猪流感病毒荧光定量PCR检测试剂盒

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1 猪流感 (Swine Influenza) 是甲型 (A 型 ) 流感病毒引起的猪或人的一种急性人畜共患呼吸道传染性疾病这种病在猪中经常发生, 很少导致猪的死亡 ( 猪的病死率为 1-4%) 人类很少感染猪流感病毒, 但也发现一些人类感染猪流感的病例, 大多数是与病猪有过直接接触的人 2009 年 3 月, 墨西哥和美国等先后发生人感染猪流感病毒, 为 A 型流感病毒, H1N1 亚型猪流感病毒毒株, 该毒株包含有猪流感禽流感和人流感三种流感病毒的基因片断, 是一种新型猪流感病毒, 可以人传染人人感染猪流感后的临床早期症状与流感类似, 有发烧咳嗽疲劳食欲不振等, 还可以出现腹泻或呕吐等症状病情可迅速进展, 突然高热肺炎, 重者可以出现呼吸衰竭多器官损伤, 导致死亡一病原学猪流感病毒属于正粘病毒科 (0rthomyxoviridae), 甲型流感病毒属 (Influenza virus A) 典型病毒颗粒呈球状, 直径为 80 nm~120 nm, 有囊膜囊膜上有许多放射状排列的突起糖蛋白, 分别是血凝素 HA 神经氨酸酶 NA 和 M2 蛋白病毒颗粒内为核衣壳, 呈螺旋状对称, 直径为 10nm 猪流感病毒为单股负链 RNA 病毒, 基因组约为 13.6 kb, 由大小不等的 8 个独立片段组成尽管不同亚型之间可以组成很多种流感病毒血清型, 但是可造成人感染猪流感病毒的血清型主要有 H1N1 H1N2 和 H3N2 猪流感病毒为有囊膜病毒, 故对乙醚氯仿丙酮等有机溶剂均敏感,200 ml/ L 乙醚 4 过夜, 病毒感染力被破坏 ; 对氧化剂卤素化合物重金属乙醇和甲醛也均敏感,10 g/ L 高锰酸钾 1 ml/ L 升汞处理 3min,750 ml/ L 乙醇 5min,1 ml/ L 碘酊 5min,1 ml/ L 盐酸 3min 和 1mL/ L 甲醛 30min, 均可灭活猪流感病毒猪流感病毒对热敏感,56 条件下,30min 可灭活 ; 对紫外线敏感, 但用紫外线灭活猪流感病毒能引起病毒的多重复活二流行病学在 1976 年美国发生所谓的新泽西事件中, 大约 500 人感染了猪流感 H1N1 亚型病毒, 该病毒与当时从猪体内分离的病毒相同, 首次证实了在自然条件下, 猪流感病毒可从猪传播给人 1999 年 10 月, 香港 1 名 10 月龄女婴感染了猪流感病毒 H3N2, 现已完全康复这些年来, 世界各地都有人感染猪流感病毒不同病毒株的报道, 但并没有大规模流行近日墨西哥及美国等部分地区暴发了人感染猪流感疫情世界卫生组织指出, 墨西哥和美国感染的病例属于 H1N1 亚型猪流感病毒的一个相同毒株 ( 一 ) 传染源主要为病猪和携带病毒的猪, 感染猪流感病毒的人也被证实可以传播病毒感染这种病毒的动物均可传播 ( 二 ) 传播途径主要为呼吸道传播, 也可通过接触感染的猪或其粪便周围污染的环境或气溶胶等途径传播某些毒株如 H1N1 可在人与人之间传播, 其传染途径与流感类似, 通常是通过感染者

毒, 可以人传染人人感染猪流感后的临床早期症状与流感类似, 有发烧咳嗽疲劳食欲不振等, 还可以出现腹泻或呕吐等症状病情可迅速进展, 突然高热肺炎, 重者可以出现呼吸衰竭多器官损伤, 导致死亡一病原学猪流感病毒属于正粘病

