Hemorrhagic Fever Virus在线视频

Hemorrhagic Fever Viruses
出血热病毒

Hemorrhage means bleeding.
Hemorrhage表示出血

The hemorrhagic fever viruses (HFVs)
出血热病毒(HFVs)

are a diverse group of viruses
是一大类

that are all capable
能够引起

of causing clinical diseases associated
与出血、发热相关的疾病

with bleeding disorder and fever,
的病毒

classically referred
临床上称这类疾病为

to as viral hemorrhagic fever (VHF).
病毒性出血热(VHF)

Learning Objectives:
以下是本节课的学习目标

At the end of this lecture,
在这节课结束后

you should be able to
希望你能够

1．List the important hemorrhagic
1. 列举重要的

fever viruses,
出血热病毒

and describe their common properties.
并描述它们的共同特征

2．Discuss the sources,
2. 描述汉坦病毒的

transmission routes and clinical findings
传染源、传播途径

of hantavirus infections.
和临床症状

Let's first see a case.
让我们来看一个

An outbreak of hemorrhagic
发生在某研究所一群学生

fever with renal syndrome (HFRS)
的肾综合征出血热(HFRS)

occurred among students in an institute.
爆发案例

Epidemiologic data indicated
流行病学数据

that the human infections
显示他们的感染

were a result of zoonotic transmission
是来自实验室小鼠的

of the virus from laboratory rats.
动物源性传播的结果

Sequence analysis
随后对病毒基因组

of the three genome segments
三个片段的序列分析

of the virus indicated
显示这个新的毒株

that this new isolate was a reassortant
是人类汉坦病毒

derived from human and rat Hantaviruses.
和大鼠汉坦病毒的重配株

Questions are:
问题来了

1．What is HFRS?
1. 什么是HFRS？

2．How did the reassortant virus evolve?
2. 重配株病毒如何进化？

3．How do humans get HFRS?
3.人类怎么患HFRS？

4．How is HFRS diagnosed?
4. 如何诊断HERS?

5．How is HFRS treated and prevented?
5. 如何预防和治疗HFRS?

To answer these questions,
为了回答这些问题

let’s start to understand these viruses.
我们一起来学习相关病毒

Hemorrhagic fever viruses
出血热病毒

can be divided into 4 distinct families:
可以分为4个病毒科

Bunyaviridae, Filoviridae,
布尼亚病毒科,丝状病毒科

Arenaviridae, and Flaviviridae.
沙粒病毒科和黄病毒科

Bunyaviridae: Hantaviruses with HFRS
布尼亚病毒科：汉坦病毒属引起

and hantavirus pulmonary syndrome (HPS),
HFRS和汉坦病毒肺综合征(HPS)

