2012-2015年广东省活禽市场外环境禽流感病毒污染状况研究

研究广东省活禽市场外环境禽流感病毒污染状况并及时发现人流感发病潜在的危险因素,为人流感防治提供科学参考依据。应用传染病技术监测平台信息管理系统数据,采用描述性流行病学方法分析各种亚型病毒感染的流行病学特征,研究2012-2015年广东省活禽市场外环境禽流感病毒污染。共采集检测广东省21个地市级样本33079份,FluA 总阳性率为24．23％,H5、H7和 H9型高致病性禽流感病毒阳性率分别为3．70％、3．89％和13．53％;除2012年阳性率呈现季节性增加外,其他年份 FluA 核酸检测阳性率均在冬春季出现一个高峰。不同部位或地点采集的标本中,宰杀或摆放禽肉案板表面阳性率最高（FluA39．49％,H58．41％,H77．41％,H923．84％）,而采集的粪便标本阳性率最低（FluA14．99％,H51．73％、H72．38％、和 H97．23％）;所采集的标本所对应的相关动物种类中,鸡（64．08％）、鸭（55．84％）和鸟类（51．92％）的禽流感病毒阳性率都达到50％以上,H5、H7和 H9在各禽类中均可以检出。同时发现,在环境中检出 H7亚型多的地区分布与其相应地区 H7N9感染的病例数呈显著相关性,（r ＝0．689,P ＜0．05）;对2322份样本进行 H6亚型核酸检测,总阳性率为2．58％,并选取 H5、H6和 H9亚型标本153份进行 N 亚型检测,检测出 H5N1、H5N2、H5N6、H6N2和 H9N2等多种亚型。2012-2015年广东省21个地市活禽市场均存在 HA 亚型（H5、H7、H9和 H6）和 NA 亚型（N1、N2、N6）等多种亚型的污染,污染程度呈现季节性分布,不同样本类型和禽类其禽流感病毒分状况不同,H7亚型的污染严重程度与 H7N9的病例感染数呈正相关性。     

禽流感病毒与人禽流感的研究进展

禽流感病毒(AIV)与甲型流感病毒同属正黏病毒科(Orthonuxoviridae).迄今根据血凝素H,共有16个亚型,神经氨酸酶N共有9个亚型,可组成144种亚型.虽然H1～16均存在于禽中,但迄今已报道可直接感染人的AIV为H5、H7、H9及H10.其中1997年香港特区流行的亚型是H5N1,有18例患者,6例死亡.1999、2000、2004年在中国内地及香港特区感染人的AIV主要是H9N2亚型.有报道,H7N2、H7N3、H7N7、H10N7亚型分别曾在荷兰、美国、加拿大、埃及感染人,但病例数少,且未有患者死亡.     

1997～2006年广州市人禽流感监测分析

目的 在禽畜饲养、销售、宰杀场所和发生人禽流感疫情的疫点开展人感染禽流感的监测,探索禽流感病毒感染人的流行病学特征。方法 采集广州市禽流感相关高危人群的血清样本,用微量血凝抑制半加敏法进行检测。对监测到的H9N2阳性病例和H5N1的感染者进行流行病学调查。结果 近年来广州市禽接触职业人群H9感染率为4．56％(0．51％～10．00％),各年龄组差异无显著性;H5N1患者有多个售卖活禽肉菜市场活动史,1例H9N2患者及1例H5N1感染者无直接接触禽类活动史,另1例H5N1感染者为活禽交易市场禽类宰杀人员。结论 H5N1和H9N2可在相关高危人群造成隐性感染或轻症感染;除禽饲养场所外,农贸市场的活禽销售、宰杀场所也存在禽流感病毒感染的风险。     

2009～2013年我国活禽市场环境样本中禽流感病毒的检测

为了解中国活禽市场环境样本中禽流感病毒分布情况,对全国2009~2013年采自活禽市场的环境样本进行流感病毒核酸检测,并利用无特殊致病原鸡胚(SPF鸡胚)对A型流感病毒核酸阳性标本进行病毒分离。结果显示,环境标本中禽流感病毒核酸阳性率的波动呈明显的季节性趋势,冬春季节核酸检测阳性率较高;我国南方地区活禽市场环境样本的禽流感病毒核酸阳性率高于北方。市场中清洗禽类的污水和宰杀或摆放禽肉案板表面的擦拭样本核酸阳性率高于其它类型的样本。2009~2013年环境样本中分离到的禽流感病毒以H5和H9亚型为主,2013年之前H5亚型多于H9亚型,而2013年H9亚型超过了H5亚型。本研究表明,对城乡活禽市场中禽流感病毒的实时监测具有重要的公共卫生意义,可为我国人感染禽流感病毒的防控和预测预警提供依据。     

