Diseases Caused by Enteroviruses在线视频

Viruses transmitted through
粪口途径传播

fecal-oral route.
的病毒

I'm Gang XIN from Department
大家好，我是辛岗老师

of Microbiology and Immunology,
来自中国

Shantou University
汕头大学医学院

Medical College, China.
微生物与免疫学教研室

Viruses transmitted by fecal-oral route
通过粪口途径传播的病毒

include enteroviruses
包括肠道病毒

and viruses causing
和

acute gastroenteritis.
急性肠胃炎病毒

These viruses can infect humans
这些病毒会通过

through gastrointestinal (GI) tract.
胃肠道感染人类

Please remember
请记住

the enteroviruses,
肠道病毒

despite its name,
尽管它的名字和肠道有关

usually do not upset the GI tract.
通常不会扰乱胃肠道的功能

We have other viruses
还有其他病毒

that actually cause gastroenteritis.
会导致胃肠炎

This chapter will cover
本章将讨论

the following viruses.
以下几种病毒

The enteroviruses,
肠道病毒

which belong to Picornaviridae,
属于小RNA病毒科

include poliovirus,
肠道病毒包括脊髓灰质炎病毒

coxsackievirus A and B,
A组和B组柯萨奇病毒

echovirus and
埃可病毒

enterovirus 68 to 71, etc.
以及68至71型肠道病毒等

The viruses causing acute
急性肠胃炎病毒包括

gastroenteritits include Reoviridae,rotavirus;
呼肠病毒科 轮状病毒

Adenoviridae,
腺病毒科

enteric adenovirus;
肠道腺病毒

Caliciviridae, norovirus;
杯状病毒科 诺如病毒

and Astroviridae, astrovirus.
和星状病毒科的星状病毒

The learning objectives
本章的

of this chapter.
学习目标是

At the end of this chapter,
在本章学习结束后

you should be able to
你应该能够

1. Describe the biological properties
1.描述肠道病毒的生物学特性

(e.g. core, receptor-binding site,
(例如核心，受体结合位点

no envelope) of enteroviruses,
没有包膜)

