Avian Influenza Pandemic Influenza

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?????? ???????? ?????? ?????????? ??????? ???????
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• Avian Influenza / Pandemic Influenza

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????? ?????????? (Influenza)

• ????? Orthomyxoviridae
• ????????    A, B, C  
• ??? A ???? ??????? (?????? ????????) ????????
• ????? B ? C ?????? ??????? ???

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????? ?????????? A
9 Neuraminidase (NA)
16 Hemagglutinin (HA)

• ??????
• ????? H5 ?H7 ????? ???????
• ???????
• H1, H2, H3
• N1, N2

?????
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???? ????? ?????????? A

• ???? ????? ??????????
• 24-48 ???? ??? ?????? ?????? ???????
• 8-12 ???? ??? ??????? ???????? ????????
• 5 ????? ??? ??????
• ?? ????? ??? ???? ????? 22? ???? 4 ????
• ??? ???? ????? ?????? ???? 30 ???
• ??? ???? ????? 60 ? ???? 30 ?????
• ???? ????????? 70 ?????? ???????

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????? ?????????? A

• ????? ????? ?????????? ???? ?????? ???? ???????
  ??? ???? ?????? ??? ???? ????? ??????? ??? ??
  ???? ??????? ??? ????? ?????? ??? ????? ?????.

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?????? ??????? ????? ???? ????? ??????????

• ?????? ????? ?????????? ?? ?????? ??? ??????? .
• ???? ??? ???? ?????? ?????????? ?? ?????? ???????
  
• ????? ?? ????? ??? ?????
• ??? ???? ????? ?????? ??? ???????
• ???? ?????????
• ??? ?????? ??? ?????? ?????? ???????
• ????? ?????? ???????? ????? ????? ?????? ??
  ??????? ?? ???? ??? ???? ??????? ??????
• ????? (Replication ) ??????? ?? ???????
• ?????? ????? ?? ????? ???? (?? ????? ??? ????)

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??????? ???????? ?? ????? ??????
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???????? ?????? H5N1

• ??? 1997 ????? 18 ????? ?????? ???????? ??????
  ????? H5N1 ?? ???? ????? ???? ???? 6
• ????? 20 ????? ????? 2005 118 ???? ????? ??
  ???????? ?????????? ???????? ??????
• 61???? (51.6)
• ???? ??????? ??? ??????? ??????? ???????

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17 Human Cases 12 Deaths 94 Human Cases 42
Deaths 4 Human Cases 4 Deaths 4 Human
case 3 Deaths
CIDRAP, 8/2005
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????? ??????? ????? ???????? ?????? H5N1
Category 1
Category 2
Category 3
Category 4
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??? ?????? ????? ???????? ?????? H5N1

• ????? ??????? ??? ??????? ??? ?????? ??????? ??
  ???? ?????? ???????
• ????? ?????? ?? ???? ??????? ?? ?????? ??????? ??
  ?????????
• ????? ??? ?????? ?? ???? ??????? ???????? ???????
  ??????? ???????? ?????? ???????
• ??? ???? ?? ???? ?? ?? ???? ???? ?? ????? ???
  ?????

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?? ???? ??????? ?? ???? ?????? ???????

• ?????
• ??????? ????????? ???? ?????? ?????? ??? ??
  ?????? ??????? ?????? ?????? ??? ???? ???????
  ??????? ?? ??? ????
• ?????????
• ???? ??? ???? ???????? ??????
• ???? ??????? ?????
• ???? ????? ????????? ?? ?????? ????????? ??????
  ??????? ???????

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?????? ????? ?????? ?????

• ???? ????? ????? ???????? ?? ??? ???? ???? ?????
  ????? ??? ?????? ???? ????? ????????
• ???? ??????? ??????? 35
• ???? ??????? ??????? ?? 0.6 ??? 2.2

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?????? ????? ?????? ?????

• ?? ??? ???? ?????? ??????? ???????? ??? ????????
  ?????? ?? ???????
• ????? ?????? ????? 1.75????? ??? ?? ???? ??????
• ???? ????? 10 ???? ???

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• ??????? ????? ???????? ?????? ?? ?????? ???????
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16
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• ???? ??????? ??????? ?? ?????? ???????? ???????
• ??? ?????? ???? (???? ?????? ???????? ?????)
• ??? ?????? ?????? ???????? ??? ??????? ?? ???????
  

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• ????? ???? ????? ???? ?????? ?? ?????? ???????
  ????????? ?????? ?? ?? ?? ????? ????? ??????
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• ????? ???? ????? ?? ????????? ????????

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• ????? ????? ????????? ?? ???????? ???????
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• ????? ???????? ??????? ???????? ??????
• ????? ??????? ?????? ???? ??????? ??????
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(No Transcript)
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??????? ????? ?????

• ??? ????? ??????? ????? ????? ?? ????? ?????
  ???????? ??????H5N1 ?? ??????? ???????? ????????
  ???????? ???????

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??????? ????? ?????

• ??? ??? ???????? ??????H5N1 ??? ???????
• ????? ????? ??????? ?? ????? ???? ????? ????????
  ??? ???????? ??? ???? ??????? ?? ???????
• ????? ??????? ???????? ?????? ??????? ?? ???????
• ????? ?????? ??? ??????? ?????? ??????? ??? ?????
  ???? ??????? ????? ????????? ???? ???? ???????
  ?????????

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??????? ????? ?????

• ????? ????????? ?????? ?????? ??????? ???? ??
  ?????? ????? (??? ????????? ????? ?????? ???????
  ???????? ??????? ??????? ?????? ???????? ???????)
• ????? ????? ???????? ??????? ??????? ??????
  ????????? (?? ??? ?????)

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??? ????? ?? ???????

• ????? ???????
• ????? ?????? (Antigen detection by IFA or ELISA)
• PCR

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??????

• ?????? ????????? Oseltamivir ???? 75 ???
• ?????? ??? ????? ????? ???? ???? ????
• ?? ??????? ??????? ?? ????? ??? ??????? ?? ?????
  ??????? ?????? ????? ??? ?????? ?? 150 ??? ?????
  ????? ???? ???? ????
• ???????? ??????? ??????

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???? ????? Prognosis

• ?????? ???????? ?? ????? 1997 ??? ?? ??????? ???
  ?? 6 ????? ????? ???????? ?????? ??????? ???? 48
  ????
• ???? ??????? (Case fatality rate) 33 ?????
  ???????
• ???? ??????? ??????? ???????? ??????? ????? 55

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??? ???? ??? ?????? H5N1

• Hospitalized patients with
• Radiographically confirmed pneumonia
• Acute respiratory distress syndrome
• Other respiratory illness and no alternative
  diagnosis
• History of travel within 10 days of onset to a
  country with documented H5N1 in poultry or humans

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??? ???? ??? ?????? H5N1

• Hospitalized patients with
• Documented temp of gt38C
• Cough
• Sore throat
• Shortness of breath
• History of contact with
• Poultry or domestic birds, or
• Known or suspected patient with influenza H5N1

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??????????? 5607144???? 5686965