?a??a ????t???, a?ap?. ?a????t??a

1
17? ?a?d?at???? Seµ?????? ???µ??e?? Feί????????
2014
????O???S ???????S?????
??O????? ??? ??? ???????S???? S???????
?a??a ????t???, a?ap?. ?a????t??a ???ast????
?????ί??????a?, ?at???? S???? ??T ?????? ???t??
??af???? G??p?? ?. ????d??
2
???µ??e?? a??te??? a?ap?e?st????
????t?da Fa?????t?da ?µ??da??t?da
?a?????t?da ??a?e??t?da
??µ???t?da Ot?t?da
S?????? ???e?e??
????? ????????µa
?p??e?a e??at?????
3
???µ??e?? ?at?te??? a?ap?e?st????
??e?a ί?????t?da ??e?a ί????????t?da ??e?µ???a
???e?e?? ? µ????ί?a??? (s?ίa??te?e?)
?p? t?? ?????te?e? a?t?e? ?a??t?? µeta?? t??
???µ?d?? ??s??.
??sp???a, ?????? p??et??, ί??a?, ad??aµ?a,
?a?????a
4
?????? ??? t?? a?ap?e?st????
5
???????
????? ????????µa
??ί??? s?µµet??a, ssRNA
???e?t???? se ??p?d?a??te?
??a?s??t?? se ?aµ??? pH
???t?st? ?e?µ???as?a 33?C
113 ???t?p??
???s?a ί?a?e?a, e?d??? ???t?p??
6
G??p??
??µ?s???????t??? (?), ?e??aµ???d?s? (?)
7
Ge?et???? a?as??d?asµ?? ??? ???p?? ?
?st??e?a ?e?et???? ?????? (RNA ?atatetµ?µ???)
???a?a s???pa??? d?af??et???? ste?e??? st?? ?d??
?e??st? ? ???µ??? t?? ?e?et???? ??????
t??? µ?sa sta p??sί?????ta ??tta?a t??
?e??st? ? ???? ??? µe t??a???? s??d?asµ???
a?t?????? p??e??µ???? ap? ta a?aµ?????ta ste????
??????S? ??? ??T?O?? S? ??T?O?? !
8
??µ?s???????t??? (H)
9
?a?a??f?????t?a?
??µ?s???????t???
?????e?d?? s?µµet??a, ssRNA, pe??ί??µa
??p?? 1 ? ??e?a ?a?????-t?a?e??-ί?????t?da lt3
et?? 2 ? ?a?????t?da (croup) se pa?d?? 3 ?
ί????????t?da se ί??f? 4 ? e?af??
s?µpt?µat?????a a?ap?e?st????
?p?µ???s? ??tta?a ?ef??? p?????? ? a????p??
10
RSV
?????e?d?? s?µµet??a, ssRNA, pe??ί??µa
??? a?µ?s???????t???
G??p?de? s??d??µ? 6 t?? pe??stat???? se pa?d??
(d?e????) 10,5-12 gtgt
(? ???. ?????ί??????a?)
??af?? s?µpt?µat?????a a?ap?e?st???? (µe?a??te?a
pa?d??)
?p?µ???s? HEP2, HeLa
11
?de?????
??p?? 1, 2, 3, 4, 5, 6, 7, 14, 21
??ί??? s?µµet??a, dsDNA
??µ?s???????t???
?a? se ???e ?????a
??e?a a?ap?e?st??? ??s?? ?e?s?????t??
?p?µ???s? a????pe?a ??tta?a p.?.
HEP2, HeLa
12
Corona
5-30 t?? a?ap?e?st???? ???µ??e??
????? ????????µa
??ί??? s?µµet??a, ssRNA, pe??ί??µa

• ??a??et??? µe???? µ???? RNA
• ? ?e????? a???µ?? ????d???
• ? ??a??pt?µe??? µ??a??sµ?? a?t???af??
• S???? µeta????e??/a?as??d?asµ??

