Babakir-Mina Muhammed, Balestra Emanuela, Perno Carlo Federico, Aquaro Stefano
Department of Experimental Medicine and Biochemical Science, University of Roma Tor Vergata, Rome, Italy.
New Microbiol. 2007 Apr;30(2):65-78.
Influenza A subtype H5N1 has represented a growing alarm since its recent identification in Asia. Previously thought to infect only wild birds and poultry, H5N1 has now infected humans, cats, pigs and other mammals in an ongoing outbreak, often with a fatal outcome. In order to evaluate the risk factors for human infection with influenza virus H5N1, here we summarize 53 case patients confirmed with H5N1 infection during 2006. The review also compares the mortality rate among human cases from late 2003 until 15 June 2006 in different countries. Neither how these viruses are transmitted to humans nor the most effective way to reduce the risk for infection is fully understood. The association between household contact with diseased poultry in human infection has been demonstrated. This association could possibly operate by 2 mechanisms. First, transmission may be by inhalation or conjunctival deposition of large infectious droplets which may travel only in short distances. Second, having infected poultry in the home and preparation of infected poultry for consumption may result in exposure to higher virus concentrations than other types of exposure. There is so far no significant evidence for repeated human to human transmission, yet some cases of human to human transmission among the family relatives in Indonesia, Azerbaijan, Iraq and Turkey have been described. Recent outbreaks of highly pathogenic avian influenza A virus (H5N1 subtype) infections in poultry and humans (through direct contact with infected birds) have raised concerns that a new influenza pandemic might occur in the near future.
自甲型H5N1流感病毒最近在亚洲被发现以来，其引发的恐慌日益加剧。此前人们认为该病毒仅感染野生鸟类和家禽，但在当前的疫情爆发中，H5N1已感染了人类、猫、猪及其他哺乳动物，且感染往往会导致致命后果。为评估人类感染H5N1流感病毒的风险因素，我们在此总结了2006年期间确诊感染H5N1的53例病例患者。本综述还比较了2003年末至2006年6月15日不同国家人类病例的死亡率。目前，人们尚未完全了解这些病毒是如何传播给人类的，也不清楚降低感染风险的最有效方法。已证实人类感染与家庭接触患病家禽之间存在关联。这种关联可能通过两种机制起作用。其一，传播可能是通过吸入或结膜接触大的感染性飞沫，这些飞沫可能仅传播较短距离。其二，家中饲养感染家禽以及处理供食用的感染家禽可能导致接触到比其他类型接触更高浓度的病毒。迄今为止，尚无确凿证据表明该病毒会在人际间反复传播，但在印度尼西亚、阿塞拜疆、伊拉克和土耳其，已有一些家庭内部人际传播的病例报道。近期，高致病性甲型禽流感病毒（H5N1亚型）在家禽和人类中爆发（通过直接接触感染禽类），引发了人们对近期可能发生新型流感大流行的担忧。
