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1、H1N1新型流感流行期間之因應衛生署疾病管制局中區傳染病防治醫療網王任賢指揮官InfluenzavirusHistoryofinfluenza430-427BC:PlagueinAthensepidemicinfluenzacomplicatedbytoxigenicstaphylococcaldiseases1901:firstisolatefromchicken1918:pandemic,20milliondeath1931:firstisolatefromswine1933:firstisolatefromhumanInfluenzavirusFamilyOrthomy
2、xoviridae(segmentednegativestrandRNAvirus)InfluenzaA:8segmentsInfluenzaB:8segmentsInfluenzaC:7segmentsTyping:CFantibodyagainstcoreproteinsM1:matrixproteinNP:nucleoproteinNeuraminidaseHemagglutininRNA+nucleoproteinM2protein(ionchannel,onlyontypeA)InfluenzaSurfaceProteinsM1proteinInfluenzaAvi
3、rusRNAsegmentandproteinRNAsegmentProteinFunction/Activity1PB2Cap-binding,endonuclease2PB1RNApolymerase3PAProteolysis4HAAttachmenttosialicacid,fusion5NPStructuralprotein6NASialidase,releaseofvirus7M1,M2Structuralprotein,Ionchannel8NS1,2RNAtransport,splicing,translateAntigenicchangeofinfluenz
4、avirusAntigenicdrift:epidemicpointmutationingeneofHAorNAresultfromincreaseimmunitypressurerate:0.5-1%peryearepidemic:>2siteschangeAntigenicshift:pandemicacquireofnewgenesegmentOriginofpandemicstrainDormancyinafrozenstateMutationofanimalinfluenzavirusGenereassortmentbetweenanimal＆humanAvian:
5、virusinrespiratory＆GItractlittleantigenicvariationrarelytransmittohumanSwine:mixingvesselAntigenicShiftSwinecellHostrangeofinfluenzavirusInfluenzaA:broadhostrangehuman,swine,horse,duck,bird,ruminant,marinemammal,reindeer,minkInfluenzaB:primarilypathogensofhumanshuman,(dog,cat,swine)Influenz
6、aC:primarilypathogensofhumanshuman流感病毒之分類上呼吸道流感病毒H1N1,H3N2,B高傳染率,低死亡率以社區傳染為主Immuneprotection：治療以抗病毒藥為主下呼吸道流感病毒H5N1低傳染率,高死亡率以院內傳染為主Immunedestruction：治療以類固醇為主YearsFluVirusMortality1918-1919“Spanish”TypeA(H1N1)20millionworldwide 550,000US1957-1958“Asian”TypeA(H2N2)70,000US1968-1969“HongKong”Ty
7、peA(H3N2)34,000US1977-1978“Russian”TypeA(H1N1)negligableGlezenWP.EpidemiolRev.1996;18:65. CentersforDiseaseControlandPrevention.InfluenzaPreventionandControl.Influenza.Availableat: http://www.cdc.gov/ncidod/diseases/flu/fluinfo.htm.InfluenzaPandemicsinth