2 咳嗽或打喷嚏等 ( 三 ) 易感人群普遍易感患者多数年龄在 25 岁至 45 岁之间, 目前报道以青壮年为主, 应注意老人和儿童 ( 四 ) 高危人群从事养猪业者在发病前 1 周内去过养猪销售及宰杀等场所者以及接触猪流感病毒感染材料的实验室工作人员为高危人群人感染猪流感常发生在冬春季节, 猪感染猪流感一般发生在夏秋季节三临床表现潜伏期一般 1 至 7 天左右, 较流感禽流感潜伏期长 ( 一 ) 临床症状人感染猪流感后的早期症状与普通人流感相似, 包括发热咳嗽喉痛身体疼痛头痛发冷和疲劳等, 有些还会出现腹泻或呕吐肌肉痛或疲倦眼睛发红等部分患者病情可迅速进展, 来势凶猛突然高热体温超过 39, 甚至继发严重肺炎急性呼吸窘迫综合征肺出血胸腔积液全血细胞减少肾功能衰竭败血症休克及 Reye 综合征呼吸衰竭及多器官损伤, 导致死亡 ( 二 ) 体征肺部体征常不明显, 部分患者可闻及湿罗音或有肺部实变体征等 ( 三 ) 预后人感染猪流感的预后与感染的病毒亚型有关, 大多预后良好 ; 而感染 H1N1 者预后较差, 病死率约为 6% ( 四 ) 实验室检查 1. 外周血象 : 白细胞总数一般不高或降低重症患者多有白细胞总数及淋巴细胞减少, 并有血小板降低 ; 2. 血清学诊断 : 可使用间接 ELISA 抗原捕捉 ELISA 荧光免疫法等 ; 3. 反转录 - 聚合酶链式反应 (RT-PCR): 由于 PCR 技术具有简便快速灵敏特异性强等特点, 已用于猪流感病毒基因的检测和分子流行病学调查等 ; 4. 病毒分离 : 从患者呼吸道标本中 ( 咽拭子口腔含漱液鼻咽或气管吸出物痰或肺组织 ) 分离猪流感病毒常用的方法有鸡胚接种法和细胞培养法现有的诊断方法中, 病毒分离法是较敏感的, 但需要 2-3 周时间 ( 五 ) 胸部影像学合并肺炎时肺内可见片状影像严重病例片状影像范围广泛四诊断 1

嗽喉痛身体疼痛头痛发冷和疲劳等, 有些还会出现腹泻或呕吐肌肉痛或疲倦眼睛发红等部分患者病情可迅速进展, 来势凶猛突然高热体温超过 39, 甚至继发严重肺炎急性呼吸窘迫综合征肺出血胸腔积液全血细胞减少肾功能衰竭败血

3 人感染猪流感的诊断主要结合流行病学史临床表现和病原学检查等, 临床上早发现早诊断是治疗的关键 ( 一 ) 人感染猪流感的诊断标准 1. 医学观察病例 : 曾到过猪流感疫区, 或与病猪及猪流感患者有密切接触史,1 周内出现流感临床表现者列为医学观察病例者, 对其进行 7 天医学观察 ( 根据病情可以居家或医院隔离 ) 2. 疑似病例 : 曾到过疫区, 或与病猪及猪流感患者有密切接触史 ( 也可流行病学史不详 ),1 周内出现流感临床表现, 呼吸道分泌物咽试子痰液血清 H 亚型病毒抗体阳性或核酸检测阳性 3. 临床诊断病例 : 被诊断为疑似病例, 且与其有共同暴露史的人被诊断为确诊病例者 4. 确诊病例 : 从呼吸道标本或血清中分离到特定病毒 ;RT-PCR 对上述标本检测, 有猪流感病毒 RNA 存在, 经过测序证实, 或两次血清抗体滴度 4 倍升高, 可确诊为人感染猪流感人感染猪流感诊疗流程见附件 ( 二 ) 人感染猪流感的鉴别诊断人感染猪流感应注意与流感禽流感上感肺炎 SARS 传染性单核细胞增多症巨细胞病毒感染军团菌肺炎衣原体支原体肺炎等鉴别五治疗 ( 一 ) 对症支持对疑似和确诊患者应进行就地隔离治疗, 强调早期治疗对人感染猪流感目前主要是综合对症支持治疗注意休息多饮水注意营养, 密切观察病情变化 ; 发病初 48 小时是最佳治疗期, 对高热临床症状明显者, 应拍胸片, 查血气 ( 二 ) 药物治疗 1. 抗病毒治疗 : 应及早应用抗病毒药物, 可试用奥司他韦 (oseltamivir 达菲 ) 达菲是一种神经氨酸酶抑制剂, 对猪流感病毒可能有抑制作用, 剂量 75mg Bid, 疗程 5 天, 儿童慎用从美国最近的猪流感病毒感染者中分离出的病毒对奥司他韦和扎那米韦 (zanamivir) 是敏感的, 对金刚烷胺和金刚乙胺耐药 2. 抗生素 : 如出现细菌感染可使用抗生素 ( 三 ) 中医辨证治疗 1. 毒袭肺卫症状 : 发热恶寒咽痛头痛肌肉酸痛咳嗽 2

