Paramyxovirus在线视频

Paramyxoviruses
副粘病毒

We have gone through influenza virus,
我们已经学习了

which belongs to Orthomyxoviridae.
正粘病毒科的流感病毒

Now let's move to another group of viruses that
现在让我们学习另一群

also can spread through the respiratory route,Paramyxoviridae.
也可以通过呼吸道传染的病毒 副粘病毒

They are measles, mumps,
副粘病毒包括麻疹病毒 腮腺炎病毒

parainfluenza, and respiratory syncytial virus (RSV)
副流感病毒和呼吸道合胞病毒

Start from a case.
我们的学习从这个案例开始

A 14-year-old boy presents fever
男孩，14岁，出现发热

and conjunctivitis for 3 days.
和结膜炎，持续三天

The child is pale and febrile at 40.0 ℃.
患儿肤色苍白，体温达40℃

His buccal mucosa has multiple blue-gray spots,
颊黏膜上有很多蓝灰色的斑点

and he has a maculopapular rash.
并且有斑状丘疹

The rash started on his face but has spread to his body.
丘疹从面部开始，现已扩散到了全身

He was never vaccinated.
他从未接种过疫苗

Try to answer the three questions.
现在请试着回答这三个问题

What is the disease?
他得了什么病？

Why did the person become infected?
为什么他会得这个病？

And how do we treat the patient and protect others?
要如何治疗并且保护其他人呢？

We will come back to this case after
我们将在讨论过副粘病毒后

we discuss the paramyxoviruses.
再回到这个案例上

Similar to orthomyxoviruses, paramyxoviruses
跟正粘病毒类似，副粘病毒

can infect human through mucous membrane.
可以通过黏膜感染人类

That is why they are called "myxo" virus.
这就是为什么它们被叫做“粘病毒”的原因

But compared with orthomyxoviruses, paramyxoviruses
但与正粘病毒相比，

have some different characteristics.
副粘病毒有不同的特性

The virion is spherical, pleomorphic,
病原体是球形，或多形的

150-300 nm in diameter (helical nucleocapsid).
直径在150到300nm（核衣壳螺旋对称）

Genome: -ss RNA, linear, non-segmented.
基因组：-ss RNA，线性，不分节段

This is different from flu virus,
这不同于基因组分节段的

which has segmented genome.
流感病毒

Envelope contains viral HN and F glycoproteins.
副粘病毒的包膜包含有病毒性HN和融合蛋白F

HN has similar activities with HA and NA.
HN有类似HA和NA的活性

F glycoprotein makes the fusion of host cells.
融合蛋白F使宿主细胞融合

Replication is in cytoplasm,
病毒的复制发生在宿主细胞的细胞质中

and particles bud from plasma membrane.
并且病毒颗粒从细胞膜以出芽方式释放

The HN glycoproteins of paramyxoviruses are more
比起甲型流感病毒，副粘病毒的HN

antigenically stable than those in influenza A viruses,
在抗原性上更加稳定

but antigenic differences have been reported over time.
但是也有抗原变异的报道

The viruses are highly infectious.
副黏病毒具有高度传染性

Diagram shows the structure of
这张图显示了

paramyxoviruses: non-segmented RNA,
副粘病毒的结构：不分节段RNA

helical nucleocapsid, spikes on the envelope,
核衣壳呈螺旋对称，包膜上有刺突

HN and F protein.
HN和 F蛋白

The F protein promotes fusion
F蛋白促进

of the envelope with the plasma membrane.
包膜和细胞质膜的融合

Paramyxoviruses are able to induce cell-to-cell fusion,
副粘病毒可以引起细胞与细胞的融合

thereby creating multinucleated giant cells.
因此引起多核巨细胞的形成

Measles virus has only one serotype.
麻疹病毒只有一种血清型

Humans are the only natural hosts.
人类是唯一的天然宿主

Measles is highly contagious and is transmitted from
麻疹是具有高度传染性的疾病

person to person by respiratory droplets.
可以通过飞沫在人与人之间传播

Clinical manifestation includes the acute
临床表现包括