SARS CoV, ?p? ??at???, 2002-03 8.098 ????sµata,
774 ???at?? - ???t?t?ta 9,1 26 ???e? (?????? ?.
?????????) ?a???s?a se p?????a e?d? e????µ?t??
?p?µ???s? (d?s???a) ??tta?a t?a?e?a? eµί????
a????p??
13
EB ???te?? (??????) ?at?te?? a?ap?e?st??? ?d??pa
??? p?e?µ????? ???s? ??ap?e?st???,
?-?eµf???tta?a ? de?aµe??? (1985)
HHV-1,2 HHV-6,7 ?p? ed?f??? HIV
?????? pa?d?? ?? e?d???
s?µpt?µat?????a
??????? ίa??t?ta, s?????? ?p?a
VZV ??e?µ???t?da, p?e?µ???a
CMV ?p?a µ? e?d??? s?µpt?µat?????a ???s??atesta?µ?
??? p?e?µ???a
ECHO ?? e?d??? s?µpt?µat?????a ??????? ίa??t?ta,
s?????? ?p?a
Coxsackie ? ? ? ?? e?d??? s?µpt?µat?????a ???????
ίa??t?ta
??a??? ?????? st?d?? ί??a?, ?ata???? ?p?p????
???a?t???tta???? p?e?µ???a !
14
?etap?e?µ????
?????e?d?? s?µµet??a, ssRNA, pe??ί??µa
?a?aί?e??????
1? ap?µ???s? t??a?a 2001, ???a?d?a.
Ge?et???? p??s??ste??? µetap?e?µ???? pt????.
10 t?? a?t????????? ad?e??????st?? a?ap?e?st????
???µ??e??. ?at? ?a???a ?p?e? ???????? e????e?.
T? de?te?? se s????t?ta a?t?? ???µ??e?? ?at?t????
a?ap?e?st???? se µ???? pa?d?? µet? t?? RSV
(µe?a??te?a pa?d??, ?p??te?? ??s?s?).
?p????? ?ata??µ? ?e?µ??a?, ta?t?????a µe ???p?.
G??p?de? s??d??µ? 6,5 t?? pe??stat???? se
pa?d?? (d?e????) 5,5-6,5
gtgt (? ???. ?????ί??????a?)
?p?µ???s? (d?s???a) ep?????a?? ??tta?a ?ef???
p??????, gtgt ί??????
a????p??
15
Boca
??ί??? s?µµet??a, ssDNA
Parvo
1? a????e?s? 2004, S???d?a-S???ap????, µe
?a?????? e??s??s? p???????? ????? a?ap?e?st????
de??µ?t??. ????????se est?asµ??? a????s? ?a?
µe??t?.
Ge?et???? p??s??ste??? ??? ί??e?d?? (bo), ???
s????? (ca)
?e??p?? 50 pa?d??? 5 et?? f????? e?d??? IgG.
PCR µ? p??t?p?p???µ??? ?a??????e?a ???
???s??? st?? a???????s? ?????? a?t?? t?? ??s??
16
"?e?te???" ???
t?? a?ap?e?st????
17
?a?aί?e??????
Nipah (?a?aί?e?????? - Henipavirus) ???µa
µa?a?s?a??? ??????, 1998. ??d?µ?a-ep?d?µ?e? ?.
?s?a, e?t?? ??????. ?e?aµe??-µet?d?s? e?t?p?e?
?a?p?f??e? ???te??de?. ???sί??? ?a? ?????
????a??? ????. ILI, p??a?? e?????? e??efa??t?da ?
???t?t?ta 9-75 !
Hendra (?a?aί?e?????? - Henipavirus) ??st?a??a
1994. ?et?d?s? ap? ??s???te? ?pp???. ??ap?e?st???
? ?a? ?e?????????? ???µ??e?? ? ???t?t?ta 60.
18
Polyoma
KI, WU (Polyoma) ??st?a??a, 2003. ?e ?a??????
e??s??s? p???????? ?????. ?????? pa?d??. ??? t?
?????. ??? p????? s?s??t?s? µe a?ap?e?st???
??s?. ?at?te?? a?ap?e?st??? (e???te s?ίa??), a???
?a? se s?µpt?µat?????. ?a?e?? ??s?s? se
a??s??atesta?µ????? (AIDS).
19
Reo
Melaka (Reo) ???µa µa?a?s?a??? pe??????,
2006. ?et?d?s? e?t?p?e? ?a?p?f??e?
???te??de?. ?e? ??e? a?e??e?e? st?? ????p? a??µ?
(2008). ?µp??et? a?ap?e?st??? ??s?µa.
Kampar (Reo) ?a?a?s?a, 2008. ?et?d?s? ?a?p??
µ???sµ???? ap? ???te??de?. ?µp??et? a?ap?e?st???
??s?µa.
20
Corona
NL63 (Corona) ???a?d?a 2003. ?a???sµ?a
d?a????s?. ?????? pa?d?? lt3 et??, ?e?µ??a?. ???t?
a?ap?e?st??? s?µpt?µat?????a, e???te a??et?
s?ίa??. S?s??t?s? µe ?. Kawasaki.
KU1 (Corona) Hong Kong 2005 se 2 pe??stat???
p?e?µ???a?. ?a???sµ?a d?a????s?. G???t?p?? ? ?a?
?. F????e?et??? p??s??ste??? µe ?? ?pat?t?da?
p??t???? !
21
MERS-CoV ? hCoV-EMC
???t? ap?µ???s? Sept?µί???? 2012 ap? as?e?? µe
p?e?µ???a ?a? epa??????? ?ef???? a?ep???e?a ap?
t? Sa??d??? ??aί?a

