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🏥 | A doctor who handles the nation's leading PCR tests and vaccinations, "Now should drop from class 2 to class 5" for corona convergence ...


Photo: Director Wataru Sasakura of "MY Medical Clinic" (Photo provided)

A doctor who handles one of the nation's leading PCR tests and vaccinations, "Now should drop from class 2 to class 5" for corona convergence ...

 
If you write the contents roughly
The new Corona, which has been vaccinated and has come out with therapeutic drugs, is a good opportunity to remove the Class 2 designation.
 

"MY Medical Clinic" (Tokyo ... → Continue reading

 Daily Gendai Healthcare

We will deliver the medical and health articles of the evening paper "Daily Gendai". From everyday health laws to the latest medical information, all articles are based on interviews with doctors and specialists.


Wikipedia related words

If there is no explanation, there is no corresponding item on Wikipedia.

vaccination

vaccination(Vaccination,British: vaccination) IssickAgainstImmunologyTo attachantigenmaterial(vaccine) Administered (Vaccination) What to do.VaccinationBy pathogeninfectionbyIllness,Obstacle,DeathCan be prevented or tempered[1].. furtherEpidemicThe simplest and most effective way to preventCost performanceHighPreventive medicine.

JapanInVaccination methodDefines as "injecting or inoculating a human body with a vaccine that has been confirmed to be effective in preventing the disease in order to obtain an immune effect against the disease" (the vaccination method) Article 2 paragraph 1).

The substance administered by inoculation is a pathogen (live, but less virulent)Bacteria-ウ イ ル ス), a dead or inactivated pathogen, or a purified substance such as a protein.

WHOAccording to the current world, vaccination avoids the death of 200 to 300 million people.[1].. However, if the vaccination rate is further improved, the death of 150 million people can be avoided.[1].

History

Human beings willing to get another kind of infectionsickThe first example trying to mitigatesmallpox.B.C.Around 1000,IndiaVaccination method(Variolation method) is practiced[2], Of smallpox patientspusTo a healthy person to cause mild onsetImmunologyWas being done. This smallpox method18st centuryIn the first halfThe United Kingdom, ThenAmericaWas also brought to.

1718 years,Mary Wortley MontagueWrote about the Turkish custom of vaccination with liquids from small-pox smallpox and gave similar vaccinations to their children.[3].The United KingdomThe doctorEdward JennerIt is,VacciniaAs to whether the vaccine can be used to generate immunity against human smallpox,1796 Have tested at least 6 people in the last few years. The six are unidentified English (around 6), Mrs Zebel (German, around 1771), Mr. Jensen (German, around 1772), and Benjamin Jestie (English, 1770). Mrs. Rendall (English, c. 1774) and Peter Prett (German, 1782).[4][5].

The word vaccination was first used1796 ,Edward JennerBy. After thisLouis PasteurAdvanced the concept of vaccination with advanced research in microbiology. The vaccination (from the Latin vacca meaning Vaccination "cattle") derives its name from the first vaccine (vaccine) that infects cattle.Cowpox virusso,smallpoxIs less symptomatic, harder to cure and deadlysmallpoxBecause it gave a certain amount of immunity to[4][5].

For vaccination attempts, there are ethics, politics, safety, religion, etc.en: Vaccine controversy) Has been around since the early days. With early successMandatoryVaccination has been widely accepted by the government and a large-scale vaccination campaign has been carried out, which has significantly reduced the incidence of many diseases across many regions.

the purpose

To make antibodies against pathogens and boost immune function

Side effects

in Japan1948 of"Vaccination methodSince then, compulsory vaccination and mass vaccination have expanded, but they have not been carried out in a safe manner.To give an example1964 ToIbarakiInsufficient interviews, inoculation of multiple people without changing needles,MASKSInoculation, infusion of inaccurate amount, etc. were performed without[6]..In Japan, the act of inoculating multiple people without changing needles was widespread.Type B,Hepatitis CIs a frequent cause[7],It is believed that( Iatrogenic diseaseSee also).

