脊髓灰質(zhì)炎課件

腸道病毒與輪狀病毒脊髓灰質(zhì)炎腸道病毒脊髓灰質(zhì)炎學(xué)習(xí)要求掌握1、脊髓灰質(zhì)炎病毒的致病性2、特異性預(yù)防（劑型）自學(xué)柯薩奇病毒3、熟悉脊髓灰質(zhì)炎病毒抵抗力、感染類型自學(xué)?？刹《炯顾杌屹|(zhì)炎脊髓灰質(zhì)炎病毒poliovirus結(jié)構(gòu)脊髓灰質(zhì)炎脊髓灰質(zhì)炎3-Dimageofpoliovirus脊髓灰質(zhì)炎VP1VP2VP35-foldAxis3-foldAxis2-foldAxis脊髓灰質(zhì)炎Fordecades,nooneknewwhatpolioviruslookedlike,sincevirusescannotbeseenunderamicroscope.In1985,ateamledbyJamesHogleofHarvardMedicalSchoolobtainedhigh-resolution,3Dimagesofpoliovirus,andtoday,thenewlyformedChildren'sHospitalBoston--HarvardMedicalSchoolstructuralbiologyunitisheirtotheEnderstradition.脊髓灰質(zhì)炎LedbyStephenHarrison,thisgroupisusingavarietyofsophisticatedtoolslikeX-raycrystallographyandmolecularelectronmicroscopytoobtaindetailed,dynamic,3Dviews--accuratedowntotheatom--ofhowvirusesmove,transferinformationandreconfigurethemselvestoattacktheirvictims.Theseimagesaresheddinglightonmanyoftoday'sviralscourges,suchasHIV,dengueandrotavirus,andprovidingnewleadsfortreatmentandvaccinedevelopment.脊髓灰質(zhì)炎Poliovirus脊髓灰質(zhì)炎AnancientEgyptianstele,portrayingaprincewithawitheredleg-probablypolio.

?WHO/GPEI脊髓灰質(zhì)炎埃及第十八朝的這塊石碑可能是脊髓灰質(zhì)炎病例的最早記載。脊髓灰質(zhì)炎脊髓灰質(zhì)炎脊髓灰質(zhì)炎脊髓灰質(zhì)炎脊髓灰質(zhì)炎AmericasRegionLuisFerminTenorioPeru1991EuropeanRegionMelikMinasTurkey1998WesternPacificRegionMumChantyCambodia1997Polio‘LastCases’PolioEradication脊髓灰質(zhì)炎脊髓灰質(zhì)炎R(shí)esearchersGlimpsePolioVirusasitEntersHostCellContact:Theimageontheleftshowsanakedpoliovirus.Thepoliovirusontherightisstuddedwith60twig-likestructures,thereceptors.SeeforamomentSmallthinstemonatree3-Dstructures脊髓灰質(zhì)炎WHOPoliocaseshavedecreasedby99.8%since1988,fromanestimated350000casesto483in2001*.Thereductionistheresultoftheglobalefforttoeradicatethedisease.脊髓灰質(zhì)炎Areaswithhigh-intensitytransmission

Together,thesecountriesaccountedformorethan85%ofthenewpoliocaseloadin2001.Theyarecharacterizedbyhavingareaswithlargepopulationsandlowroutineimmunizationcoverage,sub-optimalsanitationandrelativelywidegeographicaldistributionofthewildpoliovirus.Thesecountriesare:IndiaPakistan/AfghanistanNigeria/Niger脊髓灰質(zhì)炎PoliowasdeclarederadicatedintheU.S.in1979.YetaccordingtotheWorldHealthOrganization,poliocasesworldwiderosebyathirdin2004,dueinparttovaccineboycotts.Children'sandSpauldingRehabilitationHospitalarestillseeingnewcases--theresultofinternationaladoptionsfromThirdWorldcountriesandfromRussia.脊髓灰質(zhì)炎病毒抵抗力在污水和糞便中可活數(shù)月食品中可保存數(shù)周不易被胃酸或膽汁滅活對(duì)氧化劑敏感56。C30min被滅活脊髓灰質(zhì)炎致病性傳染源：病人或無(wú)癥狀攜帶者傳染方式：糞-口途徑致病機(jī)理脊髓灰質(zhì)炎二、致病性病毒咽部、腸壁淋巴組織入血流第1次病毒血癥入全身淋巴組織再次入血流病毒入脊髓前角運(yùn)動(dòng)神經(jīng)細(xì)胞：（脊髓型）

