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甲型H1N1流感

H1N1 Influenza

作者信息

Jilani Talha N., Jamil Radia T., Nguyen Andrew D., Siddiqui Abdul H.

机构信息

HCA Healthcare Sunrise Health Graduate Medical Education Program

Allama Iqbal Medical College

Abstract

H1N1 influenza, a subtype of influenza A virus, is an infectious viral illness that causes both upper and, in some cases, lower respiratory tract infections in its host. H1N1 influenza infections can cause symptoms such as rhinorrhea, cough, decreased appetite, fever, rigors, myalgia, headache, and, possibly, lower respiratory tract disease and gastrointestinal disease. Although other influenza strains exist, influenza A and B viruses predominantly impact human health. Three subtypes of swine influenza circulate globally—H3N2, H1N2, and H1N1. The H1N1 influenza gained worldwide attention as "swine flu" during the 2009 pandemic after swine influenza viruses were reassorted with preexisting H1N1 strains. Swine flu emerged from the recombination of various prior swine, avian, and human influenza strains, causing a global pandemic affecting millions of people and impacting industries, including food and tourism. H1N1 influenza leads to a respiratory disease that can infect pigs' respiratory tract. Humans susceptible to swine influenza are typically exposed through close association with infected pigs, a condition known as zoonotic "swine flu." Swine influenza viruses can potentially infect humans if the antigenic characteristics of the virus change through the reassortment of different influenza strains. This process can enhance replication and transmission, facilitating efficient transfer to human hosts. Such reassortments have led to pandemics, as seen in 1918 and 2009, when the virus acquired efficient person-to-person transmission capabilities. In 1918, the H1N1 influenza virus, commonly known as the Spanish flu, sparked a devastating pandemic that infected roughly 500 million individuals worldwide and led to the deaths of an estimated 50 to 100 million people, accounting for 3% to 5% of the global population at the time. This made it one of the deadliest pandemics in human history. Similarly, the H1N1 influenza strain in 2009 was classified as a pandemic by the World Health Organization (WHO). The 2009 H1N1 virus spread through airborne droplets from human to human, possibly via fomites contaminated with the virus, and subsequently transferred to the mucosa or upper respiratory tract. Notably, similarities in symptoms of H1N1 in both humans and pigs arose, potentially due to the viral reassortment of preexisting strains. This similarity in symptoms suggested a commonality in viral pathogenesis across multiple hosts, likely facilitated by reassortment, thus enhancing efficient transmission. During the pandemic, a common misconception was that individuals could contract swine flu from consuming pig products such as bacon, ham, and other pork items. However, the virus is isolated to the respiratory system and does not involve plasma, making transmission through food unlikely. This misunderstanding resulted in substantial commercial losses in the food and tourism industries.

摘要

甲型H1N1流感是甲型流感病毒的一种亚型,是一种传染性病毒性疾病,可导致宿主的上呼吸道感染,在某些情况下还会导致下呼吸道感染。甲型H1N1流感感染可引起诸如流鼻涕、咳嗽、食欲减退、发热、寒战、肌痛、头痛等症状,还可能导致下呼吸道疾病和胃肠道疾病。虽然存在其他流感毒株,但甲型和乙型流感病毒对人类健康的影响最为显著。三种猪流感亚型在全球传播——H3N2、H1N2和H1N1。2009年大流行期间,甲型H1N1流感作为“猪流感”引起了全球关注,此前猪流感病毒与已有的H1N1毒株发生了重配。猪流感是由各种先前的猪、禽和人流感毒株重组产生的,引发了一场全球大流行,影响了数百万人,并冲击了包括食品和旅游业在内的多个行业。甲型H1N1流感会导致一种可感染猪呼吸道的呼吸道疾病。易感染猪流感的人类通常通过与受感染猪密切接触而感染,这种情况被称为人畜共患的“猪流感”。如果病毒的抗原特性通过不同流感毒株的重配而发生变化,猪流感病毒就有可能感染人类。这一过程可增强病毒的复制和传播,便于有效地传播给人类宿主。这种重配导致了大流行,如1918年和2009年,当时病毒获得了有效的人际传播能力。1918年,甲型H1N1流感病毒,通常被称为西班牙流感,引发了一场毁灭性的大流行,全球约5亿人感染,估计导致5000万至1亿人死亡,占当时全球人口的3%至5%。这使其成为人类历史上最致命的大流行之一。同样,2009年的甲型H1N1流感毒株被世界卫生组织(WHO)列为大流行毒株。2009年的甲型H1N1病毒通过人与人之间的空气飞沫传播,可能通过被病毒污染的污染物传播,随后转移到黏膜或上呼吸道。值得注意的是,人类和猪的甲型H1N1流感症状出现了相似之处,这可能是由于先前毒株的病毒重配所致。症状的这种相似性表明多种宿主的病毒发病机制存在共性,重配可能促进了这种共性,从而增强了有效传播。在大流行期间,一个常见的误解是,人们可能通过食用猪肉制品如培根、火腿和其他猪肉食品感染猪流感。然而,病毒局限于呼吸系统,不涉及血浆,因此通过食物传播的可能性不大。这种误解导致了食品和旅游业的重大商业损失。

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