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Enteroviruses as agents of emerging infectious diseases

Review. Enteroviruses as agents of emerging infectious diseases. Journal of NeuroVirology, 11: 424–433, 2005. Speaker : 郭懿瑩. Enterovirus 71 and poliovirus. Enterovirus 71. Hand-foot-and-mouth disease (HFMD). Neurologic diseases, including aseptic meningitis, encephalitis, and

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Enteroviruses as agents of emerging infectious diseases

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  1. Review Enteroviruses as agents of emerging infectious diseases Journal of NeuroVirology, 11: 424–433, 2005 Speaker : 郭懿瑩 Enterovirus 71 and poliovirus

  2. Enterovirus 71 • Hand-foot-and-mouth disease (HFMD) • Neurologic diseases, including aseptic meningitis, encephalitis, and poliomyelitis-like paralysis. • EV71 has caused epidemics of severe neurologic disease in Australia, Europe, Asia, and the United States. • 1997 Malaysia 1998 Taiwan Large HFMD outbreak • EV71 was associated with fatal cases of brain-stem encephalitis. • It is the most common non-polio enterovirus associated with • poliomyelitis-like paralysis.

  3. neurological syndromes aseptic meningitis, brain-stem encephalitis, rhombencephalitis, acute flaccid paralysis. (Taiwan) It is possible that the brain stem lesions resulted from direct invasion by EV71.(Chang et al, 1998; Lum et al, 1998) • EV71 usually accounts for less than 3% of the enteroviruses reported annually in the United States. 26% adults had detectable anti-EV71 antibodies in their serum. Preliminary studies suggest that neutralizing antibodies against EV71 may have been present in the serum of approximately half of the adult population before and after the epidemic in Taiwan.

  4. Viruses of both genogroups B and C have been associated with both mild and severe disease so the viral factors influencing disease severity remain unknown.

  5. Poliovirus 1. 傳染方式 : 糞－口傳染或飛沫傳染 2. 潛伏期 : 3到35天，通常7到14天 3. 全球小兒麻痺症流行情形 :

  6. 4. 疾病 : • 1789年– Michael Underwood提出 • Poliomyelitis 來自希臘文 • Polio – 灰色， Myelon – 脊髓 • Poliovirus 感染脊髓引發的麻痺性疾病 • 世界歷史上的大流行 • 19世紀，歐洲 • 1843，1952年美國 • 名人患者– 1921，美國羅斯福總統

  7. 5. 症狀 : 90％以上的感染者 不明顯或無症狀的感染，小部分產生輕微症狀，如發燒、倦怠、噁心，或無菌性腦膜炎等，但無任何麻痺症狀。 􀂃 0.3～1％的感染者 出現麻痺症狀 – 病毒侵入中樞神經運動神經元而引起 – 麻痺部位通常是不對稱 􀂃 約有0.5%的感染者麻痺症狀無法復原。 􀂃 出現麻痺症狀者，死亡率約為5～10％。 􀂃 其他腸病毒感染或疾病也有類似症狀。

  8. 6. 預防 : 預防接種是最有效的預防方法 – 使用疫苗： 􀂃 IPV ：去活性小兒麻痺病毒疫苗 􀂃 OPV ：減毒小兒麻痺病毒疫苗

  9. VAPP ( Vaccine associated paralytic poliomyelitis ) iVDPV (immuno-deficient excretors of vaccine-derived poliovirus) cVDPV (circulated Vaccine-derived Poliovirus)

  10. 全球根除小兒麻痺症 Global Polio Eradication Initiative 􀂃 1988年開始，2003年病例已減少99% 􀂃 目標：2005年全球根除 􀂃 2003年修正 – 阻絕全球野生株小兒麻痺病毒散播(2004~2005) – 根除全球小兒麻痺症確認(2006~2008) – 口服小兒麻痺疫苗停用(2009~) – 美洲地區：1994.9.29 (1994宣布根除) – 西太平洋區：2000.10.29 (2000宣布根除) – 歐洲：1998.11 (2002宣布根除) WHO.

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