• Betacoronavirus
• ?????e?s? ???te??da
• ??????? e????a pa??µ??a µe SARS
• ??????? e??ast???a??? d?e?e???s?? de??µata
  as?e??? µe
• ?t?p? p?e?µ???a
• S?ίa?? a?ap?e?st??? ???µ??? µe ep?p?????,
• µ? a?tap??????µe?? st? ?e?ape?a,
• e?d??? a? s?s?et??eta? µe ta??d? st?? ??aί???
  ?e?s???s?

??? te?e?ta?? µ??a µ??? 3 ??a ????sµata. ????
?fes?
WHO ????? 4/2/2014 181 ????sµata e??ast???a??
ep?ίeίa??µ??a 79 as?e?e?? ?at????a? (43,6)
22
??? ???p?? A(H7N9)
WHO ?p? 1/3/2013 µ???? 24/1/2014 209 ????sµata
e??ast???a?? ep?ίeίa??µ??a 55 as?e?e?? ?at????a?
(26,3)
23
(No Transcript)
24
??? ???p?? A(H5N1)
("t?? pt????")
WHO 2003 - ?a???????? 2014 650 ????sµata
e??ast???a?? ep?ίeίa??µ??a 386 as?e?e?? ?at????a?
(59,4)
25
???????? ??? ???p?? A
Sp??ad???
?????e?s? pt??? !
? ?6?1 2013 ?????, ?a?ί??, 1 pe??stat???
? ?7?2 2007, ?. ??eta??a, 4 pe??stat???, µet?
ep????t?a pt???t??fe???
? ?7?3 2006, ?. ??eta??a, 1 pe??stat???, µet?
ep????t?a pt???t??fe???
? H7N7 2003, ???a?d?a, 89 pe??stat??? (?p?a, 1
???.), µet? ep????t?a pt???t??fe??? 2013 ?????,
?ta??a, 3 pe??stat???
? ?10?7 2004, ????pt??, 2 pa?d?? 2010,
??st?a??a, 2 e??a??µe??? pt???t??fe???
26
"????" ??? t?? a?ap?e?st????...
27
?a? ?? a?a?a???e?? pa??????? a?t??? s??e?????ta?
a?at?pa?sta, pa??????a µe t?? p???d? t??
s???????? d?a???st???? µe??d??, t? µ? pepe?asµ???
t?? ί????????? e??????? , t?? ep?st?µ?????
e??????s? t?? ?at????? ??sµ??
28
G??p? st? ?. ????da
?p? 2009 ?.e. ?1?1pdm