诺如病毒研究进展及一起邮轮诺如病毒感染疫情的实验室检测

1、会计学1诺如病毒研究进展及一起邮轮诺如病毒诺如病毒研究进展及一起邮轮诺如病毒感染疫情的实验室检测感染疫情的实验室检测 Source: Foodborne Outbreak Reporting System /foodborneoutbreaks/Cruise-ship virus）Slutsker L, et al. Ann Intern Med 1997; 126:505-13食源性急性胃肠炎的防控仍然是食源性急性胃肠炎的防控仍然是很大的挑战！很大的挑战！In 1929, Zahorsky proposed the name “winter vomiting

2、 disease” to describes outbreaks of presumed viral gastroenteritis In the 1940s, Gordon demonstrated that pooled stool filtrates obtained from patients in an institutional outbreak of nonbacterial gastroenteritis could infect inoculated volunteersIn 1968, CDC investigated an outbreak of vomiting dis

3、ease in an elementary school in Norwalk OH: 50% of students and teachers developed gastroenteritisKaplan used immune electronmicroscopy to identify viral particles in the stools of volunteers infected with the “Norwalk” strainVirus initially classified as small round viruses, later reclassified as c

4、aliciviruses when genome clonedn Dr. Albert Kapikiann 1972, electron microscopyn Small Round-Structured Virus (SRSV)n 27 nmKapikian AZ, et al. Visualization by immune electron microscopy of a 27-nm particle associated with acute infectious nonbacterial gastroenteritis. J Virol, 1972, 10 (5): 1075-10

5、81. 流行现状：流行现状：我国流行现状我国流行现状我国流行现状我国流行现状u 发病率高、致病剂量低、抵抗力强，被WHO定为B类病原体；u 对加热、低温具有较强抵抗性（能耐受零度以下到60）；u 对酸碱和去污剂等具有较强的抵抗性 (通常10ppm或10mg/L含氯去污剂处理30分钟不能有效杀灭病原体）；u 无法培养，无有效小动物模型；u 型别众多，无有效保护性抗体，常引起重复感染；nGenus Lagovirus (rabbit, hare)nGenus Vesivirus (cat, pig, sea lion, other)nGenus Norovirus (human, bovine,

6、swine, mouse)nGenus Sapovirus (human, swine)53HelProPolORF 1ORF 2ORF 3155358537469506950758876541789530212CapsidSource: GenBank M87661GIII.1_JenaGIII.2_CH126GI.3_Desert ShieldGI.7_WinchesterGI.8_BoxerGI.4_ChibaGI.5_MusgroveGI.2_SouthamptonGI.6_HesseGI.1_NorwalkGV.1_MurineGIV.1_AlphatronGII.15_J23GII

7、.4_BristolGII.11_SW918GII.8_AmsterdamGII.9_Virginia BeachGII.14_M7GII.7_LeedsGII.12_WortleyGII.1_HawaiiGII.16_TiffinGII.2_MelkshamGII.5_HillingdonGII.10_ErfurtGII.13_FayettevilleGII.17_CS-E1GII.3_TorontoGII.6_Seacroft.10GVGIVGIIIGIIGIClusters differ by 20% amino acid pairwise distanceGenogroups diff

8、er by 44-55% amino acid pairwise distance1nCell culture: no (human strains)nAnimal model: no (chimpanzees)流行现状：nCauses an estimated 23 million infections per year in the USnCauses 60% of illness due to knownnAccounts for 70-95% of gastroenteritis outbreaks感染剂量: 10-100 viruses：传播途径：n Fecal-oral trans

9、mission (shedding for up to 2-3 weeks)n Droplet transmission? (via ingestion of airborne droplets of virus containing particles)n Common cause of travelers diarrhean May cause chronic infection in transplant recipients Person-to-person Foodborne Waterborne Mixed Vomitus 腹泻86%呕吐78%腹部疼痛或绞痛 30%恶心（无呕吐）

10、15%嗜睡8%发热7%肌肉疼痛7%头痛6%头晕4%脱水4%寒颤3%喉咙疼痛1%鼻出血1%1234567Exposed to the VirusSymptoms (Vomiting and/or Diarrhea)Life Cycle of Virus by DaysContagious Time Frame (even when symptoms are no longer present)Unpublished results by Wang J. and Zhang Z.确定检测项目，检测方法排查方案（一）排查方案（二）结果：TIPS: for sample cellection1.最好采集水样便或稀便；2.最好采集发病48-72小时之间的粪便样本；3. 直肠拭子或呕吐物标本一般作参考磷钨酸负染，40,000 电镜观察检测过程总结：Slutsker L, et al. Ann Intern Med 1997; 126:5