and discuss the relationship
并讨论

between these properties
这些特点

and the clinical findings.
和临床表现之间的关系

2. List the clinical conditions
2.列举肠道病毒和

caused by enteroviruses
急性肠胃炎病毒

and viruses causing
所致疾病的

acute gastroenteritis;
临床表现

3. Discuss the possibility
3.讨论消灭

of the eradication of poliomyelitis;
脊髓灰质炎的可能性

4. Compare the pathogenicity
4.比较肠道病毒和

of enteroviruses with that of viruses
急性肠胃炎病毒

causing acute gastroenteritis.
的致病性

Let's start from enteroviruses.
让我们从肠道病毒开始

A case
病例

A 12-year-old girl developed
12岁女孩

chest pain and difficulty breathing,
感到胸痛和呼吸困难

which gradually worsened.
逐渐加重

She was seen in the Emergency Department
急诊就诊时发现

where heart failure were noted.
伴有心力衰竭

Electrocardiographic (ECG)
心电图

changes were present
出现异常

and chest X-ray
胸部X光检查

revealed an enlarged heart.
显示心脏体积增大

An enterovirus was isolated
从她的粪便中

from a stool specimen.
分离出一种肠道病毒

Which of the following
以下哪一项

is the most likely agent?
是最有可能的病原体？

A.Poliovirus 3
A.脊髓灰质炎病毒3

B.Coxsackievirus A
B.柯萨奇病毒A

C.Coxsackievirus B
C.柯萨奇病毒B

D.Echovirus 11
D.埃可病毒11型

E.Enterovirus 70
E.肠道病毒70型

What is your choice?
你的选择是什么？

You may see these key words.
你可能注意到了这些关键词

The patient was a 12-year-old girl,
病人是一名12岁的女孩

a teenager.
是青少年

She had chest pain
她感到胸痛

and difficulty breathing,
呼吸困难

and was noted to have heart failure,
同时被发现心力衰竭

and big heart.
和心脏增大

But the virus was isolated from stool,
但病毒是从粪便中分离出来的

and it's an enterovirus.
是一种肠道病毒

You may think it is interesting.
你可能也觉得这很有意思

The virus may enter through
病毒通过胃肠道

GI tract,
进入

but cause heart problem.
却导致心脏的问题

And the choices actually
五个选项实际上

are the species of enteroviruses.
都是肠道病毒

Enteroviruses include poliovirus,
肠道病毒包括脊髓灰质炎病毒

coxsackievirus,
柯萨奇病毒

enteric cytopathogenic
人肠道致细胞病变孤儿病毒

human orphan virus (ECHO)
（埃可病毒）

and New enterovirus (EV).
和新型肠道病毒

Coxsackieviruses are named
柯萨奇病毒是以

after the town of Coxsackie,
柯萨奇镇命名的

where they were first isolated.
最初是在那里被分离出来的

The name echovirus is derived from
埃可病毒的名字来源于

enteric cytopathogenic
人肠道致细胞病变孤儿病毒

human orphan virus.
的首字母

Can you guess why we call a virus
你能猜出为什么把这种病毒

an orphan virus?
称作孤儿病毒吗？

Another orphan virus is reovirus.
另一种孤儿病毒是呼肠病毒

The '-o-' in the middle
中间的“-o-”

also refers to 'orphan'.
也是指“孤儿”

The 'orphan' tells us
“孤儿”提示我们

that the disease associated with these
病原体最初分离时

agents was not initially known.
并不知道相应疾病是什么

At least 90 serotypes
人类肠道病毒至少

of human enteroviruses exist
有90种血清型

and are classified as polioviruses,
分为脊髓灰质炎病毒

coxsackieviruses A and B,
A,B组柯萨奇病毒

echoviruses,
埃可病毒

or for the more recently
和新近发现的

discovered viruses,
新型肠道病毒

as numbered enteroviruses
按发现顺序命名

(e.g., enterovirus 71).
例如，肠道病毒71型

At beginning,
最初

the viruses were identified
病毒是通过

by the properties
感染新生小鼠

of infecting newborn mice,
猴或

monkey or cultivating cells
人或猴的培养细胞

of monkey and humans.
来区分的

If the viruses can infect monkey
如果病毒能感染猴

and cultivating cells,
和培养的细胞

the viruses are polioviruses.
那病毒为脊髓灰质炎病毒

And if the viruses only infect
如果病毒只感染

newborn mice,
新生小鼠

they are coxsackieviruses.
它们就是柯萨奇病毒

If the viruses only infect cells,
如果病毒只感染细胞

they are echoviruses.
它们是埃可病毒

Since 1969,
自1969年以来

new enterovirus types
新型肠道病毒

have been assigned as number.
以发现顺序编号命名

Before we leave this slide,
另外需要记住

I just want to point out there are
脊髓灰质炎病毒

three serotypes of polio viruses
有三种血清型

(Poliovirus type 1, 2 and 3).
（脊髓灰质炎病毒1，2，3型）

Diseases caused by the enteroviruses.
肠道病毒相关疾病

Several different disease syndromes may be
一种肠道病毒血清型

caused by a specific serotype
可以引起几种不同的

of enterovirus.
疾病综合征

Likewise,
同样的

several different serotypes
几种不同的血清型

may cause the same disease,
也可能引起相同的疾病

depending on the target tissues.
这取决于其靶组织

Diseases include poliomyelitis.
疾病包括脊髓灰质炎

The 'polio' means gray,
“polio-”意思是灰色

'myelo' means 'spinal cord,
“myelo-”意思是“脊髓”

