H7N9禽流感培训课件

CHINESECENTERFORDISEASECONTROLANDPREVENTION人感染H7N9禽流感病毒病原学特点及实验室检测中国疾病预防控制中心卫生应急中心CHINESECENTERFORDISEASECONTROLANDPREVENTION既往禽H7Nx病毒简介CHINESECENTERFORDISEASECONTROLANDPREVENTIONHPAIH7N7、H7N3、H7N1LPAIH7Nx、H7N2、H7N3、H7N1、H7N9HPAIH7N7、H7N3、H7N4HPAIH7N3（Pakistan）HPAIH7N3LPAIH7N9HPAIH7N3LPAIH7N9禽中暴发的H72006年前暴发的均为HPAIH7欧洲：意大利、英国、德国、比利时、荷兰、丹麦、挪威、捷克、西班牙、瑞典LPAIH7N8、H7N9（Korea）LPAIH7N9CHINESECENTERFORDISEASECONTROLANDPREVENTION近年来人感染禽流感病毒病例病毒亚型病原来源时间/国家病例数/临床表现A/H7N7鸥1980/美国3/结膜炎A/H7N7鸭1996/英国1/结膜炎A/H5N1禽1997/香港18/ILI，肺炎A/H9N2鸡1998/中国广东5/ILI，肺炎A/H9N2禽1999/香港2/ILIA/H7N2禽2002/北美（Virginia）1/ILI，血清学诊断A/H9N2禽2003/香港1/ILIA/H5N1禽2003/香港2/ILI，肺炎A/H7N7禽2003/荷兰89/结膜炎、ILI、肺炎;1名死亡病例A/H5N1禽2003至今,15个国家602/ILI,肺炎A/H7N2(NY/107)来源不清2003/北美(NewYork)，1/肺炎A/H7N3禽2004/加拿大2/结膜炎、ILI;1名LPAI；1名HPAIA/H5N2禽2005/日本(Ibaraki)13/无临床症状，血清学诊断A/H7N2禽2007/英国(Wales)1/结膜炎、ILIA/H9N2来源不清2007/香港1/ILIA/H10N7鸭2004/埃及(Ismaillia)2/ILIA/H10N7来源于疫区的鸟2010/悉尼(NewSouthWales)7/上呼吸道感染症状、结膜炎CDC.AvianInfluenzaAVirusInfectionsofHumans.血清学证据：人感染H4,H5,H6,H7,H9,H10,H11AIVs.CHINESECENTERFORDISEASECONTROLANDPREVENTIONH7感染人（100人）美国、英国、意大利、荷兰、加拿大HPAILPAI19591/USAH7N719771/USAH7N71979-19804/USAH7N719961/EnglandH7N720021/USAH7N220031/USAH7N27/ItalyH7N389/NetherlandsH7N71died20041/CanadaH7N31/CanadaH7N320061/NorfolkH7N320074/WalesH7N22/MexicoH7N3CHINESECENTERFORDISEASECONTROLANDPREVENTIONH7N9病毒美洲,13欧洲,5亚洲,7共25株均为LPAI无感染人病例亚洲：7株均来自野禽5株—韩国2株—蒙古CHINESECENTERFORDISEASECONTROLANDPREVENTIONH7N9的致病力和传播力LPAIH7N9Nose(whitebars),lung(blackbars)HPAIH7N3和LAPIH7N9均不需经过适应便可在小鼠体内有效复制，且均能在雪貂上下呼吸道有效复制。HPAIH7N3LPAIH7N9LPAIH7N9HPAIH7N3高致病性的HPAIH7N3致小鼠死亡，在雪貂模型中可通过接触传播，但LAPIH7N9在雪貂模型中不传播。CHINESECENTERFORDISEASECONTROLANDPREVENTION中国地区H7AIVA/Baer'spochard/HuNan/414/2010(H7N1)A/chicken/Hebei/1/2002(H7N2)A/duck/Guangdong/1/1996(H7N3)A/duck/Hubei/126/1985(H7N8)A/duck/Jiangxi/1742/03(H7N7)A/duck/Jiangxi/1760/03(H7N7)A/duck/Jiangxi/1786/03(H7N7)A/duck/Jiangxi/1814/03(H7N7)A/duck/Nanchang/1904/1992(H7N1)A/duck/Nanchang/1944/92(H7N1)A/duck/Zhejiang/10/2011(H7N3)A/duck/Zhejiang/12/2011(H7N3)A/duck/Zhejiang/2/2011(H7N3)A/magpie-robin/China/28710/93(H7)亚型：H7N1,H7N2,H7N3,H7N7,H7N8野禽居多LPAICHINESECENTERFORDISEASECONTROLANDPREVENTION人感染H7N9禽流感病毒实验室检测CHINESECENTERFORDISEASECONTROLANDPREVENTION核酸检测CHINESECENTERFORDISEASECONTROLANDPREVENTION从3个病例中分离到3株病毒A/Shanghai/1/2013(H7N9)A/Shanghai/2/2013(H7N9)A/Anhui/1/2013(H7N9)病毒分离CHINESECENTERFORDISEASECONTROLANDPREVENTION三株H7N9病毒为同一基因类型PB2PB1HANPNAMPNSPA6个内部片段来源于H9N2序列测定CHINESECENTERFORDISEASECONTROLANDPREVENTION序列特点耐药性分析对烷胺类药物是耐药的，即M2蛋白25-42位氨基酸发生S31N突变。