Substances used

Inactivated vaccine

Lived with sufficiently reduced toxicityウ イ ル スInoculate.ウ イ ル スBreed, but their speed is slow. Boosting is not necessary so much because it propagates after inoculation and continues to exist as an antigen. This vaccine is produced by leaving a less virulent type of virus in tissue culture, inducing gene mutation, or removing a specific gene that exerts virulence. This major vaccine has a risk of recurrent toxicity, but removal of specific genes is relatively less risky.

Subunit vaccine

As an antigen shown to the immune systemウ イ ル スDo not inoculate sex substances.ウ イ ル スSpecific inproteinThere is a method such as separating and inoculating. The weakness of this method is that the separated proteins may be altered, in which case antibodies different from those corresponding to the virus will be produced.

Other subunit vaccines include recombinant vaccines. This is a method of injecting a protein gene of a target virus into another virus. This second virus expresses protein information but is not at risk of disease. This kind of vaccine is nowViral hepatitisIs used forEbola virus,HIVIt is being actively researched to make a vaccine against a virus that is difficult to vaccinate.[8].

Vaccination against humans

The vaccination situation in the world is as follows.

Type of vaccine

Live vaccine
A weakened virulence of a living pathogen. ,tuberculosis,Measles(Measles),Rubella,Mumps,Varieg(Mizubouso),yellow fever Such.Due to the inclusion of live pathogens, inoculated pathogens may cause mild symptoms (side reactions).
After vaccination, give another vaccine at intervals of 4 weeks (medium 27 days) or more.
Inactivated vaccine
Only the components of the pathogen that died and lost its toxicity.Hepatitis B,, pediatric,Pertussis,Polio,Japanese encephalitis,influenza,Hepatitis A,Rabiesetc.vaccineThe effect of is weak, so multiple doses are often required.
After vaccination, give another vaccine at intervals of 1 weeks (medium 6 days) or more.
Toxoid
The toxin produced by the fungus is taken out and detoxified.diphtheria,tetanus(Hashoufu) etc. As with inactivated vaccines, the vaccines are less effective and often require multiple doses. There is also the idea that it is not strictly included in the vaccine because it does not make antibodies that attack the pathogen itself.
After vaccination, give another vaccine at intervals of 1 weeks (medium 6 days) or more.

History

The practice of vaccination is believed to have its origins in ancient India, around 1000 BC.[9]Ayurvedic textbook Sact'eya Grantham was described about vaccination, according to French scholar Henri Marie Husson in Dictionaire des sciences me`dicales. It has been reported.[10] Around 200 BC, vaccinations were carried out even in ancient China[5].. Scholar Ole Lund writes: "The oldest documented example of vaccination is from 17th-century India and China, where powdered scabs of people with smallpox were used to prevent the disease. In the olden days, smallpox was a universal disease that killed 20% to 30% of infected people, smallpox accounting for 18% to 8% of deaths in several 20th-century European countries. Professor of Pathology, (en: Almroth Wright) Conducted an experiment led by a professional at Netley Hospital and shaped the form of vaccination for posterity. The results of his experiment led to the development of further vaccinations in Europe[11].

Mandatory

In order to avoid the spread of illness, at different times, states and institutions have created laws that mandate vaccination for all. For example, the 1853 law mandated smallpox vaccinations throughout England and Wales, and fined those who did not comply. Currently, the US state-wide vaccination law requires public vaccination before school. Most other countries have similar vaccinations.

Since the earliest vaccinations beginning in the 19th century, the legalization of vaccination has caused backlash from various groups. These groups are collectively known as anti-vaccinationists, who oppose vaccination from an ethical, political, hygienic, religious, and other perspectives. Common opinions are that “compulsory vaccination is excessive interference with individual problems” and “recommended vaccination is not sufficiently safe”.[12].. Modern vaccination laws provide exceptions to people with immunodeficiencies, people who are allergic to the vaccine, and those who strongly oppose it.[13].. In addition,Yogyakarta PrinciplesIn the 18th principle of "Protection against medical abuse" ofHIV infectionUnethical or unintentional vaccines forAntibacterial agentGuaranteeing protection from the administration of "(18th principle, item (d))".

Japanese vaccination

Routine vaccination

Vaccination methodWill be inoculated based on. For the vaccination costs for the target age, public funds are provided by the local government, and regarding A-type diseases,Local governmentMost of them are free of charge (administrative measures vaccinations, and there are also local governments that pay a fee). In case of health damage due to vaccination approved in Japan, there is a relief system under Article 11 of the Vaccination Law.[14].

