HFRS合并肾病综合征的出血热

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1、HemorrhagicFeverwithRenalSyndromeDepartmentofInfectiousDiseasesThirdAffiliatedHospitalofSunYat-senUniversityLinYang■Definition▲Infectiousdiseaseswithnaturalsource▲Pathogen:Hantanvirus▲Characterizedbyfever,hemorrhage,proteinuria,shockandacuterenalfailure.Fivephasesinth

2、etypicalcasesFebrilephase,Hypotensive(shock)phase,Oliguricphase,Diureticphase,Convalescentphase2EpidemicHemorrhagicFever(EHF)SuggestednamebyWHOin1982:HemorrhagicFeverwithRenalSyndrome(HFRS)3Hantanvirus▲MemberofthefamilyofBunyaviridae▲FeatureofvirusSingle-strandnegativ

3、eRNAvirusCircularorovalinshape78~210nmindiameterEnvelopeproteins:glycoprotein1(G1)glycoprotein2(G2)Viralgenome—RNA:LMSgene■Etiology4ViralproteinsL---PolymeraseM---EnvelopeproteinG1andG2themembraneantigenG2:containneutrolizationantigen(vaccineantigen)S---Nucleocapsidpr

4、otein:strongantigenicityandimmunogenicity,andcontainingcomplementbindingantigen.5▲SerologictypeofHantanvirusOvertwentyserologictypeshantaanvirus(typeI,HTNV)(汉滩病毒)seoulvirus(typeII,SEOV)(汉城病毒)puumalavirus(typeIII,PUUV)(普马拉病毒)prospecthillvirus(typeIV,PHV)(希望山病毒)dobrava-

5、belgradevirus(DEOV)(多布拉伐病毒)6HumanHFRS:causedbyfourtypeofvirus:hantaanvirus(typeI,HTNV)seoulvirus(typeII,SEOV)puumalavirus(typeIII,PUUV)dobrava-belgradevirus(DEOV)China:HantaanvirusSeoulvirushantaanvirusandDEOVshowstrongerpathogenicitythantypeIIandIIIvirus7▲Resistanceo

6、fvirusLowresistance:Inactivatedbyacid(

7、(长尾黄鼠)▶LaboratoryRats▶Otheranimals:catsdogsrabbitsPatients:unimportantInfectedfieldrats,houserats9Apodemusagrarius黑线姬鼠Musnorvegicus褐家鼠102.Modesoftransmission:Five1>.Air-bornetransmissionviainhaleaerosolcontaminatedwithvirus-containingexcretionorsecretionofrats2>.Food-

8、bornetransmissionviaoralandesophagealmucosa(eatfoodcontaminatedwithvirus-containingexcretionorsecretionofrats)113>.Infection