疑似病例 : 曾到过疫区, 或与病猪及猪流感患者有密切接触史 ( 也可流行病学史不详 ),1 周内出现流感临床表现, 呼吸道分泌物咽试子痰液血清 H 亚型病毒抗体阳性或核酸检测阳性 3.

4 治法 : 清热解毒, 宣肺透邪参考方药 : 炙麻黄杏仁生石膏柴胡黄芩牛蒡子羌活生甘草常用中成药 : 莲花清瘟胶囊银黄类制剂双黄连口服制剂 2. 毒犯肺胃症状 : 发热或恶寒, 恶心呕吐腹痛腹泻头身肌肉酸痛治法 : 清热解毒, 化湿和中参考方药 : 葛根黄芩黄连苍术藿香姜半夏苏叶厚朴常用中成药 : 葛根芩连微丸藿香正气制剂等 3. 毒壅气营症状 : 高热咳嗽胸闷憋气喘促气短烦躁不安甚者神昏谵语治法 : 清气凉营参考方药 : 炙麻黄杏仁瓜蒌生大黄生石膏赤芍水牛角必要时可选用安宫牛黄丸以及痰热清血必净清开灵醒脑静注射液等六预防 ( 一 ) 控制传染源开展人间和猪类流感疫情监测一旦发现猪类或其它动物感染猪流感病毒, 应按照动物检疫法有关规定, 对疫源地进行彻底消毒, 对病人及疑似病人进行隔离 ( 二 ) 切断传播途经对发现有病猪的养殖场曾销售病猪肉的摊档患者所在单位家庭等进行消毒, 对病死猪等废弃物应立即就地销毁或深埋 ; 收治病人的门诊和病房按禽流感 SARS 标准做好隔离消毒 ; 标本按照不明原因肺炎病例要求进行运送和处理 ( 三 ) 保护健康人群养成良好的个人卫生习惯, 充足睡眠勤于锻炼减少压力足够营养 ; 避免接触流感样症状 ( 发热, 咳嗽, 流涕等 ) 或肺炎等呼吸道病人 ; 注意个人卫生, 经常使用肥皂和清水洗手, 尤其在咳嗽或打喷嚏后 ; 避免接触生猪或前往有猪的场所 ; 避免前往人群拥挤场所 ; 咳嗽或打喷嚏时用纸巾遮住口鼻, 然后将纸巾丢进垃圾桶 ; 如在境外出现流感样症状 ( 发热, 咳嗽, 流涕等 ), 应立即就医 ( 就医时应戴口罩 ), 并向当地公共卫生机构和检验检疫部门说明 ( 四 ) 加强院感控制措施对于疑似病人或确诊病人进行隔离并佩戴外科口罩 ; 医务人员要做好个人防护, 加强手卫生, 使用快速手消毒剂进行手消毒 ; 发热门诊和感染性疾病科等重点部门的医务人员应佩戴外科口罩, 必要时佩戴护目镜或防护口罩 ; 对发热门诊和感染性疾病科等重点部门应当加强室内通风 3

