哈尔滨医科大学：《医学微生物学》课程教学资源（PPT课件）出血热病毒

第3章 Hemorrhagic Feyer Virus 出血热病毒 Department of Microbiology, HMU DHfffenep

Hemorrhagic Fever Virus 出血热病毒 Department of Microbiology, HMU 第34章

a Haemorrhagic Fever with Renal Syndrome(HFRS: later renamed hantavirus disease, HVD)first recognized in Heilongjiang, China in the 1930s, and came to the attention of the West during the Korean war when over 3000 UN troops were afflicted It transpired that the disease was not new and had been described by the Chinese 1000 years earlier In 1974, the causative was isolated from the Korean Stripped field mice and was called Hantaan virus In 1995, a new disease entity called hantavirus pulmonary syndrome was described in the"four corners" region of the U.s

◼ Haemorrhagic Fever with Renal Syndrome (HFRS: later renamed hantavirus disease, HVD) first recognized in Heilongjiang, China in the 1930s, and came to the attention of the West during the Korean war when over 3000 UN troops were afflicted ◼ It transpired that the disease was not new and had been described by the Chinese 1000 years earlier ◼ In 1974, the causative was isolated from the Korean Stripped field mice and was called Hantaan virus ◼ In 1995, a new disease entity called hantavirus pulmonary syndrome was described in the “four corners” region of the U.S

病毒体 irion Forms a separate genus in the Bunyavirus family布尼雅 病毒科 Unlike other bunyaviridae, its transmission does not involve an arthropod vector Enveloped -SSRNA virus 糖蛋白G1 Virions 98nm in diameter with 糖蛋白G2 a characteristic square grid M 包膜 like structure RNA末端结合点 核蛋白与RNA Genome consists of three RNA Segments: L, M, and S

病毒体 Virion ◼ Forms a separate genus in the Bunyavirus family 布尼雅 病毒科 ◼ Unlike other bunyaviridae, its transmission does not involve an arthropod vector ◼ Enveloped -ssRNA virus ◼ Virions 98nm in diameter with a characteristic square grid￾like structure. ◼ Genome consists of three RNA segments: L, M, and S

基于中和试验的血清型 Subtypes of Hantaviruses Based NT ■黑线姬鼠型 褐家鼠型 欧洲棕背鼠型 ■草原田鼠型 巴尔干姬鼠型 小家鼠型

基于中和试验的血清型 Subtypes of Hantaviruses Based NT ◼ 黑线姬鼠型 ◼ 褐家鼠型 ◼ 欧洲棕背鼠型 ◼ 草原田鼠型 ◼ 巴尔干姬鼠型 ◼ 小家鼠型

根据抗原和基因结构分型(10型) Hantaan(汉滩型) Porrogia and related viruses -This group is found in China, Eastern USSR, and some parts of S. Europe. it is responsible for the severe classical type of hantavirus disease. It is carried by stripped field mice Apodemus agrarius Seoul type(汉城型) e associated with moderate hantavirus disease. It is carried by rats and have a worldwide distribution. It has been identified in China, Japan, Westem USSR. USA and S america Puumala type mainly found in Scandinavian countries, France, UK and the Western It is carried by bank voles( Clethrionomys glareolus)and causes mild hantavirus disease(nephropathia epidemica) Sin Nombre(辛诺柏型) found in many parts of the US, Canada and Mexico. Carried by the Deer Mouse( Peromyscus maniculatus)and causes hantavirus pulmonary syndrome

根据抗原和基因结构分型（10型） ◼ Hantaan（汉滩型） ◆ Porrogia and related viruses - This group is found in China, Eastern USSR, and some parts of S. Europe. It is responsible for the severe classical type of hantavirus disease. It is carried by stripped field mice. (Apodemus agrarius) ◼ Seoul type（汉城型） ◆ associated with moderate hantavirus disease. It is carried by rats and have a worldwide distribution. It has been identified in China, Japan, Western USSR, USA and S.America. ◼ Puumala type ◆ mainly found in Scandinavian countries, France, UK and the Western USSR. It is carried by bank voles (Clethrionomys glareolus) and causes mild hantavirus disease (nephropathia epidemica). ◼ Sin Nombre（辛诺柏型） ◆ found in many parts of the US, Canada and Mexico. Carried by the Deer Mouse (Peromyscus maniculatus) and causes hantavirus pulmonary syndrome

