腸道感染病毒應(yīng)用

Chapter21VirusesAssociatedwithEntericInfections腸道感染病毒HumanenterovirusVirusesofcausingacutegastroenteritisPoliovirusCoxsackievirus?

groupA:types1~22,24

?

groupB:types1~6Entericcytopathogenichumanorphan(ECHO)virusNewenteroviruses

(types1~3)(31types)(types68~71)Hnmanenteroviruses

ofenterovirus

Shapeandstructure

?d=24~30nm,sphericalandnakedviruswith

icosahedral

nucleocapsid

polyprotein↓VP1~VP4andfunctionalprotein

衣殼蛋白(VP1與受體結(jié)合)?genome:+ssRNA1.Biologicalproperties

Cultivation

Rresistance(stronger)(pH3~9穩(wěn)定,污水和糞便中可存活數(shù)月)

Type-specificantigen?

D(density)/N(native)antigen

?

C(coreless)antigen

?

primarycellcultureCPE

?

animalinoculation(A1,A19,A22)2.Pathogenicityofenteroviruses

Viafecal-oralroutecauseavarietyofdiseasesorsyndromes

(夏秋季為主要流行季節(jié))

不同腸道病毒可引起相同的臨床癥狀,同一種病毒可引起幾種不同的臨床疾病P275~276表(通常有二次病毒血癥)fromsubclinicalinfectiontosevereinfectionofCNS

?

sourceofinfection

(patientsandcarrier)

?causepoliomyelitisbyfecal-oralroute?

clinicalfindingsofpoliomyelitis

⑴Poliovirus(neurotropicvirus)

*subclinicalinfection(90%)*abortiveinfection(5%)*nonparalyticpoliomyelitis/asepticmeningitis(1-2%)*paralyticpoliomyelitis(0.1%-2%)

nonparalytic:paralytic=100~1000:1

pathogenofpoliomyelitis(脊髓灰質(zhì)炎或小兒麻痹癥)

⑵CoxsackievirusandECHOvirus⑶Enterovirus71

causeavarietyofdiseasesorsyndromes

(suchasasepticmeningitisandencephalitisandso.on)

(P275~276表)?initialsiteofinfectionandrouteoftransmission

?E70,CA24andAd3,7→AHC(急性出血性結(jié)膜炎)Themaincauseofacutehemorrhagicconjunctivitis(AHC)⑷

Enterovirus71

lifelongtype-specificimmunity(neutralizingantibody)

cause

viralCNSdisease(suchasasepticmeningitisandencephalitisandso.on)and

HFMD(hand-foot-and-mouthdisease,手足口病)3.Immunity

ofenteroviruses(neurotropicvirus)4.Laboratorydiagnosis

ofenterovirusesIsolationandidentificationofvirusDetectionofviralantibodyandRNA

5.

Specificpreventionofpoliovirus

Artificialactiveimmunity

Artificialpassiveimmunity?IPV(Salkvaccine)?OPV(Sabinvaccine)

均為三價(jià)混合疫苗；但OPV與疫苗相關(guān)麻痹型脊髓灰質(zhì)炎(VAPP)發(fā)生有關(guān)(CPE)VirusesofcausingacutegastroenteritisRotavirus(RV)OtheracutegastroenteritisvirusGastroenteritisVirus1.Shapeofviriond=60-80nm,sphericandnakedviruswithdouble-shelledcapsid

2.Genome

appearanceofa“wheel”

(輪狀病毒)

consistsof11segmentsofds-RNA

codefor6structuralproteins(VP1-4,6,7)and5non-structuralproteins(NSP1~NSP5)

Rotavirus3.Pathogenicity

Sourceofinfection

Routeoftransmission

Themainviralcauseofacutegastroenteritis?groupA:mainpathogenofacutegastroenteritisininfants?

groupBcauseepidemicdiarrheainadult?

groupC:causehumanoranimalsporad