毒壅气营症状 : 高热咳嗽胸闷憋气喘促气短烦躁不安甚者神昏谵语治法 : 清气凉营参考方药 : 炙麻黄杏仁瓜蒌生大黄生石膏赤芍水牛角必要时可选用安宫牛黄丸以及痰热清血必净清开灵醒脑静注射液等六预防 ( 一 ) 控制传染源开

5 猪流感疫苗 : 目前只有用于猪的猪流感疫苗, 还没有专门用于人类的就目前情况看, 普通的流感疫苗对预防人类猪流感没有明显效果附件 : 人感染猪流感诊疗流程.doc 猪流感病毒基因序列 : 4

6 科技文献目录最新猪 H1N1 流感病毒序列年 3 至 4 月美国南加州两儿童感染 A 型 (H1N1) 猪流感病毒美国出现对奥司他韦有耐药性的 A 型 (H1N1) 流感病毒感染中国从猪体中检测的人源 H1N1 和 H3N2 流感病毒分离和基因序列分析美国威斯康星州出现人感染三源重配株 A 型 (H1N1) 猪流感病毒病例对奥司他韦有耐药性的 A 型 (H1N1) 流感病毒院内感染的发病率和死亡率欧洲禽和猪 A 型 H1N1 流感病毒不同的演化轨迹年 11 月西班牙 Aragon 地区出现人感染猪流感 A 型 (H1N1) 病毒病例

.. 11 4. 美国威斯康星州出现人感染三源重配株 A 型 (H1N1) 猪流感病毒病例... 11 5.

7 最新猪 H1N1 流感病毒序列 Newest swine influenza A (H1N1) sequences Swine Flu 2009 Outbreak The Centers for Disease Control and Prevention (CDC) and other health officials are actively tracking the recent emergence of human cases of swine influenza A (H1N1) virus infection. The following swine influenza A (H1N1) sequences were submitted to NCBI and are available in GenBank: April 29, 2009, 1 submitted by University of Regensburg, Germany; 3 by CDC: PB2 PB1 PA HA NP NA MP NS (A/Regensburg/Germany/01/2009(H1N1)) (A/California/06/2009(H1N1)) FJ FJ FJ (A/California/08/2009(H1N1)) FJ April 28, 2009, 34 submitted by CDC: PB2 PB1 PA HA NP NA MP NS

The following swine influenza A (H1N1) sequences were submitted to NCBI and are available in GenBank: April 29, 2009, 1 submitted by University of Regensburg, Germany;

8 Swine Flu 2009 Outbreak (A/New York/19/2009(H1N1)) (A/New York/20/2009(H1N1)) (A/Kansas/03/2009(H1N1)) (A/Ohio/07/2009(H1N1)) (A/California/04/2009(H1N1)) (A/California/07/2009(H1N1)) (A/California/08/2009(H1N1)) (A/California/10/2009(H1N1)) (A/Texas/04/2009(H1N1)) (A/Texas/05/2009(H1N1)) April 27, 2009, 40 submitted by CDC: FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ

submitted by CDC: FJ969509 FJ969542 FJ969541 FJ969523 FJ969521 FJ969535 FJ969520 FJ969534 FJ969516 FJ969515 FJ969512 FJ969517 FJ969513 FJ969514 FJ969530

9 Swine Flu 2009 Outbreak (A/California/04/2009(H1N1)) (A/California/05/2009(H1N1)) (A/California/06/2009(H1N1)) (A/California/07/2009(H1N1)) (A/California/09/2009(H1N1)) (A/Texas/04/2009(H1N1)) (A/Texas/05/2009(H1N1)) PB2 PB1 PA HA NP NA MP NS FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ FJ 摘自 8

FJ966086 FJ966955 FJ966958 FJ966957 FJ966952 FJ966953 FJ966956 FJ966954 FJ966963 FJ966965 FJ966964 FJ966960 FJ966961 FJ966962 FJ966976 FJ966978 FJ966977 FJ966974