and nairovirus with Crimean-Congo
内罗病毒属引起

hemorrhagic fever virus (CCHF), etc.
克里米亚-刚果出血热(CCHF)等

Filoviridae: Ebola and Marburg viruses;
丝状病毒科：埃博拉病毒和马堡病毒

Arenaviridae: Lassa fever virus
沙粒病毒科：拉沙热病毒

and a group of viruses referred
和其他被称为

to as the New World arenaviruses;
“新世界沙粒病毒”的病毒

Flaviviridae:
黄病毒科：

dengue, yellow fever virus, and so on.
登革病毒，黄热病病毒等

We have already discussed flaviviruses
在虫媒病毒的课程中

in the Arbovirus session.
我们已经讨论了虫媒病毒

Different viral diseases may occur
在世界不同地区

in different areas of the world.
流行的病毒性疾病不同

In this session,
这节课中

I will just go through hantavirus and HFRS,
我介绍汉坦病毒和HFRS

CCHF and Ebola virus briefly.
并简要介绍克里米亚-刚果出血热和埃博拉病毒

Here are the 4 families:
四个病毒科中

Arenaviridae, Bunyaviridae,
沙粒病毒科,布尼亚病毒科

and Filoviridae are all -ssRNA viruses.
丝状病毒科都是-ssRNA

Flaviviridae is +ssRNA virus.
黄病毒科是+ssRNA

Common features
病毒性出血热（VHF）的

of viral hemorrhagic fever (VHF) :
共同特征是

1．They are all RNA viruses
1. 它们都是RNA病毒

each with a lipid envelope.
都有脂质包膜

2．Zoonotic in nature -
2. 动物性源性

HFVs are transmitted to humans
HFVs通过节肢动物

from animal reservoirs either directly
或直接

or via arthropod vectors.
从动物传播给人类

Some viruses,
一些病毒

such as Ebola and Crimean-Congo
比如埃博拉病毒和

hemorrhagic fever viruses,
克里米亚-刚果出血热病毒

are transmissible between humans.
可以在人际传播

3．The viruses disrupt the integrity
3. 病毒会破坏血管系统

of the vascular system,
的完整性

resulting in increased vascular
导致血管通透性增加

permeability and hence bleeding.
引起出血

4．The route of transmission varies
4. 不同病毒的

with the specific virus.
传播途径不同

Some are spread by mosquitoes or ticks.
一些病毒是通过蚊和蜱传播的

Others are transmitted
其他的病毒通过接触

by contact with infected blood or semen.
感染者的血液或精液传播

Some can be inhaled
一些病毒则是通过

from infected rat feces or urine.
吸入感染小鼠的粪便或尿液形成的气溶胶传播

5．While some types of hemorrhagic
5. 虽然一些出血热病毒

fever viruses can cause relatively
导致疾病比较轻微

mild illnesses,
但大多数出血热病毒

many of these viruses cause severe,
导致严重的

life-threatening disease.
危及生命的疾病

Now, let's discuss about hantavirus.
现在，让我们来讨论汉坦病毒

The virion of hantavirus is spherical,
汉坦病毒颗粒是球形的

120 nm in diameter.
直径为120nm

Nucleocapsid includes NP,
核衣壳包括核衣壳蛋白

with helical symmetry,
螺旋对称

and core, -ssRNA, 3 segments.
核心是-ssRNA，分为三个节段

Please note,
请注意

it is a segmented genome,
这是一个分节段的基因

with a potential for gene reassortment.
有可能出现基因重配

The virion is enclosed by an envelope,
病毒颗粒被包膜包绕着

containing two glycoprotein spikes,
包膜上有两个糖蛋白突起

G1 and G2.
G1和G2

Glycoproteins
糖蛋白

can bind to neutralizing antibodies
可以结合中和性抗体

and induce the hemagglutination
凝集

of goose RBCs.
鹅红细胞

Hantavirus causes two serious
汉坦病毒主要引起人体的

diseases in humans:
两种急性传染病

hemorrhagic fever with renal syndrome
肾综合征出血热

(HFRS)
(HFRS)

(also known as epidemic hemorrhagic
（在中国称为

fever in China)
流行性出血热）

and hantavirus pulmonary syndrome (HPS).
和汉坦病毒肺综合征(HPS)

There are more than 40 hantavirus species.
汉坦病毒超过40种

Some examples are shown in this table.
表格中展示了一些例子

Hantaan, Seoul,
汉滩病毒，汉城病毒

Puumala viruses are associated with HFRS,
普马拉病毒都和HFRS有关

whereas Sin nombre virus
辛诺柏病毒（西班牙语,意为无名病毒）

(No-name virus in Spanish) causes HPS.
导致HPS

Hantaan virus is widely distributed in Asia,
汉滩病毒在亚洲广泛分布

such as China,
例如中国

and Seoul virus also
汉城病毒在世界范围内

has a worldwide distribution.
广泛分布

Hantaviruses are carried in
汉坦病毒的宿主动物

and transmitted by rodents.
和传染源均为啮齿动物

Each hantavirus species is unique
每个型别的汉坦病毒

to a different rodent host.
有不同的啮齿动物宿主

Let’s talk more about HFRS.
让我们学习更多

Hemorrhagic fever with renal
HFRS的知识

syndrome (HFRS) is an acute interstitial
HFRS是一种以发热和

nephropathy characterized by high fever
不同程度的肾功能损害

and varying degrees
和出血为特征的

of renal insufficiency and bleeding.
急性间质性肾病

How do humans get HFRS?
人们如何患肾综合征出血热呢?

