Cox N J, Subbarao K
Influenza Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Annu Rev Med. 2000;51:407-21. doi: 10.1146/annurev.med.51.1.407.
Pandemics are the most dramatic presentation of influenza. Three have occurred in the twentieth century: the 1918 H1N1 pandemic, the 1957 H2N2 pandemic, and the 1968 H3N2 pandemic. The tools of molecular epidemiology have been applied in an attempt to determine the origin of pandemic viruses and to understand what made them such successful pathogens. An excellent example of this avenue of research is the recent phylogenetic analysis of genes of the virus that caused the devastating 1918 pandemic. This analysis has been used to identify evolutionarily related influenza virus genes as a clue to the source of the pandemic of 1918. Molecular methods have been used to investigate the avian H5N1 and H9N2 influenza viruses that recently infected humans in Hong Kong. Antigenic, genetic, and epidemiologic analyses have also furthered our understanding of interpandemic influenza. Although many questions remain, advances of the past two decades have demonstrated that several widely held concepts concerning the global epidemiology of influenza were false.
大流行是流感最严重的表现形式。20世纪发生了三次大流行：1918年的H1N1大流行、1957年的H2N2大流行和1968年的H3N2大流行。分子流行病学工具已被用于确定大流行病毒的起源，并了解是什么使它们成为如此成功的病原体。这条研究途径的一个绝佳例子是对导致1918年毁灭性大流行的病毒基因进行的近期系统发育分析。该分析已被用于识别进化相关的流感病毒基因，作为1918年大流行源头的线索。分子方法已被用于研究最近在香港感染人类的H5N1和H9N2禽流感病毒。抗原性、遗传学和流行病学分析也加深了我们对两次大流行之间流感的理解。尽管仍有许多问题，但过去二十年的进展表明，一些关于流感全球流行病学的广泛持有的概念是错误的。