10 ShineGene Molecular Biotech,Inc. 上海闪晶分子生物科技有限公司年 3 至 4 月美国南加州两儿童感染 A 型 (H1N1) 猪流感病毒 MMWR Morb Mortal Wkly Rep Apr 24;58(15): Swine Influenza A (H1N1) infection in two children--southern California, March-April Centers for Disease Control and Prevention (CDC). On April 17, 2009, CDC determined that two cases of febrile respiratory illness occurring in children who resided in adjacent counties in southern California were caused by infection with a swine influenza A (H1N1) virus. The viruses from the two cases are closely related genetically, resistant to amantadine and rimantadine, and contain a unique combination of gene segments that previously has not been reported among swine or human influenza viruses in the United States or elsewhere. Neither child had contact with pigs; the source of the infection is unknown. Investigations to identify the source of infection and to determine whether additional persons have been ill from infection with similar swine influenza viruses are ongoing. This report briefly describes the two cases and the investigations currently under way. Although this is not a new subtype of influenza A in humans, concern exists that this new strain of swine influenza A (H1N1) is substantially different from human influenza A (H1N1) viruses, that a large proportion of the population might be susceptible to infection, and that the seasonal influenza vaccine H1N1 strain might not provide protection. The lack of known exposure to pigs in the two cases increases the possibility that human-to-human transmission of this new influenza virus has occurred. Clinicians should consider animal as well as seasonal influenza virus infections in their differential diagnosis of patients who have febrile respiratory illness and who 1) live in San Diego and Imperial counties or 2) traveled to these counties or were in contact with ill persons from these counties in the 7 days preceding their illness onset, or 3) had recent exposure to pigs. Clinicians who suspect swine influenza virus infections in a patient should obtain a respiratory specimen and contact their state or local health department to facilitate testing at a state public health laboratory. PMID: [PubMed - indexed for MEDLINE] 2. 美国出现对奥司他韦有耐药性的 A 型 (H1N1) 流感病毒感染 JAMA Mar 11;301(10): Epub 2009 Mar 2. Comment in: JAMA Mar 11;301(10): Add: Floor 2,Building A,328# Wuhe Road, Shanghai China Tel: Web: Fax: master@shinegene.org.cn

On April 17, 2009, CDC determined that two cases of febrile respiratory illness occurring in children who resided in adjacent counties in southern California were caused by infection with a swine

11 ShineGene Molecular Biotech,Inc. 上海闪晶分子生物科技有限公司 Infections with oseltamivir-resistant influenza A(H1N1) virus in the United States. Dharan NJ, Gubareva LV, Meyer JJ, Okomo-Adhiambo M, McClinton RC, Marshall SA, St George K, Epperson S, Brammer L, Klimov AI, Bresee JS, Fry AM; Oseltamivir-Resistance Working Group.Collaborators (44) Ahmed F, Nalluswami K, Bascom SD, Berisha V, Boulton RB, Cohen J, Corkren E, Crockett M, Dao C, Deyde VM, Hall H, Patton M, Sheu TG, Wallis TR, Hales C, Sunenshine R, Erhart LM, Komatsu K, Sunenshine R, Goodin K, Hanson M, Koepsell J, Rietberg K, Haupt T, Laplante JM, Mingle L, Linchangco P, Louie J, Moore A, McHugh L, Moore Z, Najera R, Park S, Rajan R, Person CJ, Yousey-Hindes K, Powell RJ, Reisdorf E, Shult PA, Van TT, Richards SM, Siston A, Stoute A, Van Houten C Jr. Epidemic Intelligence Service, Office of Workforce and Career Development Assigned to Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS A-32, Atlanta, GA 30333, USA. nfd6@cdc.gov CONTEXT: During the influenza season, oseltamivir resistance among influenza A(H1N1) viruses increased significantly for the first time worldwide. Early surveillance data suggest that the prevalence of oseltamivir resistance among A(H1N1) viruses will most likely be higher during the season. OBJECTIVES: To describe patients infected with oseltamivir-resistant influenza A(H1N1) virus and to determine whether there were any differences between these patients and patients infected with oseltamivir-susceptible A(H1N1) virus in demographic or epidemiological characteristics, clinical symptoms, severity of illness, or clinical outcomes. DESIGN, SETTING, AND PATIENTS: Influenza A(H1N1) viruses that were identified and submitted to the Centers for Disease Control and Prevention by US public health laboratories between September 30, 2007, and May 17, 2008, and between September 28, 2008, and February 19, 2009, were tested as part of ongoing surveillance. Oseltamivir resistance was determined by neuraminidase inhibition assay and pyrosequencing analysis. Information was collected using a standardized case form from patients with oseltamivir-resistant A(H1N1) infections and a comparison group of patients with oseltamivir-susceptible A(H1N1) infections during MAIN OUTCOME MEASURES: Demographic and epidemiological information as well as clinical information, including symptoms, severity of illness, and clinical outcomes. RESULTS: During the season, influenza A(H1N1) accounted for an estimated 19% of circulating influenza viruses in the United States. Among 1155 influenza A(H1N1) viruses tested from 45 states, 142 (12.3%) from 24 states were resistant to oseltamivir. Data were available for 99 oseltamivir-resistant cases and 182 oseltamivir-susceptible cases from this period. Among resistant cases, median age was 19 years (range, 1 month to 62 years), 5 Add: Floor 2,Building A,328# Wuhe Road, Shanghai China Tel: Web: Fax: master@shinegene.org.cn

