INFLUENZA PANDEMIC PREPAREDNESS IN ASIA

流感病毒在所有年龄段的人中都能引起严重的感染和疾病，这是公认的。这些年度流感疫情的严重程度各不相同，并可归因于这些病毒经历快速遗传进化的方式。直到1997年底，本世纪S的历史记录表明，只有H1、H2和H3亚型可以影响人类。然而，面对香港爆发的H5N1疫情，这一假设被打破了，当时有18人感染了H5N1禽流感病毒。这些病例中有6例死亡。虽然大家都知道禽鸟和猪(猪)病毒可以在不改变病毒基因的情况下感染人类，但香港人类感染个案的性质令人非常关注，因为我们可能正面对一场大流行的开始。H5N1流感病毒从家禽向人类的传播强调了需要有关于世界动物宿主中流行的所有流感亚型的信息。众所周知，世界上的水禽使已知的每一种亚型流感病毒永久化。然而，目前还不知道哪些亚型和变种占主导地位。对于控制大流行性流感，我们必须对世界各地，特别是亚洲的禽鸟和动物的流感病毒进行系统和持续的监测，并生产和储存病毒、试剂和技术，以促进快速定性和信息交流。了解欧亚和美洲流感病毒谱系之间的根本差异、流感病毒传播到其他宿主时发生的分子变化以及特定亚型在其自然宿主中的优势也是至关重要的。如果我们能够在这些问题上获得知识，我们可能就能更好地为迅速应对新出现的流感大流行做好准备。

Influenza viruses are recognized for their ability to cause serious infection and disease, in all age-groups of people. These annual influenza epidemics vary in severity, and are attributable to the way in which these viruses undergo rapid genetic evolution. Up until late 1997, this century~s historical record suggested that only H1, H2 and H3 subtypes could affect humans. However this assumption came unraveled in the face of the H5N1 outbreak in Hong Kong in which 18 people became infected with an H5N1 avian (chicken) influenza virus. Six of these cases were fatal. While it is recognized that avian and swine (pig) viruses can infect man without reassortment of the viral genes, the nature of the human cases in Hong Kong aroused great concern that we were possibly facing the beginning of a pandemic. The transmission of H5N1 influenza viruses from domestic poultry to humans emphasizes the need to have information available on all influenza subtypes circulating in the animal reservoirs of the world. It is well established that the aquatic birds of the world perpetuate each of the known subtypes of influenza viruses. However, it is not known which subtypes and variants are dominant. It is essential for the control of pandemic influenza that we implement systematic and continuous surveillance for influenza viruses in birds and animals of the world, particularly in Asia, and production and storage of viruses, reagents and technologies to facilitate rapid characterization and exchange of information. It is also essential to understand the fundamental differences between the Eurasian and American lineages of influenza viruses, the molecular changes that occur when influenza viruses transmit to other hosts and the dominance of particular subtypes in their natural reservoirs. If we can gain knowledge on these issues, we might be better prepared to respond rapidly to an emerging influenza pandemic.