摘要
禽流感病毒是甲型流感病毒,一般只在禽间传播,不会直接感染人类.当病毒基因发生重组或突变,会获得感染人的能力.自1959年发生人感染H7N7禽流感以来,各亚型禽流感病毒感染人的事件时有发生.1997年,我国香港特区暴发人感染H5N1禽流感是首次明确记录的禽流感病毒感染导致人类呼吸道疾病和死亡的疫情.迄今人感染禽流感已成为全球科学界关注的重要公共卫生问题.鉴于禽流感病毒可以长期存在于天然宿主体内且具有高度的遗传分化特性,因此具备成为前体病毒或导致流感大流行的可能性.20世纪发生的4次流感大流行,均与禽流感病毒密切相关.禽类是禽流感病毒的天然存储宿主,最容易传染人的传染源是携带病毒的家禽和感染病毒的病死禽,而传播途径主要为禽-人和环境-人传播.人感染不同亚型禽流感病毒后的临床症状表现不一,既有普通流感样症状(ILI)、结膜炎或关节炎,也会出现重症肺炎、呼吸衰竭、休克甚至死亡.目前针对人感染禽流感最重要的治疗手段是使用抗病毒药物,早期大剂量使用抗病毒治疗可显著提高禽流感病例的存活率.
Avian influenza virus is an influenza A virus, which generally spreads among birds, without direct infection of human. According to the pathogenicity to chicken or turkey, it is divided into high, medium and low/non pathogenic. When the virus gene recombination or mutation, it will get the ability to infect human. Additionally, avian influenza virus can also infect human directly, such as H5N1, H7N9, H5N6, H10N8 subtype. The cases of human infection with avian influenza reported frequently after the outbreak of human infection with H7N7 avian influenza in 1959, the first death case due to avian influenza virus infection causing respiratory disease was the outbreak of human infection with H5N1 in Hongkong in 1997. To date, human infection with avian influenza is a global public health problem. As avian influenza viruses perpetuated in their natural hosts, with their high genetic divergence, it would be precursor viruses even for pandemic potential. In the 20 th century, four influenza pandemics were closely related to avian influenza viruses, avian is the natural host of the avian influenza virus, poultry carrying virus and dead/sick poultry infected with avian influenza virus are easier to spread virus to human, the main transmission routes are birds-human transmission（exposure to sick/dead poultry） and environment-human transmission（such as visit live poultry market）. Poultries exposure and chronic medical condition are the main risk factors of human infection with avian influenza. The symptoms varies including ordinary influenza-like illness（ILI）, conjunctivitis, arthritis, severe pneumonia, respiratory failure, shock and death. At present, the treatment of human infection with avian influenza includes antiviral treatment, symptomatic treatment, Chinese medicine treatment, but the most important therapy of human infection with avian influenza is the treatment of antiviral drugs（neuraminidase inhibitors）, using high dose antiviral drugs in the early stage can significantly improve the survival rate. PCR and real-time PCR are the best methods for preliminary diagnosis of human infection with avian influenza. At the same time, the increase of serum antibody titer in acute stage or recovery stage can alao be confirmed. In addition, effective preventive measures（such as publicity and education, behavioral intervention and vaccination development and application） are the important means to protect human from avian influenza.
作者
姜慧
赖圣杰
秦颖
张志杰
冯录召
余宏杰
JIANG Hui LAI ShengJie QIN Ying ZHANG ZhiJie FENG LuZhao YU HongJie(Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China)
出处
《科学通报》
EI
CAS
CSCD
北大核心
2017年第19期2104-2115,共12页
Chinese Science Bulletin
基金
国家杰出青年科学基金(81525023)
传染病监测与防治项目资助
关键词
人感染禽流感
全球
疫情
流行病学特征
human infection with avian influenza
global
epidemic
epidemiological
