流感病毒与流感疫苗 - Influenza and Influenza Vaccines.ppt

Influenza and Influenza Vaccines Clinician’s Outreach and Communication Activity 2007-2008 Season Influenza Highly infectious viral illness Epidemics reported since 16th century Virus first isolated in 1933 Influenza Virus Strains Type A moderate to severe illness all age groups humans and other animals  Type B changes less rapidly than type A milder epidemics humans only primarily affects children Surface Antigens and Immunity Immunity reduces likelihood of infection and severity of disease Antibodies are specific to different types of surface antigens Changes in H and N allow virus to evade previously developed immune responses Antigenic changes: drift and shift Influenza Antigenic Changes Antigenic Drift Minor change, same subtype Caused by point mutations in gene May result in epidemic Example of antigenic drift In 2003-2004, A/Fujian/411/2002-like (H3N2) virus was dominant A/California/7/2004 (H3N2) began to circulate and became the dominant virus in 2005 Influenza Antigenic Changes Antigenic Shift Major change, new subtype Caused by exchange of gene segments May result in pandemic Example of antigenic shift H2N2 virus circulated in 1957-1967 H3N2 virus appeared in 1968 and completely replaced H2N2 virus Burden of Influenza 10% to 20% of the population is infected with influenza virus each year Average of more than 200,000 excess hospitalizations each year Persons 65 and older and 2 years and younger at highest risk Average of 36,000 deaths each year Persons 65 and older at highest risk of death Influenza Associated Pulmonary and Circulatory Deaths, 1998 Hospitalization Rates for Influenza By Age and Risk Group* Influenza Epidemiology Reservoir Human, animals (type A only) Transmission Respiratory Probably airborne Temporal pattern Peak December - March in temperate area May occur earlier or later Communicability Maximum 1-2 days before to 4-5 days after onset Influenza Seasonal Trends Infl