MedicalMicrobiologyDepartmentofMicrobiology,

HMU第三篇醫(yī)學(xué)相關(guān)病毒第31章腸道感染病毒Gastrointestine-InfectedViruses微生物學(xué)教研室鐘照華教學(xué)大綱掌握內(nèi)容腸道病毒種類及共同特性脊髓灰質(zhì)炎病毒主要生物學(xué)性狀、致病性、微生物學(xué)檢查法及防治原則柯薩奇病毒分組、分型及致病性熟悉內(nèi)容?？刹《?、腸道病毒70型、腸道病毒71型的致病性GroupsandSerotypesPicornaviridae（小RNA病毒科）Atleast71serotypes,dividedinto4subgroupsPolioviruses（脊髓灰質(zhì)炎病毒）Coxsackieviruses（柯薩奇病毒）Echoviruses（埃可病毒）Newenteroviruses（新腸道病毒）morerecently,newenterovirusessubtypehavebeenallocatedsequentialnumbers(68-71))EnterovirusesSerotypesMorphology27nm,icosahedralsymmetry,noenvelope腸道病毒特點生物學(xué)性狀小球形病毒（~30nm），無包膜核酸為+ssRNA，有感染性衣殼蛋白VP1-VP3分布在表面，VP4與RNA結(jié)合在胞漿增殖，有明顯CPE，破胞釋放耐酸耐乙醚，但鼻病毒除外引起多種疾病麻痹、無菌性腦膜炎、心肌損傷、腹瀉、皮疹脊髓灰質(zhì)炎病毒（Poliovirus）Firstidentifiedin1909byinoculationofspecimensintomonkeysFirstgrownincellculturein1949whichbecamethebasisforvaccinesTransmissionFecal–oralroute(糞－口途徑)viahandsandobjects viafoodandwaterThefirstwrittenrecordofvirusinfectionAheiroglyphfromMemphis,drawninapproximately1400BC,whichdepictsatemplepriestcalledSiptahshowingtypicalclinicalsignsofparalyticpoliomyelitisFranklinD.RooseveltInthesummerof1921,whenhewas39,disasterhit-hewasstrickenwithpoliomyelitis.Demonstratingindomitablecourage,hefoughttoregaintheuseofhislegs,particularlythroughswimming.免疫性牢固特異免疫，體液免疫為主腸道局部sIgA血液中和性IgG、IgM抗體中和抗體可長時間維持（終生）3型間交叉保護極弱LaboratoryDiagnosisVirusIsolationSerologyCurrentStatusofWildPoliovirusTransmission我國政府規(guī)定每年12月5日和1月5日為脊灰疫苗日。PathogenesisFecal-OralroutetrasmissionSpreadinthebodylikepoliovirusesDiseaseAssociationsParalyticDiseaseMeningitisEncephalitisUndifferentiatedfebrileillnessHandfootmouthdiseaseHerpanginaEpidemicPleurodynia(Bornholmdisease)MyocarditisRespiratoryInfectionsRubelliformrashesNeonatalInfectionConjunctivitisPancreatitis/DiabetesExanthems-RubelliformrashesEVleadingcauseinsummer&fall.AlltypesofrashHand-foot-and-mouthdiseaseHand-foot-and-mouthdisease:mostlycoxackieAfever,malaise,sorethroat,vesiclesonbucalmucosa,tongue,hands,feet,buttockshighlyinfectiousresolution–1wHerpanginaHerpangina–usuallycoxackieAacuteonset,fever,sorethroat,dysphagialesions–posteriorpharynxcanpersistw’snogingivitisLaboratoryDiagnosisVirusIsolationSerologyManagementandPreventionThereisnospecificantiviraltherapyavailableagainstenterovirusesotherthanpolio.IVIGHNIGThereisnovaccineEchovirusesThefirstechoviruseswereaccidentallydiscoveredin1951duringepidemiologicalstudiesofpolioviruses.CPEincellculturesTypesThereare32echoviruses

NogroupAgPathogenesis主要導(dǎo)致無菌性腦炎、類脊髓灰質(zhì)炎等感染后對同型病毒可產(chǎn)生持久免疫診斷困難尚無疫苗預(yù)防以隔離為主NewEnteroviruses4newenteroviruses(68-72)Enterovirus71appearstobehighlypathogenicandhasbeenassociatedwithepidemicsofavarietyofacutediseasesEnterovirus72wasassignedtoanewfamilycalledheptovirusesDiseasesassociatedwithEnterovirusesVirusesCausedAcuteGastroenteritisRotavirusHumanCalicivirus,HuCVSmallRoundStructureVirus,SR