腸道病毒與輪狀病毒脊髓灰質炎腸道病毒脊髓灰質炎學習要求掌握1、脊髓灰質炎病毒的致病性2、特異性預防（劑型）自學柯薩奇病毒3、熟悉脊髓灰質炎病毒抵抗力、感染類型自學埃可病毒脊髓灰質炎脊髓灰質炎病毒poliovirus結構脊髓灰質炎脊髓灰質炎3-Dimageofpoliovirus脊髓灰質炎VP1VP2VP35-foldAxis3-foldAxis2-foldAxis脊髓灰質炎Fordecades,nooneknewwhatpolioviruslookedlike,sincevirusescannotbeseenunderamicroscope.In1985,ateamledbyJamesHogleofHarvardMedicalSchoolobtainedhigh-resolution,3Dimagesofpoliovirus,andtoday,thenewlyformedChildren'sHospitalBoston--HarvardMedicalSchoolstructuralbiologyunitisheirtotheEnderstradition.脊髓灰質炎LedbyStephenHarrison,thisgroupisusingavarietyofsophisticatedtoolslikeX-raycrystallographyandmolecularelectronmicroscopytoobtaindetailed,dynamic,3Dviews--accuratedowntotheatom--ofhowvirusesmove,transferinformationandreconfigurethemselvestoattacktheirvictims.Theseimagesaresheddinglightonmanyoftoday'sviralscourges,suchasHIV,dengueandrotavirus,andprovidingnewleadsfortreatmentandvaccinedevelopment.脊髓灰質炎Poliovirus脊髓灰質炎AnancientEgyptianstele,portrayingaprincewithawitheredleg-probablypolio.

?WHO/GPEI脊髓灰質炎埃及第十八朝的這塊石碑可能是脊髓灰質炎病例的最早記載。脊髓灰質炎脊髓灰質炎脊髓灰質炎脊髓灰質炎脊髓灰質炎AmericasRegionLuisFerminTenorioPeru1991EuropeanRegionMelikMinasTurkey1998WesternPacificRegionMumChantyCambodia1997Polio‘LastCases’PolioEradication脊髓灰質炎脊髓灰質炎ResearchersGlimpsePolioVirusasitEntersHostCellContact:Theimageontheleftshowsanakedpoliovirus.Thepoliovirusontherightisstuddedwith60twig-likestructures,thereceptors.SeeforamomentSmallthinstemonatree3-Dstructures脊髓灰質炎WHOPoliocaseshavedecreasedby99.8%since1988,fromanestimated350000casesto483in2001*.Thereductionistheresultoftheglobalefforttoeradicatethedisease.脊髓灰質炎Areaswithhigh-intensitytransmission

Together,thesecountriesaccountedformorethan85%ofthenewpoliocaseloadin2001.Theyarecharacterizedbyhavingareaswithlargepopulationsandlowroutineimmunizationcoverage,sub-optimalsanitationandrelativelywidegeographicaldistributionofthewildpoliovirus.Thesecountriesare:IndiaPakistan/AfghanistanNigeria/Niger脊髓灰質炎PoliowasdeclarederadicatedintheU.S.in1979.YetaccordingtotheWorldHealthOrganization,poliocasesworldwiderosebyathirdin2004,dueinparttovaccineboycotts.Children'sandSpauldingRehabilitationHospitalarestillseeingnewcases--theresultofinternationaladoptionsfromThirdWorldcountriesandfromRussia.脊髓灰質炎病毒抵抗力在污水和糞便中可活數月食品中可保存數周不易被胃酸或膽汁滅活對氧化劑敏感56。C30min被滅活脊髓灰質炎致病性傳染源：病人或無癥狀攜帶者傳染方式：糞-口途徑致病機理脊髓灰質炎二、致病性病毒咽部、腸壁淋巴組織入血流第1次病毒血癥入全身淋巴組織再次入血流病毒入脊髓前角運動神經細胞：（脊髓型）

延髓和腦干：延髓型大腦運動皮質區：腦炎型第2次病毒血癥脊髓灰質炎感染類型人群中絕大多數為隱性感染或輕型感染顯性感染引起麻痹者僅為顯性感染的0.1%-1%頓挫感染脊髓灰質炎免疫性SIgA：清除腸道內病毒，阻止病毒入血IgM,IgG:阻斷血流中病毒向中樞神經系統擴散感染后獲得對同型病毒較牢固的免疫力脊髓灰質炎預防口服脊髓灰質炎減毒活疫苗糖丸(1957年發明）

OralvaccinationwithlivevaccineVaccinationprogramshaveeradicateditfromtheWesternworldandpromisetoeliminateitglobally

DrAlberSabin脊髓灰質炎疫苗使用的效果脊髓灰質炎脊髓灰質炎

Scientistshavebuiltthevirusthatcausespoliofromscratchinthelab,usingnothingmorethangeneticsequenceinformationfrompublicdatabasesandreadilyavailabletechnology.Thefactprovesthatevenifallthepoliovirusintheworldweredestroyed,itwouldbeeasilypossibletoresurrectthecripplingdisease,saysAnikoPaulattheStateUniversityofNewYorkatStonyBrook,oneoftheresearchersconductingthestudy.新進展Date:Thu,11Jul2002Bringbackintouse脊髓灰質炎Journalreference:Science(DOI:10.1126/science.1072266)Theresulthasmajorimplicationsforvaccinationprogramsthathavenearlyridtheworldofpolio."Ithinkitmeansyou'reprobablynotgoingtobeabletostopvaccinatingpeopleevenafteryoueradicatethevirus,"saysDianeGriffinoftheJohnsHopkinsBloombergSchoolofPublicHealth.脊髓灰質炎Paulbelievesthesynthesismethodcouldbeappliedtootherviraldiseases."Wefeelthiscouldbeusedforebola,smallpox,justaboutanything,"shesays.Thisraisestheworryingpossibilitythatbioterroristscoulduseasimilarapproachtocreatedevastatingdiseaseswithouthavingtogainaccesstoprotectviralstocks.脊髓灰質炎paralysiselectronmicroscopyandX-raycrystallography.SummaryofpoliovirusvaccinationprogramshaveeradicateditfromtheWesternworldandpromisetoeliminateitgloballySurprisinglylittleisknownabouthowpoliovirusentersthecellsoftheintestines,letalonehowitmakesitswaytothenervoussystemwhereitcandamagemotorneuronsandcauseparalysis脊髓灰質炎輪狀病毒脊髓灰質炎形態核心為dsRNA，外有雙層衣殼，內外兩層呈放射狀排列脊髓灰質炎輪狀病毒分組：A、B、C組：可引起人、動物腹瀉，最常見A組(有稱為小兒輪狀病毒）D-G組：僅引起動物腹瀉A組抵抗力：耐乙醚、弱酸室溫中傳染性可保持7個月-20。C長期保存脊髓灰質炎A組輪狀病毒所致疾病：