苏州活禽市场禽流感病毒(H7N9)季节变化及HA、NA、PB2基因系统进化分析

自2013年3月中国首次发现新型禽流感病毒H7N9以来,其于2013-2014年期间发生流行,2015年也有散发性感染。该病毒的流行不仅危及家禽养殖业,还对公共卫生安全造成严重威胁。为调查活禽市场中H7N9的进化史和季节性变化,本研究于2013年7-12月在H7N9主要流行地区之一江苏省苏州市活禽市场采集2 655份鸡、鸭咽拭子样本,对样本中流感病毒核酸进行检测。结果显示,冬季样本中H7N9阳性率显著高于夏季样本,同时发现样本中存在H5、H7和H9亚型毒株之间的混合感染。进一步对H7N9阳性样本的HA、NA和PB2基因序列进行分析,结果表明阳性样本中HA、NA和PB2基因序列与新型H7N9病毒的相应基因序列同源,其在家禽体内传代时也在继续进化。特别是一些样品中PB2基因序列与H5N1病毒PB2基因序列的同源性较高。结果提示,苏州存在一种新型H7N9病毒基因重排的可能性,建议在活禽市场对所有禽流感病毒亚型进行持续监控,从而有助于流感病毒的及时防控。     

H7亚型禽流感病毒与禽类和人类的关系

2013年在中国首次发生了H7N9亚型流感病毒感染人事件,已经证实H7N9型禽流感是一种新型禽流感,是全球首次发现感染人类的新亚型流感病毒,以往这种病毒只在野生鸟类存在和传播。H7N9型禽流感病毒属于H7亚型中的一种,全球感染人的H7亚型病毒主要分为两大支系,即北美支系和欧亚支系,感染人的流感亚型也主要集中在H7N7,H7N3,H7N2等亚型上。为了清晰的了解H7亚型病毒的来龙去脉,本文重点讨论了A亚型流感病毒的宿主分布、H7亚型病毒感染禽类和人类的历史、H7亚型病毒的生物学特性以及未来研究展望。     

H3亚型鸭源流感病毒聚合酶PB1基因的序列分析

目的阐明H3亚型鸭流感病毒与其他亚型流感病毒的关系。方法对活禽市场分离的3株H3N8亚型鸭源流感病毒聚合酶PB1基因进行了序列分析。结果3株鸭源H3N8流感病毒聚合酶PB1基因核苷酸同源性为99.9%,与H9N2亚型流感病毒(DK/ST/2143/00)的同源性为96.31%~96.44%,而与H3N8亚型鸭流感病毒(Mal/Alberta/279/98)为88.65%~88.79%。系统进化树分析表明,本实验中的3株病毒属于相同的分支,且与A/duck/Hong Kong/Y439为代表的H9N2亚型禽流感病毒位于一进化分支,说明三株H3N8亚型流感病毒重排了H9N2亚型禽流感病毒的基因片段。结论不同亚型禽流感病毒在贮存宿主体内的重排以及重排病毒的新特点如鸭H3N8亚型流感病毒对禽的致病性,应当引起我们的高度重视。     

禽流感病毒H9N2在人肺组织的复制

禽流感病毒H9N2亚型在多种陆禽流行并反复感染哺乳动物猪和人,其对公共卫生安全呈潜在巨大威胁。本文应用体外禽流感病毒H9N2亚型感染人肺组织和免疫组化实验,探讨禽流感病毒H9N2亚型跨种间感染人的机制、H9N2病毒在人肺组织复制特性及组织嗜性。结果显示,禽流感病毒H9N2亚型(Ck/GX/1875/04、Ck/GX/187/05)和季节性人流感病毒H3N2亚型(A/ST/602/05)均可感染人肺组织;免疫组化检测流感病毒核蛋白(Nucleoprotein,NP),病毒复制的主要靶细胞为肺泡细胞、呼吸细支气管上皮细胞和细支气管上皮细胞;免疫组化和免疫荧光双重染色法检测流感病毒感染肺泡类型,禽流感病毒H9N2亚型感染II型肺泡细胞。结果提示,禽流感病毒H9N2可适应宿主人以及在人肺上皮细胞有效复制,病毒持续感染人有助于病毒基因进化进而演变成大流行新型流感病毒的潜能。     