延髓和腦干：延髓型大腦運(yùn)動(dòng)皮質(zhì)區(qū)：腦炎型第2次病毒血癥脊髓灰質(zhì)炎感染類型人群中絕大多數(shù)為隱性感染或輕型感染顯性感染引起麻痹者僅為顯性感染的0.1%-1%頓挫感染脊髓灰質(zhì)炎免疫性SIgA：清除腸道內(nèi)病毒，阻止病毒入血IgM,IgG:阻斷血流中病毒向中樞神經(jīng)系統(tǒng)擴(kuò)散感染后獲得對(duì)同型病毒較牢固的免疫力脊髓灰質(zhì)炎預(yù)防口服脊髓灰質(zhì)炎減毒活疫苗糖丸(1957年發(fā)明）

OralvaccinationwithlivevaccineVaccinationprogramshaveeradicateditfromtheWesternworldandpromisetoeliminateitglobally

DrAlberSabin脊髓灰質(zhì)炎疫苗使用的效果脊髓灰質(zhì)炎脊髓灰質(zhì)炎

Scientistshavebuiltthevirusthatcausespoliofromscratchinthelab,usingnothingmorethangeneticsequenceinformationfrompublicdatabasesandreadilyavailabletechnology.Thefactprovesthatevenifallthepoliovirusintheworldweredestroyed,itwouldbeeasilypossibletoresurrectthecripplingdisease,saysAnikoPaulattheStateUniversityofNewYorkatStonyBrook,oneoftheresearchersconductingthestudy.新進(jìn)展Date:Thu,11Jul2002Bringbackintouse脊髓灰質(zhì)炎Journalreference:Science(DOI:10.1126/science.1072266)Theresulthasmajorimplicationsforvaccinationprogramsthathavenearlyridtheworldofpolio."Ithinkitmeansyou'reprobablynotgoingtobeabletostopvaccinatingpeopleevenafteryoueradicatethevirus,"saysDianeGriffinoftheJohnsHopkinsBloombergSchoolofPublicHealth.脊髓灰質(zhì)炎Paulbelievesthesynthesismethodcouldbeappliedtootherviraldiseases."Wefeelthiscouldbeusedforebola,smallpox,justaboutanything,"shesays.Thisraisestheworryingpossibilitythatbioterroristscoulduseasimilarapproachtocreatedevastatingdiseaseswithouthavingtogainaccesstoprotectviralstocks.脊髓灰質(zhì)炎paralysiselectronmicroscopyandX-raycrystallography.SummaryofpoliovirusvaccinationprogramshaveeradicateditfromtheWesternworldandpromisetoeliminateitgloballySurprisinglylittleisknownabouthowpoliovirusentersthecellsoftheintestines,letalonehowitmakesitswaytothenervoussystemwhereitcandamagemotorneuronsandcauseparalysis脊髓灰質(zhì)炎輪狀病毒脊髓灰質(zhì)炎形態(tài)核心為dsRNA，外有雙層衣殼，內(nèi)外兩層呈放射狀排列脊髓灰質(zhì)炎輪狀病毒分組：A、B、C組：可引起人、動(dòng)物腹瀉，最常見(jiàn)A組(有稱為小兒輪狀病毒）D-G組：僅引起動(dòng)物腹瀉A組抵抗力：耐乙醚、弱酸室溫中傳染性可保持7個(gè)月-20。C長(zhǎng)期保存脊髓灰質(zhì)炎A組輪狀病毒所致疾?。?/p>