and '-itis' means inflammation.
“-itis”后缀表示炎症

So the disease is inflammation
所以这个疾病是

of the gray matter of the spinal cord.
脊髓灰质的炎症

We will discuss poliomyelitis
稍后我们将

in detail later.
详细讨论脊髓灰质炎

Another diseases caused by enterovirus.
肠道病毒引起其他疾病

The boy presents with oral ulcers,
这个男孩患有口腔溃疡

vesicular rash of the hands and feet.
手和脚上出现水疱性皮疹

What disease?
这是什么病？

Yes, hand-foot-and-mouth disease
对，手足口病

(HFMD).
(HFMD）

The disease could be caused by
可由

Cox A16 and EV71.
柯萨奇病毒A16和肠道病毒71型引起的

Herpangina is a severe
疱疹性咽峡炎是一种严重的

febrile pharyngitis,
发热性咽炎

and is caused by several types
由几种A组柯萨奇病毒

of coxsackievirus A.
引起

Coxsackievirus A is associated with
A组柯萨奇病毒与

diseases involving vesicular lesions.
水疱病变的疾病有关

The disease is self-limiting and
本病是自限性疾病

requires only symptomatic management.
只需要对症治疗

Aseptic meningitis
无菌性脑膜炎

Almost all types of enteroviruses
几乎所有类型的肠道病毒

can cause viral (aseptic) meningitis.
都能引起病毒性(无菌性)脑膜炎

Common symptoms are fever,
常见症状有发热

malaise, headache, nausea,
不适，头痛，恶心

and abdominal pain.
和腹痛

The disease could be fatal.
本病可以引起死亡

Cardiac and muscular disease
心脏和肌肉疾病

Coxsackievirus B (B for body)
B组柯萨奇病毒 (B代表身体)

is most frequently associated
最常与胸痛

with pleurodynia and myocarditis.
和心肌炎相关

Pleurodynia is an acute illness
胸痛是一种急性病

in which patients
患者会

have a sudden onset of fever
因为胸膜受感染

and stabbing chest pain
而突然发热

due to the inflammation
并感到胸口

of the pleura..
刀割般的疼

The disease is self-limiting
疾病具有自限性

and recovery is complete.
能够彻底痊愈

Myocarditis is an acute inflammation
心肌炎是

of the heart or pericarditis,
由B组柯萨奇病毒引起的

caused by coxsackievirus B.
心脏或心包的急性炎症

Ocular: acute hemorrhagic conjunctivitis
眼部:急性出血性结膜炎

Enterovirus 70
肠道病毒70型

and a variant of coxsackievirus A24
和柯萨奇病毒A24型的变异株

have been associated with the
被认为与

extremely contagious ocular disease,
一种极具传染性的眼部疾病

acute hemorrhagic conjunctivitis.
即急性出血性结膜炎有关

The disease has a
这种病

24-hour incubation period
潜伏期24小时

and resolves within 1 or 2 weeks.
会在1或2周内痊愈

Respiratory infections
呼吸道感染

Fever, rash, and common
感染了埃可病毒

coldlike symptoms may occur in patients
或柯萨奇病毒的病人

infected with echoviruses
可能会出现

or coxsackieviruses.
发热、皮疹和常见的类似感冒的症状

Coxsackieviruses A21 and A24
柯萨奇病毒A21和A24

and echoviruses 11 and 20
和埃可病毒11和20

can cause rhinovirus-like symptoms
可引起鼻病毒样的症状

resembling the common cold.
与普通感冒相似

Coxsackievirus B infections
B组柯萨奇病毒感染

of the beta cells of the pancreas
胰腺β细胞

are a major cause of
造成胰岛的

type 1 insulin-dependent diabetes
免疫功能被破坏

as a result of immune destruction
是1型糖尿病

of the islets of Langerhans.
的主要病因

Pathogenesis of enterovirus infections
肠道病毒感染的发病机制

Contrary to their name,
与它们的名字相反

enteroviruses do not
肠道病毒通常不会

usually cause enteric disease,
导致肠道疾病

but they do replicate within
它们在肠道

and are transmitted by
复制增殖

the fecal-oral route.
并通过粪口途径传播

The viruses are acquired
病毒通过

through mouth,
口腔进入人体

then infect intestine.
后感染肠道

Viremia, virus in blood stream,
病毒血症，病毒通过血液

spreads the virus to
播散到

different target tissues.
不同的靶组织

Then the enteroviruses cause
然后引起

diseases of central nervous system,
中枢神经系统的疾病

conjunctivitis,
结膜炎

mucous membranes,
粘膜

and upper and lower respiratory tract.
和上、下呼吸道疾病

Also, diseases of skin,
还有，皮肤病

heart and muscles.
心脏和肌肉的疾病

Then the virus excrete from stool.
最后病毒从粪便中排出

Please note,
请注意

although they may initiate infection
尽管最初通过

in the gastrointestinal tract,
胃肠道的感染

the enteroviruses rarely cause
但肠道病毒

enteric disease.
几乎不引起肠道疾病

Let's have a break.
现在休息一下

We will discuss about
回来后

poliovirus infection
我们将讨论

when we come back.
脊髓灰质炎病毒的感染