猪流感病毒在世界范围内的流行情况及公共卫生意义

猪流感病毒(Swine influenza virus, SIV)是引起猪的急性呼吸道疾病的重要原发病原之一, 常常与其他病原体混合感染造成更严重的损害。目前, 猪流感(Swine influenza, SI)已遍布美洲、亚洲、欧洲和非洲, 是规模化养猪场普遍存在且难以根除的群发性疾病。猪在流感病毒的种间传播和遗传进化中起着重要的作用, 猪可被禽流感病毒和人流感病毒感染, 因此, 猪被认为是人、禽和/或猪流感病毒通过基因重排产生新的亚型流感病毒的“混合器”。SIV不仅危害猪群, 而且同时具有感染人和禽的潜力。目前世界范围内猪群中流行的SIV亚型主要有3种：H1N1、H3N2和H1N2, 其中包括古典H1N1、类禽H1N1、类人H3N2、基因重排的H3N2和多基因型的H1N2亚型。研究表明, 禽流感病毒、人H3N2亚型病毒和古典猪H1N1亚型病毒在我国猪群中共存, 为产生含有禽流感病毒基因片段的重排病毒创造了条件, 这将对养猪业以及人类公共卫生都具有潜在的威胁。     

猪流感病毒在世界范围内的流行情况及公共卫生意义

猪流感病毒(Swine influenza virus,SIV)是引起猪的急性呼吸道疾病的重要原发病原之一,常常与其他病原体混合感染造成更严重的损害.目前,猪流感(Swine influenza,SI)已遍布美洲、亚洲、欧洲和非洲,是规模化养猪场普遍存在且难以根除的群发性疾病.猪在流感病毒的种间传播和遗传进化中起着重要的作用,猪可被禽流感病毒和人流感病毒感染,因此,猪被认为是人、禽和/或猪流感病毒通过基因重排产生新的亚型流感病毒的"混合器".SIV不仅危害猪群,而且同时具有感染人和禽的潜力.目前世界范围内猪群中流行的SIV亚型主要有3种:H1N1、H3N2和H1N2,其中包括古典H1N1、类禽H1N1、类人H3N2、基因重排的H3N2和多基因型的H1N2亚型.研究表明,禽流感病毒、人H3N2亚型病毒和古典猪H1N1亚型病毒在我国猪群中共存,为产生含有禽流感病毒基因片段的重排病毒创造了条件,这将对养猪业以及人类公共卫生都具有潜在的威胁.     

A Cross-Sectional Study of Avian Influenza in One District of Guangzhou, 2013

Since Feb, 2013, more than 100 human beings had been infected with novel H7N9 avian influenza virus. As of May 2013, several H7N9 viruses had been found in retail live bird markets (LBMs) in Guangdong province of southern China where several human cases were confirmed later. However, the real avian influenza virus infection status especially H7N9 in Guangzhou remains unclear. Therefore, a cross-sectional study of avian influenza in commercial poultry farms, the wholesale LBM and retail LBMs in one district of Guangzhou was conducted from October to November, 2013. A total of 1505 cloacal and environmental samples from 52 commercial poultry farms, 1 wholesale LBM and 18 retail LBMs were collected and detected using real-time RT-PCR for type A, H7, H7N9 and H9 subtype avian influenza virus, respectively. Of all the flocks randomly sampled, 6 farms, 12 vendors of the wholesale LBM and 18 retail LBMs were type A avian influenza virus positive with 0, 3 and 11 positive for H9, respectively. The pooled prevalence and individual prevalence of type A avian influenza virus were 33.9% and 7.9% which for H9 subtype was 7.6% and 1.6%, respectively. None was H7 and H7N9 subtype virus positive. Different prevalence and prevalence ratio were found in different poultry species with partridges having the highest prevalence for both type A and H9 subtype avian influenza virus. Our results suggest that LBM may have a higher risk for sustaining and transmission of avian influenza virus than commercial poultry farms. The present study also indicates that different species may play different roles in the evolution and transmission of avian influenza virus. Therefore, risk-based surveillance and management measures should be conducted in future in this area.     

The continued pandemic threat posed by avian influenza viruses in Hong Kong

In 1997, a highly pathogenic avian H5N1 influenza virus was transmitted directly from live commercial poultry to humans in Hong Kong. Of the 18 people infected, six died. The molecular basis for the high virulence of this virus in mice was found to involve an amino acid change in the PB2 protein. To eliminate the source of the pathogenic virus, all birds in the Hong Kong markets were slaughtered. In 1999, another avian influenza virus of H9N2 subtype was transmitted to two children in Hong Kong. In 2000-2002, H5N1 avian viruses reappeared in the poultry markets of Hong Kong, although they have not infected humans. Continued circulation of H5N1 and other avian viruses in Hong Kong raises the possibility of future human influenza outbreaks. Moreover, the acquisition of properties of human viruses by the avian viruses currently circulating in southeast China might result in a pandemic.     

