新興傳染病的認識 - sle.org.tw

1 VVeerrttiiccaall ttrraannssmmiissssiioonn HHoorriizzoonnttaall ttrraannssmmiissssiioonn 11997733 33 55 Emerging infectious diseases Reemerging infectious diseases 1 _____ / HIV/AIDS SARS / Hantavirus /HPS / JEV/Australia / Vibrio cholerae O1/O139 / Avian influenza virus/Human / Dengue virus/Americas _____ 30 2 11111111999999997777777766666666 _____ 1976 Legionnaire s disease 1976 Ebola Hemorrhagic fever 1977 Lyme disease 1982 E.

2 Coli O157 H7 1983 HIV/AIDS 1988 C- Hepatitis C 1991 Cholera O139 1993 Hantavirus pulmonary syndrome 1994 New-variant CJD 1997 Hong Kong avian influenza 1998 71 Enterovirus 71 2003 SARS _____ SARSSARSSARSSARS SSSSSSSSAAAAAAAARRRRRRRRSSSSSSSS 2002 11 atypical pneumonia 2003 3 15 Severe acute respiratory syndrome SARS SARS 38 SARS SARS SARS SARS SARS SARS SARS SARS-CoV SARS 2003 7 SARS SARS 346 37 11% 20% 68 SARS SSSSSSSSAAAAAAAARRRRRRRRSSSSSSSS SARS ribavirin lopinarvir/ritovir IFN- 300 SARS 21 SARS SARS AAAAAAAA vvvvvvvviiiiiiiiaaaaaaaannnnnnnn iiiiiiiinnnnnnnnfffffffflllllllluuuuuuuu eeeeeeeennnnnnnnzzzzzzzzaaaaaaaa

3 Bbbbbbbbiiiiiiiirrrrrrrrdddddddd fffffffflllllllluuuuuuuu 1878 1955 A 2004 H5N1 H5N1 H5N2 AA H N H 16 H1-H16 N 9 N1-N9 subtype HH11 HH22 HH33 NN11 NN22 HH11 HH33 NN11 NN22 HH77 NN77 NN88 HH11--HH1166 NN11--NN99 1997 H5N1 18 6 16 H H5 H7 H9 30% 20oC 7 4oC 30 105.

4 3-10 21 H5 H7N7 H5N1 Tamiflu H5N1 1997 1500 2003 2300 SARS 7711 Enterovirus Type 71 Enterovirus Type 71 Enterovirus Type 71 Enterovirus Type 71 7777777711111111 RNA Picornaviridae 1969 71 1998 405 78 19% 71 10% 71 7-10 71 80% 5 5 2 71

5 80-90% 7777777711111111 NorovirusNorovirusNorovirusNorovirus Norwalk- like viruses 2002 2,300 5 310 2005 2006 72 61 24 48 75%

6 SARS