流行病毒学 Epidemiology Natural host: Rodent apodemus agrarius ( Stripped field mice,黑线姬鼠) 传染源:黑线姬鼠、褐家鼠、大林姫鼠 Viral contamination comes from rodent urine stool, salivary secretion a Seasonal and regional distribution (autumn and winter, Oct.-Jan) The infection route is still uncertain. The possible entries are respiratory tract, mouth and direct contact

流行病毒学 Epidemiology ◼ Natural host: Rodent Apodemus agrarius (Stripped field mice, 黑线姬鼠) ◼ 传染源：黑线姬鼠、褐家鼠、大林姬鼠 ◼ Viral contamination comes from rodent urine, stool, salivary secretion ◼ Seasonal and regional distribution (autumn and winter, Oct.-Jan.) ◼ The infection route is still uncertain. The possible entries are respiratory tract, mouth, and direct contact

Rodent carriers of hantaviruses Stripped field mouse(Apodemus agrarius) Bank vole(Clethrionomys glareolus) Deer Mouse(Peromyscus maniculatus) Rat(Rattu

Rodent Carriers of Hantaviruses Stripped field mouse (Apodemus agrarius) Bank vole (Clethrionomys glareolus) Deer Mouse (Peromyscus maniculatus) Rat (Rattus)

临床特点 Clinical Features Incubation: 2 weeks, HFRS a Pathogenesis mechanism is unknown Immunological reaction may play role ■极低的隐性感染率 Very low subclinical infection rate (1-4%) 病后稳定的免疫力,一般不再发病 Stable humoral immunity. no repeat infection

临床特点 Clinical Features ◼ Incubation: 2 weeks, HFRS ◼ Pathogenesis mechanism is unknown. Immunological reaction may play role ◼ 极低的隐性感染率 Very low subclinical infection rate (1-4%) ◼ 病后稳定的免疫力，一般不再发病 Stable humoral immunity. no repeat infection

致病性 Pathogenesis a The multisystem pathology of HVD is characterized by damage to capillaries and small vessel walls, resulting in vasodilation and congestion with hemorrhages Classically, hantavirus disease consists of 5 distinct phases. These phases may be blurred in moderate or mild cases

致病性 Pathogenesis ◼ The multisystem pathology of HVD is characterized by damage to capillaries and small vessel walls, resulting in vasodilation and congestion with hemorrhages ◼ Classically, hantavirus disease consists of 5 distinct phases. These phases may be blurred in moderate or mild cases

■ Febrile phase发热期 e abrupt onset of a severe flu-like illness with a erythematous rash after an incubation period of 2-3 days Hypotensive phase低血压期 begins at day 5 of illness Oliguric phase少尿期 4 begins at day 9 of illness The patient may develop acute renal failure and shock. Haemorrhages are usually confined to petechiae. The majority of deaths occur during the hypotensive and oliguric phases Diuretic phase多尿期 o occurs between days 12-14 Convalescent phase恢复期 o may require up to 4 months

◼ Febrile phase 发热期 ◆ abrupt onset of a severe flu-like illness with a erythematous rash after an incubation period of 2-3 days ◼ Hypotensive phase 低血压期 ◆ begins at day 5 of illness ◼ Oliguric phase 少尿期 ◆ begins at day 9 of illness. The patient may develop acute renal failure and shock. Haemorrhages are usually confined to petechiae. The majority of deaths occur during the hypotensive and oliguric phases ◼ Diuretic phase 多尿期 ◆ occurs between days 12-14 ◼ Convalescent phase 恢复期 ◆ may require up to 4 months