Collaborators (44) Ahmed F, Nalluswami K, Bascom SD, Berisha V, Boulton RB, Cohen J, Corkren E, Crockett M, Dao C, Deyde VM, Hall H, Patton M, Sheu TG, Wallis TR, Hales C, Sunenshine R, Erhart LM,

12 ShineGene Molecular Biotech,Inc. 上海闪晶分子生物科技有限公司 patients (5%) were hospitalized, and 4 patients (4%) died. None reported oseltamivir exposure before influenza diagnostic sample collection. No significant differences were found between cases of oseltamivir-resistant and oseltamivir-susceptible influenza in demographic characteristics, underlying medical illness, or clinical symptoms. Preliminary data from the influenza season identified resistance to oseltamivir among 264 of 268 influenza A(H1N1) viruses (98.5%) tested. CONCLUSIONS: Oseltamivir-resistant A(H1N1) viruses circulated widely in the United States during the influenza season, appeared to be unrelated to oseltamivir use, and appeared to cause illness similar to oseltamivir-susceptible A(H1N1) viruses. Circulation of oseltamivir-resistant A(H1N1) viruses will continue, with a higher prevalence of resistance, during the season. 3. 中国从猪体中检测的人源 H1N1 和 H3N2 流感病毒分离和基因序列分析 Biochem Biophys Res Commun Apr 27;356(1):91-6. Epub 2007 Feb 27. Isolation and genetic analysis of human origin H1N1 and H3N2 influenza viruses from pigs in China. Yu H, Zhang GH, Hua RH, Zhang Q, Liu TQ, Liao M, Tong GZ. National Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin , PR China. es of subtypes H1N1 and H3N2 have been reported widely in pigs, associated with clinical disease. These mainly include classical swine H1N1, avian-like H1N1, and human-like or avian-like H3N2 viruses. From 2005 to 2006, we carried out swine influenza virus surveillance in eight provinces of China. Here we report, for the first time, the isolation and genetic analysis of a human-like influenza H1N1 virus from a pig in a farm of Guangdong province of southern China, a host suspected to generate new pandemic strains through genetic reassortment. Each of the eight gene segments is of human origin. Phylogenetic analysis indicates that these genes form a human lineage, suggesting that this virus is the descendant of recent human H1N1 influenza viruses. In addition, four swine H3N2 viruses were also isolated. The three H3N2 viruses from Guangdong province are descendants of recent human viruses, while an H3N2 virus from Heilongjiang province derives from early human viruses. Isolation and genetic analysis of human H1N1 and H3N2 influenza viruses from pigs in China provides further evidence about the interspecies transmission of human influenza viruses to pigs and emphasizes the importance of reinforcing swine influenza virus surveillance. 4. 美国威斯康星州出现人感染三源重配株 A 型 (H1N1) 猪流感病毒病例 Add: Floor 2,Building A,328# Wuhe Road, Shanghai China Tel: Web: Fax: master@shinegene.org.cn

No significant differences were found between cases of oseltamivir-resistant and oseltamivir-susceptible influenza in demographic characteristics, underlying medical illness, or clinical symptoms.

