肠道感染病毒应用

Chapter21VirusesAssociatedwithEntericInfections肠道感染病毒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

衣壳蛋白(VP1与受体结合)•genome:+ssRNA1.Biologicalproperties

Cultivation

Rresistance(stronger)(pH3~9稳定,污水和粪便中可存活数月)

Type-specificantigen•

D(density)/N(native)antigen

•

C(coreless)antigen

•

primarycellcultureCPE

•

animalinoculation(A1,A19,A22)2.Pathogenicityofenteroviruses

Viafecal-oralroutecauseavarietyofdiseasesorsyndromes

(夏秋季为主要流行季节)

不同肠道病毒可引起相同的临床症状,同一种病毒可引起几种不同的临床疾病P275~276表(通常有二次病毒血症)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(脊髓灰质炎或小儿麻痹症)

⑵CoxsackievirusandECHOvirus⑶Enterovirus71

causeavarietyofdiseasesorsyndromes

(suchasasepticmeningitisandencephalitisandso.on)

(P275~276表)•initialsiteofinfectionandrouteoftransmission

•E70,CA24andAd3,7→AHC(急性出血性结膜炎)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)

均为三价混合疫苗；但OPV与疫苗相关麻痹型脊髓灰质炎(VAPP)发生有关(CPE)VirusesofcausingacutegastroenteritisRotavirus(RV)OtheracutegastroenteritisvirusGastroenteritisVirus1.Shapeofviriond=60-80nm,sphericandnakedviruswithdouble-shelledcapsid

2.Genome

appearanceofa“wheel”

(轮状病毒)

consistsof11segmentsofds-RNA

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

Rotavirus3.Pathogenicity

Sourceofinfection

Routeoftransmission

Themainviralcauseofacutegastroenteritis•groupA:mainpathogenofacutegastroenteritisininfants•

groupBcauseepidemicdiarrheainadult•

groupC:causehumanoranimalsporad