Reservoirs for HFRS include:
HFRS的储存宿主包括：

The striped field mouse is the reservoir
汉滩病毒的储存宿主是

for Hantaan virus while the brown
黑线姬鼠

or Norway rat is the reservoir
汉城病毒的储存宿主

for Seoul virus.
是褐家鼠

Transmission route of HFRS.
肾综合征出血热的传播途径

The viral colonization
感染的啮齿动物

in rodents is life-long
可终身携带病毒

and without deleterious effects.
但不发病

People can become infected after
人暴露在

exposure to aerosolized urine,
尿液

droppings,
粪便

or saliva of infected rodents.
或者唾液的气溶胶中可被感染

Transmission may also occur when
其他感染途径有

infected urine or other materials
含有病毒的尿液或其他成分

are directly introduced into broken skin
直接接触破损皮肤

or onto the mucous membranes
进入鼻或口的黏膜

of the eyes,
或者被啮齿动物咬伤时

nose or mouth, or through rodent bites.
人都可能受到传染

Transmission from one human
人际间水平传播

to another may occur,
可能会发生

but is extremely rare.
但极其罕见

Laboratory diagnosis:
实验室诊断

Several laboratory tests are used to
很多实验室检查

confirm the clinical diagnosis of HFRS.
可以用于确诊HFRS

Serologic test to measure the viral
血清学检查：检测特异性IgM抗体

specific IgM and paired IgG titers.
和双份血清中IgG抗体滴度

Detection of viral RNA
检测血液或组织中的

in blood or tissue.
病毒RNA

HFRS Treatment:
HFRS的治疗

Currently no antiviral drug is available.
目前没有可使用的抗病毒药物

Prompt diagnosis
快速诊断

and timely supportive
和及时的支持性治疗

therapy can improve patient survival.
可以提高病人的生存率

Depending on which virus
根据引起HFRS

is causing the HFRS,
的病毒的不同

death varies from less
患者的死亡率不同

than 1% to as many as 15% of patients.
死亡率可以低于1%，也可以高达15%

Mortality ranges from 5-15%
汉滩病毒引起的HFRS

for HFRS caused by Hantaan virus.
死亡率约为5%-15%

Prevention:
预防措施

A vaccine is available for HFRS.
有HFRS疫苗可用

Rodent control is the primary strategy
防鼠灭鼠是预防汉坦病毒感染的

for preventing hantavirus infections.
基本策略

Individuals should:
个人应做到

Avoid contact with rodents
防止接触鼠类

and their habitats.
及其栖息地

Do not keep rodents as pets.
不要养啮齿动物作宠物

Keep all food in sealed containers.
食物要密封保存

Virions may be stable for 2 days
病毒颗粒可在干燥表面

on a dry surface so disinfection
存活两天

of contaminated areas is important.
所以要对污染区域进行消毒

A 10% solution of household bleach
浓度10%的家用漂白剂

is effective.
能有效消毒

Summary of hantavirus.
以下是对汉坦病毒

Biological Properties:
生物学性状的总结

Bunyaviridae, hantavirus.
布尼亚病毒科，汉坦病毒

Virion is spherical,
病毒颗粒是球形的

120 nm in diameter, enveloped.
直径为120nm，有包膜

Core: -ssRNA, trisegmented.
核心：-ssRNA，分三段

Capsid: NP, helical symmetry.
衣壳：核衣壳蛋白，螺旋对称

Envelope: G1 and G2 proteins
包膜：G1和G2蛋白

Pathogenicity:
致病性

Source:
传染源是

striped field mice and brown rats.
黑线姬鼠和褐家鼠

Transmission:
传播途径

aerosol, fecal-oral, direct contact
气溶胶传播，粪-口传播，直接接触

Diseases: HFRS and HPS
疾病：HFRS和HPS

Immunity: Permanent
免疫性：永久性

Treatment and control:
防治措施：

No specific treatment.
无特异性治疗

Vaccine for HFRS, and rodent control.
HFRS疫苗和鼠类防治

Now,
现在

let me briefly introduce Crimean-Congo
我简单地介绍一下

hemorrhagic fever virus (CCHF).
克里米亚-刚果出血热病毒

Biological Properties:
生物学性状

Bunyaviridae, Nairovirus
布尼亚病毒科，内罗病毒

The virion is similar to hantavirus.
病毒颗粒和汉坦病毒相似

Pathogenicity:
致病性

Source and natural host:
传染源和自然宿主

wild rodents & domestic animals
野生啮齿类动物和家养动物

Vector: ticks
传播媒介：脾

(direct contact or person-to-person)
（直接接触传播或人-人传播）

Disease: Hemorrhagic fever
疾病：出血热

Immunity is permanent.
终身免疫

Management include bite prevention
防治措施包括

and vaccination.
预防叮咬和接种疫苗

Next,
接下来

we’ll briefly summarize Ebola virus.
简单总结埃博拉病毒

Filoviridea
丝状病毒科

The virion is a filamentous form,
病毒颗粒是丝状体

80 nm in diameter,
直径80nm

but highly variable in length.
但是长度变化很大

It is an enveloped -ssRNA virus.
是有包膜的-ssRNA病毒

Pathogenicity. Source: fruit bats;
致病性：传染源：果蝠

infected animals; patients.
感染的动物、病人

Transmission:
传播途径

direct contact via mucous membrane
直接接触黏膜

Disease: Ebola hemorrhagic fever.
疾病：埃博拉出血热

Immunity: People who recover
免疫性：病人痊愈后

from Ebola infection develop antibodies
至少10年内

that last for at least 10 years.
能在体内检测到抗体

Treatment and control:
防治原则：

No vaccine; no specific treatment.
无疫苗和特异性治疗

Isolation to prevent spread.
隔离以防止病毒传播

Recovery from Ebola depends
支持性治疗

on good supportive care
和病人的免疫应答

and the patient’s immune response.
决定疾病能否痊愈

Now could you answer
现在你能回答有关

all the questions on the case?
前面的案例的问题吗？

Trust you can get them all correct!
相信你都能正确回答！

That is all for this session.
以上是本节课的全部内容

As for the other viruses
请同学们自学

causing hemorrhagic fever,
其他引起出血热

please go through by yourself.
的病毒

Thank you for your attention.
谢谢同学们