measles illness and SSPE.
急性的麻疹和亚急性硬化性全脑炎

Measles is a serious febrile illness.
可以出现发热

The incubation period lasts 7 to 13 days.
潜伏期7到13天

The classical symptoms of measles include four day fevers,
麻疹经典的症状包括发热4天

the three Cs — cough,
3个C——咳嗽

coryza (runny nose) and conjunctivitis (red eyes).
伤风（流涕）以及结膜炎（红眼）

The disease is most infectious during this time.
在这段时间内，传染性最强

After 2 days of prodromal illness, the typical mucous
前驱症状出现2天后，出现典型的粘膜病灶

membrane lesions known as Koplik spots appear.
被称为柯氏斑

The Koplik spots on the mucosa of the cheeks
柯氏斑出现在口腔两颊内侧以及舌头的粘膜上

and tongue appear as irregularly-shaped,
其形状不规则

bright red spots often with a bluish-white central dot.
常呈现为周围亮红色、中间青白色

Within 12 to 24 hours of the appearance of Koplik spots,
在柯氏斑出现后的12到24小时内

the exanthem of measles starts below the ears
耳后出现麻疹的特征皮疹

and spreads over the body.
接着蔓延至全身

The characteristic measles rash begins several days
特征性的麻疹皮疹会在

after the fever starts.
发热开始后的几天出现

Typical rash starts on the face and upper neck,
典型的皮疹出现在面部和颈部上半部分

spreads down the back and trunk,
一直延伸到背部和躯干

then extends to four limbs.
最后到四肢

The fever is highest and the patient is sickest
皮疹出现当天

on the day the rash appears.
患者症状最重，体温最高

Pneumonia, which can be a serious complication,
肺炎作为一种严重的并发症

accounts for 60% of the deaths caused by measles.
占据麻疹致死案例的60%

Bacterial superinfection is common in patients with
麻疹并发肺炎的患者容易出现

pneumonia caused by the measles virus.
细菌的二重感染

One of the most feared complications of measles is encephalitis,
麻疹最严重并发症之一是脑炎

which occurs in as few as 0.5% of those infected
虽然只在0.5%的被感染者中出现

but carries a fatality rate of 15%.
但一旦出现致死率高达15%

Encephalitis may rarely occur during acute disease
急性感染过程中脑炎很少见

but usually begins 7 to 10 days after the onset of illness.
常常在疾病发病后7到10天出现

Subacute sclerosing panencephalitis (SSPE)
亚急性硬化性全脑炎（SSPE）

is an extremely serious,
是一种非常严重的

very late neurologic sequela of measles that afflicts
麻疹晚期神经性后遗症

approximately seven of every one million patients.
每一百万个患者中约有7个患者出现SSPE

Infectious virus disappears. Measles proteins in infected
虽然麻疹病毒被清除，但是在感染后

brain cells result from defective virus replication
由于缺陷病毒的增殖

after initial infection.
感染的脑细胞中的麻疹病毒蛋白仍然存在

Recommend you to watch House MD series
推荐同学们观看

episode 2 of season 1 if you have time.
豪斯医生第一季第二集

You may get some information about measles and SSPE.
也许会对麻疹和亚急性硬化性全脑炎的了解有帮助

The clinical manifestations of measles are usually
麻疹的临床表现

so characteristic that it is rarely necessary to perform
一般都很典型

laboratory tests to establish the diagnosis.
通常不需要实验室检查结果就可以确诊

No specific antiviral treatment is available for measles.
麻疹治疗，目前没有特异性的抗病毒药物

The immunity is lifelong after infected by measles virus.
感染麻疹病毒后，免疫能力将持续终生

MMR (measles-mumps-rubella) vaccine is recommended.
疫苗一般采用MMR（麻疹-腮腺炎-风疹）三联疫苗

Mumps virus also has only one serotype.
