cell immunity might pre-exist in the general population against epitope sequences that are found totally conserved in S- OIV. 5/25/2010

with only 17% (1/6) conserved in the HAand NA surface proteins,a new vaccine based on the specific S-OIV HA and NA proteins is likely to be required to prevent infection 5/25/2010

vaccine for H1N1 flu Two types ： One is a “shot” that is given with a needle, usually in the arm. The other is a “nasal spray” (a spray inhaled through the nose).

� Narayan, O (1977). "Antigenic shift of visna virus in persistently infected sheep". Science)197 (4301): 376–378. doi:10.1126/science.195339. PMID 195339. ) � Treanor, John (2004-01-15). "Influenza vaccine--outmaneuvering antigenic shift and drift". New England Journal of Medicine350 (3): 218–220. doi:10.1056/NEJMp038238. PMID14724300. http://content.nejm.org/cgi/content/full/350/3/218. Retrieved 2008- 01-07. � Al Hajjar, S. and K. McIntosh (2010). "The first influenza pandemic of the 21st century." Ann Saudi Med 30 (1): 1-10. � Gordon, S. M. (2009). "Update on 2009 pandemic influenza A (H1N1) virus." Cleve Clin J Med 76 (10): 577-582. � Joshi, S. R., A. C. Shaw, et al. (2009). "Pandemic influenza H1N1 2009, innate immunity, and the impact of immunosenescence on influenza vaccine." Yale J Biol Med 82 (4): 143-151 � http://qe.qe.cn/HTML/296856.shtml

� “Pre-existing immunity against swine-origin H1N1 influenza viruses in the general human population,” Jason A. Greenbaum, Maya F. Kotturi, Yohan Kim, Carla Oseroff, Kerrie Vaughan, Nima Salimi, Randi Vita, Julia Ponomarenko, Richard H. Scheuermann, Alessandro Sette ， Bjoern Peters � Lopez-Cervantes, M., A. Venado, et al. (2009). "On the spread of the novel influenza A (H1N1) virus in Mexico." J Infect Dev Ctries 3 (5): 327-330 � http://www.flightsone.com/blog/ � http://www.google.com

谢谢！