Kilbourne E D
Department of Microbiology and Immunology, New York Medical College, Valhalla 10595, USA.
J Infect Dis. 1997 Aug;176 Suppl 1:S29-31. doi: 10.1086/514171.
During the 20th century, indisputable pandemics of influenza occurred in 1918, 1957, and 1968. The pandemics of 1957 (A/H2N2) and 1968 (A/H3N2) were associated with major antigenic changes in the virus, probably reflecting introduction by recombination of animal virus genes. The 1918 epidemic is beyond the reach of modern virology but, based on seroarcheology, appears to have been caused by a virus very similar to present swine (A/H1N1) influenza viruses. Changes in both principal antigens of the A/H1N1 subtype in 1947 resulted in total vaccine failure and pandemic spread of virus. On the basis of three periods of prevalence in the 20th century, A/H1N1 may be the "default" human virus, although the 39-year persistence of A/H3N2 to the present challenges this view. Only H1, H2, and H3 and N1 and N2 antigens have been found in human influenza viruses, but virologic history is too brief to preclude the contribution of other antigens to future pandemics.
在20世纪，1918年、1957年和1968年发生了无可争议的流感大流行。1957年（A/H2N2）和1968年（A/H3N2）的大流行与病毒的主要抗原变化有关，这可能反映了动物病毒基因通过重组引入。1918年的疫情超出了现代病毒学的研究范围，但根据血清考古学，似乎是由一种与目前猪（A/H1N1）流感病毒非常相似的病毒引起的。1947年A/H1N1亚型的两种主要抗原发生变化，导致疫苗完全失效，病毒大流行传播。基于20世纪的三个流行期，A/H1N1可能是“默认”的人类病毒，尽管A/H3N2持续存在至今39年，这一观点受到挑战。在人类流感病毒中仅发现了H1、H2和H3以及N1和N2抗原，但病毒学历史过于短暂，无法排除其他抗原对未来大流行的影响。
