emerging and re-emerging transboundary infectious...
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Emerging and Re-emerging Transboundary Infectious Diseases
X.-F. Henry Wan, Ph.D.
Department of Basic Sciences
College of Veterinary Medicine
Mississippi State University
E-mail: [email protected]
Lab: http://sysbio.cvm.msstate.edu
ONE HEALTH
ONE FLU
Zoonotic diseases
• Natural history of influenza A virus
• Influenza host pathogen interaction (genotype-phenotype correlation)
• Vaccine strain selection and universal vaccine design
One HEALTH: Influenza Outbreaks in Human 2011
H3N2
1918
Spanish Flu
H1N1
1900 1950 2000
1957
Asian Flu
H2N2
1968
Hong Kong Flu
H3N2
1977
Russian Flu
H1N1
2011
1997
H9N2
1999
2003
H7N7
2004
H7N3
Influenza B
Seasonal Influenza Avian Influenza Pandemic Influenza
40 million
deaths
1 million
deaths 2 million
deaths
H7N2
H5N1
2005
H1N1 1976
H1N1 …
2009
H1N1
Swine Influenza
2013
H7N9
2013
H10N8
One Flu
Terrestrial poultry
H subtypes 4,5,6,7,9,10;
N subtypes 1,2,4,7
e.g. H9N2; H6N1.
Human
H1N1, H3N2, H1N2, H2N2;
H5N1, H7N2, H7N3, H7N7,H7N9, H9N2
Pig
H1N1; H3N2;
H1N2; H3N1
Equine
H3N8; H7N7
Canine
H3N8; H3N2
Aquatic birds
H1-16; N1-9
Sea mammals (seals; whales)
H7N7; H4N5; H4N6; H3N3
H3N2; H13N9
H1-H18
N1-N10
• Mutation
• Reassortment
• Recombination
• Gradual genetic changes
• Punctual antigenic changes
(Belshe, 2005, NEJM)
Reassortment Facilitates Emergence of Pandemic Strains
2009 H1N1 Swine Origin Influenza
(Adapted from NSOII, 2009, NEJM)
H7N9
H5N1, H9N2
H3N2CIV
H6N6SIV
SARS
H10N8
(Wan et al. 1998; Guo et al. 1999)
Emergence of H5N1 HPAIV
A/goose/Guangdong/1/1996 (H5N1)
A/goose/Guangdong/2/1996 (H5N1)
Hong Kong 97 H5N1 Outbreaks
(http://www.info.gov.hk/)
l First case in May 1997
l Late 1997 and early 1998
l 18 confirmed human case
l 6 deaths
l 1.5 m domestic poultries killed
Avian Influenza Since 2003
l >200 million birds culled
l More than 602 human cases with 355 deaths
HA from 1996 to 2007
(Zhao et al., 2008, Journal of General Virology)
A/turkey/England/50-92/1991 (H5N1)
2001 2002 2003 2004 2005 2006 2007 1998 1999 2000 1996 1997
PR1
PR2
PR7
PR10 11 PR6
PR18 PR21
PR9
PR8
PR12
PR14
PR15 16
19 PR18 PR5
PR4
PR3
PR13
PR17
20
(Wan et al. 2005. Archives of Virology; Zhao et al., 2008, Journal of General Virology)
H5N1 Human Infections in China
Between 10/2005 and 06/2010, 38 confirmed human cases of H5N1
infection in China, with a mortality rate of 65.7%.
These cases were widely distributed across 17 districts or provinces and
occurred in individuals aged 2 to 62 years (median, 32 years). No
significant geographic clusters were found, although one possible case
of human-to-human transmission was detected.
After 2004, massive H5N1 vaccination campaigns reduced the number
of H5N1 outbreaks in poultry from 50 in 2004 to 32 in 2005 and then to
only 12 in 2006. From January to September of 2006 alone,
approximately 8.2 billion poultry were vaccinated in China.
Human infections have continued to occur in China in the absence of
corresponding outbreaks in poultry.
Contact with poultry has been identified as a risk factor for human
infection with H5N1 highly pathogenic avian influenza virus, but there is
little conclusive evidence of the source of these infections.
Patient Environmental samples
Index*
Date of
clinical
disease
onset
City or
province Isolate
Sample site†
Date of
sample collection
Total
samples
Influenza
A virus +‡
H5N1+‡ H5N1 isolates (Genotype)
30 12/4/2008 Beijing A/Beijing/1/2009(H5N1)
Sanheqingong, Hebei
market
01/06/2009
6
6
6
A/water/Hebei/1/2009(H5N1) (V5)
A/water/Hebei/2/2009(H5N1) (V5)
A/water/Hebei/3/2009(H5N1) (V5) A/duck feces/Hebei/5/2009(H5N1) (V5)
32 01/07/2009 Shanxi None
Changsha,
Hunan
market
01/16/2009
8
8
4
A/water/Hunan/3/2009(H5N1)(V4)
A/water/Hunan/7/2009(H5N1)(V)
33 01/08/2009 Hunan A/Hunan/1/2009(H5N1)
Guizhou,
Guiyang, household
01/17/2009
18
1
0
0
34 01/10/2009 Xinjiang A/Xinjiang/1/2009(H5N1)
Changjie,
Xinjiang market
01/22/2009
17
6
2
A/water/Xinjiang/3/2009(H5N1)(V)
A/environment/Xinjiang/6/2009(H5N1)
(V)
35 01/15/2009 Guizhou A/Guizhou/1/2009(H5N1)
Guiyang,
Guizhou
market
01/24/2009
9
6
4
A/environment/Guizhou/2/2009(H5N1)
(V5) A/environment/Guizhou/4/2009(H5N1)
(V5)
A/environment/Guizhou/7/2009(H5N1)
(V5)
A/environment/Guizhou/9/2009(H5N1)
(V5)
37 01/23/2009 Hunan A/Hunan/2/09(H5N1) Xupu, Hunan
household
01/29/2009
11
4
1
0
1
Detection of H5N1 virus in environmental samples associated with human H5N1 infection in China (2008-2009)
69 32 12 (Wan et al. 2011. J Virol)
(Wan et al. 2011. J Virol)
Emerging H6N6 Avian Origin Swine Influenza Virus can cause both contact limited aerosol
transmission among ferrets
(Zhang et al. 2011; Sun et al. Submitted)
Emergence of H3N2 Avian Origin Canine Influenza Virus
(Li et al. 2010)
Emerging H7N9 Low Pathogenic Avian Influenza Virus
• 10 billion US dollars economic losses with 2 months
• Over 230 human cases; Since Jan 1, 2014, Over 102 confirmed case!