13 ShineGene Molecular Biotech,Inc. 上海闪晶分子生物科技有限公司 Emerg Infect Dis Sep;14(9): Human case of swine influenza A (H1N1) triple reassortant virus infection, Wisconsin. Newman AP, Reisdorf E, Beinemann J, Uyeki TM, Balish A, Shu B, Lindstrom S, Achenbach J, Smith C, Davis JP. Centers for Disease Control and Prevention, Atlanta, Georgia, USA. apn01@health.state.ny.us Zoonotic infections with swine influenza A viruses are reported sporadically. Triple reassortant swine influenza viruses have been isolated from pigs in the United States since We report a human case of upper respiratory illness associated with swine influenza A (H1N1) triple reassortant virus infection that occurred during 2005 following exposure to freshly killed pigs. 5. 对奥司他韦有耐药性的 A 型 (H1N1) 流感病毒院内感染的发病率和死亡率 JAMA Mar 11;301(10): Epub 2009 Mar 2. Morbidity and mortality associated with nosocomial transmission of oseltamivir-resistant influenza A(H1N1) virus. Gooskens J, Jonges M, Claas EC, Meijer A, van den Broek PJ, Kroes AM. Department of Medical Microbiology, E4-65, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. j.gooskens@lumc.nl CONTEXT: The sudden emergence and rapid spread of oseltamivir-resistant influenza A(H1N1) viruses with neuraminidase (NA) gene H274Y amino acid substitution is the hallmark of global seasonal influenza since January Viruses carrying this mutation are widely presumed to exhibit attenuated pathogenicity, compromised transmission, and reduced lethality. OBJECTIVE: To investigate nosocomial viral transmission in a cluster of patients with influenza A(H1N1) virus infection. DESIGN, SETTING, AND PATIENTS: Descriptive outbreak investigation of 2 hematopoietic stem cell transplant recipients and an elderly patient who developed hospital-acquired influenza A virus infection following exposure to an index patient with community-acquired H274Y-mutated influenza A(H1N1) virus infection in a medical ward at a Dutch university hospital in February The investigation included a review of the medical records, influenza virus polymerase chain reaction and culture, phenotypic oseltamivir and zanamivir susceptibility determination, and hemagglutinin chain 1 (HA(1)) gene and NA gene sequence analysis. MAIN Add: Floor 2,Building A,328# Wuhe Road, Shanghai China Tel: Web: Fax: master@shinegene.org.cn

us Zoonotic infections with swine influenza A viruses are reported sporadically. Triple reassortant swine influenza viruses have been isolated from pigs in the United States since 1998.

