. .

21/10/2009
www.loimoxi.blogspot.com


;
;

;

10 ;

;
;

 91


Orthomyxoviridae / RNA

Influenza A
(, )

Influenza

Influenza C


()




3-5 . /
250.000-500.000
>50

(32 11) /



1-3
:

,


( / )
5 . ( 2)
65

, , ,
, , (..
),


:




Guillain-Barr
Reye
:
, ,


Influenza A
1918-1919

11

1957

22

1965-1967

32

?? 2009

11

(I )

(Hong-Kong)

 2009 H1N1;
24-02-09

Patient zero
6-month-old girl from . Mexico

: 3/09
2009 11

( ),
(2 , 1
, 1 )
Science 2009;325:197-201
N Engl J Med 2009;361:279-285

 2009 H1N1 ;

:
- (, )
-
2-8
: - 70-100C
-

- 1/10
-





(1-4%)

 ;
4-6
:
1
5-7

( <1 - 4%)
,
.
www.cdc.gov/ctober, 2009

CDC/September 16, 2009


;

-
( )
- , , , ,
( +
)
-
<19

<5

,
, ,
, , , ,
, ,

37.8 C
/

real-time RT-PCR
11
x 4 11 ()

test influenza A
human H1 H3
CDC 2009
( RT-PCR)


;


(.. , / )

-






>3

-



-

(7 .)



-
( )

 -
:


,


: 48

 -
( )
(Tamiflu)

(Relenza)

(
, .
)


(5 )

(10
)

75mg 2 /

75 mg 1 /

<15 kg

30 mg 2 /

30 mg 1 /

15-23 kg

45 mg 2 /

45 mg 1 /

24-40 kg

60 mg 2 /

60 mg 1 /

>40 kg

75 mg 2 /

75 mg 1 /

>12 )


(5 )

(10 )

5 mg
( 10)
/

5 mg
( 10)
/

5 mg
( 10)
/
>5

5 mg
( 10)
/ >7







,
.
:
1.
2.
3.

,
.
.

, .
.
.
O
. .
, , .
.
.

 :
- ,

-
-
-
-
-


;;

: S. pneumoniae
25%



6

J Hyg 1949;47:434-8.
Quart J Med 1952;21:291-306
Vaccine 1999;17:S3-10
JAMA 1970;214:1825-32
National Vital Statistics Reports 1999;47:27-3

7
Prevenar
2 5
9

10
2 2

23
Pneumo 23


-2
- 60

Synflorix


2009-2010 :
A/Brisbane/59/2007 (H1N1)-like
A/Brisbane/10/2007 (H3N2)-like
B/Brisbane/60/2008-like


6 . - 8 . ,
2 ,
.

H1N1

CDC 2009
MMWR 2009

6 18

6
A
CDC 2009
MMWR 2009


;;;

:
6 59

( ),
( ), --- ( )


(> 18 ):

50

, , ,
, , ,

( HIV)


< 5 . > 50 .,
< 6


CDC 2009
MMWR 2009


. Guillain-Barr

11 -
FDA 4 1N1,

Sanofi Pasteur
Novartis
CSL
straZeneca
straZeneca

Sanofi
6 .
FirstWord 15-09-2009

Celvapan

Baxter AG

A California/07/2009 (H1N1)v

Focetria

7.5 micrograms / 0.5 ml

Novartis Vaccines

A/California/7/2009 (H1N1)v like strain (X-181)

7.5 micrograms / 0.5 ml

Pandemrix GlaxoSmithKline Biologicals s.a.

A/California/7/2009 (H1N1)v-like strain (X-179A)

3.75 micrograms / 0.5 ml

+ ASO3 adjuvant

EMEA, 2009

11 -
( -
):


<6 ( , ,
)

6 24
25-64

MMWR August 28, 2009 / 58(RR10);1-8

11

6
6 -18
19-64 (
, ,
, ,
, ,
, )

.
19-49 .
2 3

2009



1N1



www.who.int/csr (31-08-09)
http://ecdc.europa.eu/ (3-9-09)
www.cdc.gov/h1n1flu (7-09-09)
http://www.niaid.nih.gov/ (7-09-09)

11 -

;;

:
:
:
:

34%
43%
35%
50%
Reuters. September 30, 2009.

:
38%

72%
The AP-GfK Poll. October 12, 2009



,
.


.


.