腮腺炎病毒同样只有一种亚型

Humans are the only natural hosts.
人类是唯一的天然宿主

1/3 of Mumps infections are asymptomatic.
三分之一的腮腺炎病毒感染是无症状的

Clinical illness usually manifests as a parotitis.
临床表现为腮腺炎

Patients show the swelling of the salivary glands.
患者表现为唾液腺肿大

Orchitis (rarely oophoritis) may occur and cause sterility.
睾丸炎（较少为卵巢炎），会导致不孕不育

Some patients may develop meningitis.
部分患者发生脑膜炎

The immunity is permanent.
免疫能力是持久的

MMR vaccine could be used to prevent the mumps.
MMR疫苗可以被用于预防腮腺炎

Respiratory syncytial virus (RSV).
呼吸道合胞病毒

One serotype.
只有一个血清型

RSV is the most dangerous cause of lower respiratory
呼吸道合胞病毒是年幼儿童下呼吸道感染中

infections in young children.
最常见的致病因素

RSV can cause any respiratory tract illness,
RSV可以导致任何呼吸道疾病，

from a common cold to pneumonia
从普通的感冒到肺炎

A more severe lower respiratory tract illness,
婴儿还可能出现

bronchiolitis, may occur in infants.
更加严重的下呼吸道感染——细支气管炎

Bronchiolitis is usually self-limiting,
细支气管炎通常是自限性的

but it can be a fatal in premature babies,
但对于早产儿

persons with underlying lung disease,
有肺部疾病的人

and immunocompromised people.
以及免疫受损的人可能致命的

No vaccine is currently available for RSV prophylaxis.
对于RSV的预防，现在还没有可用的疫苗

Parainfluenza virus
副流感病毒

Four serologic types within the parainfluenza genus
对人类致病的副流感病毒

are human pathogens.
有四种血清型

Parainfluenza virus can cause common respiratory
副流感病毒可以引起全年龄段的

illnesses in persons of all ages.
常见的呼吸系统疾病

It is the second major pathogens of severe respiratory
是引起胎儿和幼儿的

tract disease in infants and young children.
严重呼吸道疾病的第二大病因

Types 1, 2, and 3 are associated with
1，2，3型与

laryngotracheobronchitis (croup).
喉气管支气管炎（哮吼）有关

Type 4 causes only mild upper respiratory tract
4型病毒仅引起儿童和成人的

infection in children and adults.
上呼吸道的轻微感染

Reinfections are common.
复发感染很常见

No specific antiviral agents are available.
没有特异性的抗病毒药物

No effective vaccine so far.
目前没有有效的疫苗

These are the paramyxoviruses.
这就是=是关于副流感病毒的全部内容

OK, back to the case.
好，回到案例

What virus is he infected with? Based on the typical
得了什么病？

symptoms and signs, high fever, conjunctivitis,
基于典型的症状和体征 高热 结膜炎

Koplik spots and rash from head to trunk,
从头部到躯干的柯氏斑和皮疹

the preliminary diagnosis can be measles.
初步诊断是麻疹

We can easily diagnose this condition by the characteristic
不借助实验室检查

clinical features without relying on the lab test.
也可以很容易根据这些特征性的临床表现作出诊断

Why did he become infected?
患者如何被感染的?

Measles is transmitted by aerosols.
麻疹是通过气溶胶传播的

There are some serious complications,
可出现某些严重并发症

such as pneumonia and encephalitis. SSPE is rare but fatal.
例如肺炎和脑炎。SSPE罕见但致命

What can be done if he is infected?
如何治疗和预防？

No specific anti-viral drugs so far.
目前没有特异的抗病毒药物

People should be vaccinated to get the protection.
接种疫苗可以获得免疫力

Please review this section after the class.
请在课后复习这部分内容

We will finish this chapter next time.
下次是本章的最后一节

Thank you for your listening. Let's have a break.
感谢聆听 休息一下