Influenza virus A (H5N1): a pandemic risk?

Influenza A subtype H5N1 has represented a growing alarm since its recent identification in Asia. Previously thought to infect only wild birds and poultry, H5N1 has now infected humans, cats, pigs and other mammals in an ongoing outbreak, often with a fatal outcome. In order to evaluate the risk factors for human infection with influenza virus H5N1, here we summarize 53 case patients confirmed with H5N1 infection during 2006. The review also compares the mortality rate among human cases from late 2003 until 15 June 2006 in different countries. Neither how these viruses are transmitted to humans nor the most effective way to reduce the risk for infection is fully understood. The association between household contact with diseased poultry in human infection has been demonstrated. This association could possibly operate by 2 mechanisms. First, transmission may be by inhalation or conjunctival deposition of large infectious droplets which may travel only in short distances. Second, having infected poultry in the home and preparation of infected poultry for consumption may result in exposure to higher virus concentrations than other types of exposure. There is so far no significant evidence for repeated human to human transmission, yet some cases of human to human transmission among the family relatives in Indonesia, Azerbaijan, Iraq and Turkey have been described. Recent outbreaks of highly pathogenic avian influenza A virus (H5N1 subtype) infections in poultry and humans (through direct contact with infected birds) have raised concerns that a new influenza pandemic might occur in the near future.     

Pathogenesis of avian influenza (H7) virus infection in mice and ferrets: enhanced virulence of Eurasian H7N7 viruses isolated from humans

Before 2003, only occasional case reports of human H7 influenza virus infections occurred as a result of direct animal-to-human transmission or laboratory accidents; most of these infections resulted in conjunctivitis. An increase in isolation of avian influenza A H7 viruses from poultry outbreaks and humans has raised concerns that additional zoonotic transmissions of influenza viruses from poultry to humans may occur. To better understand the pathogenesis of H7 viruses, we have investigated their ability to cause disease in mouse and ferret models. Mice were infected intranasally with H7 viruses of high and low pathogenicity isolated from The Netherlands in 2003 (Netherlands/03), the northeastern United States in 2002-2003, and Canada in 2004 and were monitored for morbidity, mortality, viral replication, and proinflammatory cytokine production in respiratory organs. All H7 viruses replicated efficiently in the respiratory tracts of mice, but only Netherlands/03 isolates replicated in systemic organs, including the brain. Only A/NL/219/03 (NL/219), an H7N7 virus isolated from a single fatal human case, was highly lethal for mice and caused severe disease in ferrets. Supporting the apparent ocular tropism observed in humans following infection with viruses of the H7 subtype, both Eurasian and North American lineage H7 viruses were detected in the mouse eye following ocular inoculation, whereas an H7N2 virus isolated from the human respiratory tract was not. Therefore, in general, the relative virulence and cell tropism of the H7 viruses in these animal models correlated with the observed virulence in humans.     

Cross-reactive, cell-mediated immunity and protection of chickens from lethal H5N1 influenza virus infection in Hong Kong poultry markets

In 1997, avian H5N1 influenza virus transmitted from chickens to humans resulted in 18 confirmed infections. Despite harboring lethal H5N1 influenza viruses, most chickens in the Hong Kong poultry markets showed no disease signs. At this time, H9N2 influenza viruses were cocirculating in the markets. We investigated the role of H9N2 influenza viruses in protecting chickens from lethal H5N1 influenza virus infections. Sera from chickens infected with an H9N2 influenza virus did not cross-react with an H5N1 influenza virus in neutralization or hemagglutination inhibition assays. Most chickens primed with an H9N2 influenza virus 3 to 70 days earlier survived the lethal challenge of an H5N1 influenza virus, but infected birds shed H5N1 influenza virus in their feces. Adoptive transfer of T lymphocytes or CD8(+) T cells from inbred chickens (B(2)/B(2)) infected with an H9N2 influenza virus to naive inbred chickens (B(2)/B(2)) protected them from lethal H5N1 influenza virus. In vitro cytotoxicity assays showed that T lymphocytes or CD8(+) T cells from chickens infected with an H9N2 influenza virus recognized target cells infected with either an H5N1 or H9N2 influenza virus in a dose-dependent manner. Our findings indicate that cross-reactive cellular immunity induced by H9N2 influenza viruses protected chickens from lethal infection with H5N1 influenza viruses in the Hong Kong markets in 1997 but permitted virus shedding in the feces. Our findings are the first to suggest that cross-reactive cellular immunity can change the outcome of avian influenza virus infection in birds in live markets and create a situation for the perpetuation of H5N1 influenza viruses.     

