鳥インフルエンザから新型インフルエンザ大流行へ
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- ゆゆこ かやぬま
- 7 years ago
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1
2
3 H1 - H16 N1 - N9 Aquatic birds Poultry Humans Pigs Horses Aquatic mammals Cats Dogs Influenza Branch
4 ( )
5
6 1997 H5N1 18 6
7 H5N1 HPAI , , Feb. 2004, Chickens 6, 1 12 Jan.2004 Chickens 17 Feb,2004 Bantams, duck -3 Mar. 2004, Chickens -7 Mar.2004, Crows -10 Mar. 2004
8
9 H5N1
10
11 2005 1
12 Lombok, Indonesia, 2008
13 2006 3
14
15 Clade 1 Clade 2.1 Clade 2.2 Clade 2.3 Clade 0 10
16 ( Clade 2.2 Clade 2.3 Clade 1 Clade 2.1
17
18
19 Country 5) Total Azerbaijan (5) (5) Bangladesh (0) 0 1(0) Cambodia (4) 2 (2) 1 (1) 1 (0) 0 8 (7) China 1 (1) 0 8 (5) 13 (8) 5 (3) 4 (4) 7 (5) 38 (25) Djibouti (0) (1) Egypt (10) 25 (9) 8 (4) 2 (0) 53 (24) Indonesia (12) 56 (46) 42 (37) 24 (20) 2 (2) 143 (117) Iraq (2) (2) Laos (2) (2) Myanmar (0) (0) Nigeria (1) (1) Pakistan (1) (1) Thailand 0 17 (12) 5 (2) 3 (3) (17) Turkey (4) (4) Vietnam 3 (3) 29 (20) 61 (19) 0 8 (5) 6 (5) ) Total 4 (4) 46 (32) 97 (42) 116 (80) 88 (59) 44 (33) 11 (7) 407 (256)
20 .
21 H5N
22 2005
23
24 2-8 ( ) 7-15
25 Emerg. Infect. Dis. J. 2005
26 De Jong et al. Nature Med 2006
27 - NP ( /
28 α
29
30 ( ;
31
32
33
34 ( ) ( ) (
35 (Russian Flu Pandemic)
36
37 1918
38
39
40 - 8
41
42 (1) (3) (2)
43
44 α α
45 HA Clade Receptor binding Receptor site specificity Gln Leu Ser Ser α(2-3) Arg Glu Ser/Gly Gly α(2-6) A/goose/Guandong/1/96(H5N1) 3 Gln Leu Ser Ser α(2-3) A/Hong Kong/156/97(H5N1) 3 Gln Leu Ser Ser α(2-3) A/chicken/Vietnam/1/2004(H5N1) 1 Gln Leu Ser Ser α(2-3) A/Vietnam/1193/2004(H5N1) 1 Gln Leu Ser Ser α(2-3) A/Thailand/16/2004(H5N1) 1 Gln Leu Ser Ser α(2-3) A/duck/Cambodia/JP52A/2005(H5N1) 1 Gln Leu Ser Ser α(2-3) A/Vietnam/JPHN20408/2005(H5N1) 2-2 Gln Leu Ser Ser α(2-3) A/goose/Shantou/2086/2006(H5N1) 2-2 Arg Leu Gly Ser α(2-6) A/Turkey/15/2006(H5N1) 2-2 Arg Leu Gly Ser α(2-6) A/Egypt/2947/NAMRU2/2006(H5N1) 2-2 Arg Leu Gly Ser α(2-6) A/Indonesia/13/2006(H5N1) 2-1 Gln Leu Ser Ser α(2-3)
46
47 H5N1 HPAI
48
49 H3N8 H2N2 H2N2 H1N1 H5 H9 H6 H H3N2 H1N Russian Influenza H2N Old HK Influenza H3N Spanish Influenza H1N Asian Hong Kong Influenza Influenza H2N2 H3N2
50
51
52 ) vs. PQ RERRRRKR GL H5
53 HA1 HA2 Clade 0 A/ Hong Kong/ 258/ 97 A/ Hong Kong/ 156/ 97 PQ RERRRKKR PQ RERRRKKR GL GL Clade 1 A/ Viet Nam/ 1194/ 2004 PQ RERRRKKR GL Clade 2.1 A/ Indonesia/05/2006 PQ RESRRKKR GL A/ Indonesia/13/2006 PQ RESRRKKR GL Clade 2.2 A/ Turkey/12/2006 PQ GERRRKKR GL A/ Egypt/2616/NAMRU-3/2007 PQ GERRRRKR GL - - Clade 2.3 A/ Anhui/2/2005 PQ RE RRRKR GL - - A/ Myanmar/NIID-23/2008 PQ RERRRKKR GL - -
54 ) NS1 ; TNFα F92E or D S42P : TNFα PB2 ; E627K (4 36 PB1-F2 N66S 2
55 PB2 RNA (. PB1-F2 HA. HA NS PDZ
56
57 H5N1 H9N2 H7N(2,3,7) H6N1 H2N ~ ?
58
59
60 The big pandemic of 1918
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74 )
75 )
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77 ( (
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84 Deaths Rates / 100,000 Population (Annual Basis) 1918 Death Rates: Philadelphia v St. Louis Philadelphia St. Louis /14/1918 9/21/1918 9/28/ /5/ /12/ /19/ /26/ /2/ /9/ /16/ /23/ /30/ /7/ /14/ /21/ /28/1918 Date Weekly mortality data provided by Marc Lipsitch (personal communication)
85 St. Louis *Estimated attack rate before interventions: 2.2% /9/ /9/ /9/ /10/5 1918/10/ /10/ /10/ /11/2 1918/11/9 1918/11/ /11/ /11/ /12/7 1918/12/ /12/ /12/28 Date *derived from mortality data using 2% CFR Death Rate / 100,000 Population (Annual Basis)
86 14000 Philadelphia *Estimated attack rate before interventions: 10.8% /14/18 9/21/18 9/28/18 10/5/18 10/12/18 10/19/18 10/26/18 11/2/18 11/9/18 11/16/18 11/23/18 11/30/18 12/7/18 12/14/18 12/21/18 12/28/18 Date *derived from mortality data using 2% CFR Death Rate / 100,000 Population (Annual Basis)
87
88 4
89 social distancing)
90 .
91
92 (Oseltamivir, Zanamivir) (Tamiflu) ( ) + (Relenza),
93
94 Clade 2.2 M2: L26I, S31N NA: H Y, S N Clade2
95
96 ICH E2B guideline
97
98 H5N1 VietNam/2004 Clade1 Clade2.1,Clade 2.2(, Clade2.3 1/2 8 Clade Pre-pandemic
99 Prepandemic
100
101
102 6 1 1
103 ?
104
105
106
107
108
109
110 PPE
111 2 ( ) (
112 ~6 4.8~ (4.4 trillion)
113
114
115
116
117
118
119 1. (
120
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122 (BCP) Business Continuity Plan
123 P) M)
124 Business Continuation Plan,BCP)
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