14 ShineGene Molecular Biotech,Inc. 上海闪晶分子生物科技有限公司 OUTCOME MEASURE: Phylogenetic relationship of patient cluster influenza A(H1N1) viruses and other seasonal influenza A(H1N1) viruses. RESULTS: Viral HA(1) and NA gene sequence analysis from the 4 patients revealed indistinguishable nucleotide sequences and phylogenetic clustering of H274Y-mutated, oseltamivir-resistant influenza A(H1N1) virus, confirming nosocomial transmission. Influenza virus pneumonia (3 patients) and attributable mortality (2 patients) during active infection was observed in patients with lymphocytopenia at onset. CONCLUSION: Seasonal oseltamivir-resistant influenza A(H1N1) viruses with NA gene H274Y mutation are transmitted and retain significant pathogenicity and lethality in high-risk patients. 6. 欧洲禽和猪 A 型 H1N1 流感病毒不同的演化轨迹 J Virol Mar 18. Different evolutionary trajectories of European avian-like and classical swine H1N1 influenza A viruses. Dunham EJ, Dugan VG, Kaser EK, Perkins SE, Brown IH, Holmes EC, Taubenberger JK. Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA; Center for Infectious Disease Dynamics, Department of Biology, The Pennsylvania State University, University Park, PA, USA; Virology Department, Veterinary Laboratories Agency - Weybridge, Addlestone, Surrey, UK; Fogarty International Center, National Institutes of Health, Bethesda, MD, USA. In 1979 a lineage of avian-like H1N1 influenza A virus emerged in European swine populations independently from the 'classical' swine H1N1 virus lineage that had circulated in pigs since the 'Spanish' influenza pandemic of To determine whether these two distinct lineages of swine-adapted A/H1N1 viruses have evolved in similar ways, as might be expected given their common host species and origin from avian-like A/H1N1 ancestors, we compared patterns of nucleotide and amino acid change in whole genome sequences of both groups. An analysis of nucleotide compositional bias across all 8 genomic segments for the two swine lineages showed a clear lineage-specific bias, although a segment-specific effect was also apparent. As such, there only appears to be a relatively weak host-specific selection pressure. Strikingly, despite each lineage evolving in the same species host for decades, amino acid analysis revealed little evidence for either parallel or convergent changes. These findings suggest that although adaptation due to evolutionary lineages can be distinguished, there are functional and structural constraints on all gene segments, and that the evolutionary trajectory of each lineage of swine A/H1N1 virus has a strong historical contingency. Thus, in the context of emergence of an influenza A virus strain via a host-switch event, it is difficult to predict what specific polygenic changes are needed for mammalian adaptation. Add: Floor 2,Building A,328# Wuhe Road, Shanghai China Tel: Web: Fax: master@shinegene.org.cn

RESULTS: Viral HA(1) and NA gene sequence analysis from the 4 patients revealed indistinguishable nucleotide sequences and phylogenetic clustering of H274Y-mutated, oseltamivir-resistant influenza

15 ShineGene Molecular Biotech,Inc. 上海闪晶分子生物科技有限公司年 11 月西班牙 Aragon 地区出现人感染猪流感 A 型 (H1N1) 病毒病例 Euro Surveill Feb 19;14(7). pii: Human case of swine influenza A (H1N1), Aragon, Spain, November Adiego Sancho B, Omenaca Teres M, Martinez Cuenca S, Rodrigo Val P, Sanchez Villanueva P, Casas I, Pozo F, Perez Brena P. Direccion General de Salud Publica (Directorate General of Public Health), Zaragoza, Spain. mbadiego@aragon.es A human case of swine influenza A (H1N1) in a 50-year-old woman from a village near Teruel (Aragon, in the north-east of Spain), with a population of about 200 inhabitants, has been reported in November Shanghai ShineGene Molecular Bio-tech Co.,Ltd. Add:Floor 2,Building A,328#, Wuhe Road,Shanghai,201109,China Tel: Fax: master@shinegene.org.cn WebSite: Add: Floor 2,Building A,328# Wuhe Road, Shanghai China Tel: Web: Fax: master@shinegene.org.cn

Direccion General de Salud Publica (Directorate General of Public Health), Zaragoza, Spain. mbadiego@aragon.

0 年上半年评价与考核细则序号部门要素值考核内容考核方式考核标准考核 ( 扣原因 ) 考评得 3 安全生产目 30 无同等责任以上道路交通亡人事故无轻伤责任事故无重大质量

0 年上半年评价与考核细则序号部门要素值考核内容考核方式考核标准考核 ( 扣原因 ) 考评得 3 安全生产目 30 无同等责任以上道路交通亡人事故无轻伤责任事故无重大质量 0 年上半年评价与考核细则序号部门要素值考核内容考核方式考核标准无同等责任以上道路交通亡人事故 3 无轻伤责任事故目标 30 及事无重大质量工作过失故管无其他一般责任事故理在公司文明环境创建中, 无工作过失及被追究的