【体外膜肺ECMO精品课件】 Rodent-Borne Viral Diseases.pptVIP

Rodent-Borne Viral Diseases Chapter 38 Rodent-Borne Viral Diseases Rodents act as both vector and reservoir Usually nonpathogenic in rodents Viruses often speciate with their rodent reservoirs Two principal groups Bunyaviruses Hantaviruses Arenaviruses Hantaviruses Family Bunyaviridae Genus Hantavirus Negative sense ssRNA Tripartite segmented genome S = nucleocapsid M = Gn/Gc glycoproteins L = RNA polymerase Enveloped 70 nm particles Hantavirus Transmission Cycle Spillover from aerosolized excreta Horizontal Transmission Urine Feces Throat swab Blood (acute) Hantaviruses probably originated in shrews, moles or bats, then jumped to rodents and diverged Hantavirus Disease (Pre-1993) Hemorrhagic Fever with Renal Syndrome (HFRS) Nephritis Eurasia Ancient China WWI WW2 Korean War Virus isolation 1976 (Hantaan virus) 100,000 to 200,000 cases each year (5% mortality) First recognized in 1993 Four-Corners outbreak Specific to the Americas Acute febrile illness associated with headache, malaise and myalgia Progression to ARDS within 4-6 days characterized by thrombocytopenia, pulmonary edema, dyspnea and hypoxia 36% fatality rate due to cardiovascular shock Rapid, dramatic clinical progression Viral target: capillary endothelial cells Supportive care Extracorporeal membrane oxygenation (ECMO) Relieves stress on heart Hantavirus Cardiopulmonary Syndrome U. S. Distribution of Hantavirus Cases Colorado Hantavirus Cases 67 cases, 25 fatal, through 2009 Nonfatal Fatal County Interleukin-1β Interleukin-2 Interleukin-4 Interferon-γ Tumor necrosis factor Lymphotoxin The Role of Cytokines in Pulmonary Hantavirus Infections Pro-inflammatory No direct viral cytopathology Cytokine-mediated immunopathology Proliferation of Deer Mouse T Cells to SNV KLH-specific T cells (uninfected deer mice) SNV N-Ag-specific T cells (infected deer mice) Acute Infection KLH-specific T cells (uninfected deer mice) SNV N-Ag-specific T cells (infected deer mice) Persistent Infection Culture for Cytokine