The Influenza Virus
The Influenza Virus
复制标题
流感病毒
DOI：
10.1038/scientificamerican0453-27
复制
发表时间：
1953
影响因子：
3
通讯作者：
Sir Macfarlane Burnet
中科院分区：
文献类型：
--
作者：
Sir Macfarlane Burnet
在一个医学和社会进步几乎消除了严重传染病的世界里，流感占有独特的地位。在发达的西方国家，它是唯一一种仍然侵袭大多数成年人的急性传染病。它是20世纪唯一一种显示出毒性增强的疾病，在世界范围内不受控制地蔓延，在此过程中导致数百万人死亡。这发生在1918- 1919年。这样的疫情会再次爆发吗？如果再次爆发，我们现在的疫苗和药物能控制它吗？目前还没有人能给出答案。流感工作的主要目标是，一旦流感再次出现，做好应对这种致命大流行的准备。近年来我们经历的周期性流感流行，其中一场正在北美和欧洲蔓延，其形式较温和。只要流感保持它自1933年以来所表现出的特征，我们的实际目标就有限。疫苗免疫主要应用于军事人员，目的是避免浪费时间，特别是在训练期间。从理论上讲，用类似的方法保护全体人口可能是可取的；对士兵有好处的，对平民也一定有好处。实际上，没有多少人认为流感是一种严重到每年秋天都要打一两次免疫“针”的危险，而且，如果没有比我们更了解哪些流感病毒株可能产生流行病，就很难对大规模免疫产生热情。然而，麦克法兰·伯内特爵士（Sir Macfarlane Burnet）的平民群体中有一个群体需要密切研究，以便决定我们是否应该设法每年为其所有成员接种疫苗。这些是老年人。每当流感在一个社区流行时，老年人因各种原因死亡的人数就会急剧上升。任何因身体残疾而变得虚弱的老年人都有可能患上流感。这一点在1951年英国流感爆发期间尤为突出。在利物浦，这种流行病像死亡天使一样在老年人中间传播。在高峰周，死亡人数超过了1918- 1919年大流行最严重的一周。对老年人适当接种流感疫苗可能挽救生命的调查似乎是一项非常有价值的项目。我们现在对1933年首次分离出的人流感病毒有了大量的了解。对于这些知识，我们在很大程度上要归功于1941年前后的两项重大技术发现：(1)一种方便的方法（在鸡胚中）培养病毒，(2)一种检测病毒存在的方法（悬浮在试管中的红细胞结块）。由于有了这些实验室辅助工具，我们可以毫不夸张地说，如今对流感病毒的了解已经与白喉杆菌或肺炎球菌一样透彻。它们极大地促进了对流感各个方面的研究。研究任何疾病的第一个要求是能够根据致病微生物对其进行定义。这在本案中尤为重要
IN A WORLD from which medical science and social progress have al most eliminated serious infectious disease, influenza holds a unique posi tion. It is the only acute infectious ill ness that still attacks most adults in advanced Western countries. And it is the only disease which in the 20th cen tury has shown a capacity to increase in virulence and sweep unchecked around the world, killing millions in the process. That happened in 1918-19. Could such an outbreak occur again, and if it did, could our present-day vaccines and drugs control it? No one can yet say. The main objective of work on influ enza is to be prepared to deal with a lethal pandemic of that type, should one appear again. The periodic epidemics of influenza that we have had in recent years, one of which is now running its course in North America and Europe, have been of a milder form. As long as influenza retains the character it has shown since 1933, our practical objec tives are limited. Immunization with vaccines has been applied mainly to military personnel for the purpose of avoiding loss of time, particularly dur ing training. Theoretically it might be desirable to protect the whole popula tion by similar methods; what is good for the soldier surely is good for the civilian. Actually not many people re gard influenza as a serious enough dan ger to want to have one or two immu nizing" shots" each fall, and without a better knowledge than we have of what strains of influenza viruses are likely to produce epidemics, it is diffi cult to become enthusiastic about large scale immunization. Yet there is one group in the civilian by Sir Macfarlane Burnet population that needs close study, with a view to deciding whether we should try to immunize all its members each year. These are the elderly people. Whenever an epidemic of influenza passes through a community, there is a sharp peak of deaths from various causes among the aged. Any elderly person rendered frail by physical disability is likely to succumb to an attack of influ enza. This was heavily underlined dur ing the 1951 influenza outbreak in Great Britain. In Liverpool the epidemic passed like an angel of death amongst the old. During the peak week there were more deaths than in the worst week of the 1918-19 pandemic. An investiga tion of the saving of life that might be effected by appropriate immunization of the aged against influenza would seem to be a very worthwhile project.WE NOW HAVE a substantial fund of knowledge about the virus of hu man influenza, which was first isolated in 1933. For this knowledge we are largely indebted to two major technical discoveries made about 1941:(1) a convenient way of growing the virus (in chick embryos), and (2) a test to deter mine the presence of the virus (the clumping of red blood cells suspended in a test tube). Thanks to these labora tory aids, it is hardly too much to say that the influenza virus today is as well understood as the diphtheria bacillus or the pneumococcus. They have given a tremendous stimulus to the investigation of all aspects of influenza. The first requirement in the study of any disease is to be able to define it in terms of the responsible microorganism. This is especially important in the case