- 期刊
Influenza: Prospect for Prevention and Control
流行性感冒：預防與控制的遠景
摘要
流行性感冒不但是一種危機性(emerging)的疾病，也是一種隨時浮現(Reemerging)的傳染性疾病。自從1930年代後期(1933感冒病毒被分離出來)以來，每年流行性感冒病毒都可以從全世界各流行區域被分離出來。流行性感冒病毒在流行病學上的成功優勢，主要歸功於其難以預期的快速基因改變(Antigenic drift，基因飄變)與新型病毒的產生(Antigenic shift，基因轉變)。後者通常導因於人的流行性感冒病毒與鳥型流行性感冒病毒間的基因重組(Reassortment)。1957年全球性的亞洲型感冒(H2N2)及1968年的香港型感冒(H3N2)即是流行性冒病毒基因轉變的例子。由於近年來各地浮現出不平凡的流行性感冒病毒(例如1997年的H5N1與1999年的H9N2鳥型流感病毒，及在歐洲出現於禽與人之人鳥型病毒)，因而引起專家們的推測，不久將有流行性感冒大爆發的可能性。流行性感冒因不明顯感染多、潛伏期短、傳染性高，所以常常突然爆發而且迅速漫延到周圍社區與國家。隔離似乎難以有效防堵流行性冒的散播。雖然非完全但預防接種與抗病毒藥物可以有效的減少流感的散播、減輕病症、減少死亡率、降低社會成本與經濟的損失。對於未來控制流感可能的流行，需要全國性與國際性的密切合作，不斷的監測流感活動及其動向、交換流感資訊，以為流感疫苗製造及抗流感病毒藥物之發展基礎。
並列摘要
Influenza is an emerging and re-emerging disease. Since the late 1930s influenza viruses have been isolated yearly from different parts of the world during epidemics and pandemics. The ”epidemiologic success” of influenza is due largely to rapid and unpredictable antigenic changes (antigenic drift) among human influenza viruses, and the emergence of new subtypes (antigenic shift), mostly from reassortment between human and avian influenza viruses. Antigenic shifts were attributed to the global pandemic viruses of 1957 (B2N2 Asian flu) and 1968 (H3N2 Hong Kong flu). Concern over possible new pandemics has been heightened by recent reports of human infection in Asia in 1997 with avian viruses (H5N1) and in 1999 (H9N2) and isolation of human-avian reassorted viruses from pigs and humans in Europe. Influenza has a high rate of inapparent infection, short incubation and high infectivity; epidemics usually start abruptly and spread rapidly to neighboring communities and countries. Isolation and quarantine are often unsuccessful in preventing the spread of the infection. Although not perfect, immunization and chemoprophylaxis are highly effective at minimizing the spread of influenza and reducing morbidity and mortality, social disruption and economic loss. Plans for future influenza epidemics and pandemics require national and international programs to be in place for the monitoring of influenza activity, the dissemination and exchange of information and the provision and delivery of sufficient quantities of vaccines and antiviral agents. This paper reviews and discusses the antigenic variations of the influenza virus, potential influenza pandemics, protective efficacy of inactivated vaccines and antiviral agents and preparation for control of future epidemics and pandemics.