Indications that live poultry markets are a major source of human H5N1 influenza virus infection in China

Human infections of H5N1 highly pathogenic avian influenza virus have continued to occur in China without corresponding outbreaks in poultry, and there is little conclusive evidence of the source of these infections. Seeking to identify the source of the human infections, we sequenced 31 H5N1 viruses isolated from humans in China (2005 to 2010). We found a number of viral genotypes, not all of which have similar known avian virus counterparts. Guided by patient questionnaire data, we also obtained environmental samples from live poultry markets and dwellings frequented by six individuals prior to disease onset (2008 and 2009). H5N1 viruses were isolated from 4 of the 6 live poultry markets sampled. In each case, the genetic sequences of the environmental and corresponding human isolates were highly similar, demonstrating a link between human infection and live poultry markets. Therefore, infection control measures in live poultry markets are likely to reduce human H5N1 infection in China.     

H9N2 influenza virus in China: a cause of concern

The recent human infection with avian influenza virus revealed that H9N2 influenza virus is the gene donor for H7N9 and H10N8 viruses infecting humans. The crucial role of H9N2 viruses at the animal-human interface might be due to the wide host range, adaptation in both poultry and mammalian, and extensive gene reassortment. As the most prevalent subtype of influenza viruses in chickens in China, H9N2 also causes a great economic loss for the poultry industry, even under the long-term vaccination programs. The history, epidemiology, biological characteristics, and molecular determinants of H9N2 influenza virus are reviewed in this paper. The contribution of H9N2 genes, especially RNP genes, to the infection of humans needs to be investigated in the future.     

H7N9禽流感病毒与其他流感病毒对雪貂致病性与传播力的比较

目的针对2013年3月中国爆发的人感染H7N9禽流感病毒,在雪貂体内进行致病性及传播力的研究,并与甲型H1N1流感病毒、H5N1禽流感病毒进行比较。方法对新发H7N9毒株、甲型H1N1流感病毒、H5N1禽流感病毒感染雪貂后的临床症状、体征,呼吸道排毒情况,组织病理学变化等进行评价和比较,并对H7N9毒株在雪貂群体中的传播力进行研究。结果雪貂模型的临床症状、死亡率、病毒传播以及组织病理学分析显示:H7N9病毒的致病性低于H5N1,与2009年起源于北美的甲型H1N1流感病毒相当。新发H7N9禽流感病毒可以在雪貂的呼吸道、心脏、肝脏以及嗅球进行复制。值得注意的是H7N9禽流感可以通过飞沫在雪貂间进行低水平的传播,并且在传播过程中,病毒基因组内有多个位点的氨基酸发生了替换。结论 H7N9禽流感病毒对雪貂的致病性较H5N1禽流感病毒低,与甲型H1N1流感病毒对雪貂的致病性相当,H7N9禽流感病毒可在雪貂间进行传播。     

Investigation of avian influenza virus in poultry and wild birds due to novel avian-origin influenza A(H10N8) in Nanchang City,China

Multiple reassortment events within poultry and wild birds had resulted in the establishment of another novel avian influenza A(H10N8) virus, and finally resulted in human death in Nanchang, China. However, there was a paucity of information on the prevalence of avian influenza virus in poultry and wild birds in Nanchang area. We investigated avian influenza virus in poultry and wild birds from live poultry markets, poultry countyards, delivery vehicles, and wild-bird habitats in Nanchang. We analyzed 1036 samples from wild birds and domestic poultry collected from December 2013 to February 2014. Original biological samples were tested for the presence of avian influenza virus using specific primer and probe sets of H5, H7, H9, H10 and N8 subtypes by real-time RT-PCR. In our analysis, the majority (97.98%) of positive samples were from live poultry markets. Among the poultry samples from chickens and ducks, AIV prevalence was 26.05 and 30.81%, respectively. Mixed infection of different HA subtypes was very common. Additionally, H10 subtypes coexistence with N8 was the most prevalent agent during the emergence of H10N8. This event illustrated a long-term surveillance was so helpful for pandemic preparedness and response.