均对神经氨酸酶抑制剂类药物，如奥斯他韦（达菲）和扎那米韦（依乐韦）敏感。HA连接肽分析HA蛋白339位连接肽由单个（PKGRGLFG）碱性氨基酸组成，根据既往研究，具有这种序列特点的病毒对禽类呈低致病性。受体结合位点及其它重要位点分析Shanghai/1/2013的HA蛋白226-228位氨基酸属于禽源受体结合位点（为QSG）。Shanghai/2/2013和Anhui/1/2013的HA蛋白226-228位氨基酸受体结合位点（为LSG）PB2蛋白627位氨基酸为K，提示致病性增强。NS1蛋白92位氨基酸为D，与禽流感病毒一致，而与人流感病毒不同。CHINESECENTERFORDISEASECONTROLANDPREVENTIONHA核酸同源性比较CHINESECENTERFORDISEASECONTROLANDPREVENTIONA/northern_pintail/Akita/1370/2008_H7N7_JapanA/mallard/Korea/GG3/2007_H7N7_South_KoreaA/environment/Mongolia/1-51/2007_H7N7_MongoliaA/duck/Korea/BC10/2007_H7N3_South_KoreaA/duck/Mongolia/119/2008_H7N9_MongoliaA/duck/Korea/A349/2009_H7N2_South_KoreaA/duck/Thailand/CU-LM7291T/2010_H7N6_ThailandA/quail/Thailand/CU-J2882/2009_H7N1_ThailandA/wild_bird/Korea/5-77/2005_H7N8_South_KoreaA/duck/Zhejiang/12/2011_H7N3_ChinaA/Shanghai/1/2013A/Shanghai/2/2013A/Anhui/1/2013A/duck/Jiangxi/1742/03_H7N7_ChinaA/wild_bird_feces/Korea/HDR16/2003_H7N2_South_KoreaA/duck/Mongolia/867/2002_H7N1_MongoliaAY338455_A/Netherlands/127/03_H7N7_NetherlandsAY338457_A/Netherlands/33/03_H7N7_NetherlandsAY338459_A/Netherlands/219/2003_H7N7_NetherlandsA/chicken/Italy/444/99_H7N1_ItalyA/chicken/Italy/322/2001_H7N1_ItalyA/quail/Italy/4610/2003_H7N2_ItalyA/turkey/Italy/5425/2007_H7N3_ItalyA/mallard/Sweden/100993/2008_H7N7_SwedenA/mute_swan/Hungary/5973/2007_H7N7_HungaryA/mallard/Italy/497-35/2006_H7_ItalyA/goose/Czech_Republic/1848-K9/2009_H7N9_Czech_RepublicA/mallard/Korea/822/2010_H7N7_South_KoreaA/duck/Thailand/CU-10507T/2011_H7N4_ThailandA/wild_goose/Dongting/PC0360/2012_H7N7_ChinaA/spot-billed_duck/Korea/447/2011_H7N9_South_KoreaA/parrot/England/1174/94_H7N1_United_KingdomA/ostrich/South_Africa/5352/92_H7N1_South_AfricaAF028020_A/England/268/1996_H7N7_United_KingdomGU053110_A/England/AV877/1996_H7N7_United_KingdomA/England/AV877/1996_H7N7_United_KingdomA/chicken/Pakistan/16/99/95_H7N3_PakistanA/chicken/Karachi/NARC-23/2003_H7N3_PakistanA/quail/Aichi/1/2009_H7N6_JapanA/duck/Hong_Kong/301/1978_H7N2_Hong_KongA/black_kite/Egypt/054/2004_H7N7_EgyptA/chicken/Jena/1816/87_H7N7_GermanyA/chicken/Hebei/1/2002_H7N2_ChinaA/African_starling/England-Q/983/1979_H7N1_United_KingdomA/duck/Vietnam/OIE-0178/2012_H7N1_Viet_NamEurasianA/mallard/New_Zealand/1365-355/2005_H7N7_New_ZealandA/equine/Prague/1/1956_H7N7_Czech_RepublicA/equine/Cambridge/1/63_H7N7_United_KingdomA/equine/Argentina/1/1977_H7N7_ArgentinaEquineA/chicken/Chile/184240-1/2