[] Name of vaccine

Type A disease --For the purpose of preventing the outbreak of the disease and the spread of the disease in the population, the vaccination target or its guardian is obliged to make efforts for vaccination.
diphtheria-Social Services Lizard-tetanus-Polio(Acute poliomyelitis)[Four kinds of mixed vaccine, DPT-IPV],measles(Measles)rubella(Three days measles)MR vaccine],Japanese encephalitis,tuberculosis(BCG),Varieg,Hib, PediatricPneumococcusInfection【Pneumococcal vaccine, PCV13】,Cervical cancerHPV vaccine],Hepatitis B, Rotavirus[15]
Type B disease -Mainly focused on individual prevention. No effort required.
People over the age of 65, or between the ages of 60 and under 65, with severe heart, kidney, or respiratory problems,Acquired immunodeficiency syndromeIf you are suffering frominfluenza.. In the case of people aged 65 or over, under 60 years of age and under 65 years of age, with severe heart, kidney, or respiratory disorders, or those with AIDS and weakened immunity, pneumococcal infection [23-valent pneumococcal capsular polysaccharide vaccine, PPSV23】.

Temporary inoculation

Vaccination methodWill be inoculated based on. When the prefectural governor finds that there is an urgent need to prevent the spread, the prefectural governor may instruct the mayor to do so. Municipalities will subsidize the vaccination costs for the target ages, and in principle, the A-type diseases will be free. If health damage occurs due to vaccination, there is a relief system under Article 11 of the Vaccination Law.[14].

Type A disease -The vaccination target person or their guardian is required to make vaccination efforts.
smallpoxIn addition, type A diseases are targeted.
Inoculation was started in 2021.New coronavirus OfvaccineIs carried out in the form of imposing an obligation to make efforts for inoculation[16].
Type B disease -No vaccination effort is imposed.
HXNUMXNXNUMX influenza(As a single vaccineNew influenza measures special measures law2011 years from 23 (5)[17].. A(H2011N12)pdm1 has been included in seasonal influenza vaccine since FY1/09[18]. )

Optional vaccination

Vaccination is voluntary by the vaccinated person (or their parental authority, etc.), which is not stipulated in the Vaccination Law.

All vaccination costs will be borne by the owner. If health damage occurs due to vaccination,Relief system for adverse drug reactionsIs applied.

Mumps(Mumps),Hepatitis A, For adultsPneumococcus,Rabies,Weil's disease Autumn darknessIn addition to the above, other vaccinations other than the age groups subject to regular vaccination are also optional vaccinations.

Precautions for vaccination

According to the Vaccination Regulations, those who have a clear fever, those who have a serious acute illness, and allergies or anaphylaxis due to the components of the vaccination solution for vaccination related to the disease are revealed by the test. Those who have become ineligible are considered unsuitable and cannot be vaccinated. Pregnant persons will not be vaccinated for acute poliomyelitis, measles and rubella.

In addition, those who are known to have basic diseases such as cardiovascular diseases, kidney diseases, liver diseases, blood diseases and developmental disorders, those who have fever within 2 days after the previous vaccination, or systemic rashes, etc. Of allergic allergies, having a history of convulsions in the past, having been previously diagnosed with immunodeficiency, or being allergic to the components of the inoculum to be vaccinated Some people are obliged to take vaccinations carefully based on the judgment of the doctor.

Vaccination health damage relief system

Occurrence of health damage due to side effects of vaccination is seen, although it is extremely rare. A system for prompt relief when a causal relationship between vaccination and health damage is recognized, regardless of whether or not there is negligence in the vaccination.[19].

  • Vaccination based on the Vaccination Law (=RegularInoculation,ExtraordinaryIf the Minister of Health, Labor and Welfare finds that the health damage has been caused by the
    • Benefits are provided by the municipality.
    • Minister of Health, Labour and WelfareIn the certification of, the causal relationship is examined by a disease/disability certification examination committee composed of a third party.
    • If you receive medical treatment at a medical institution, you will be required to pay the medical expenses and your expenses.
    • When disability remains, child disability pension or disability pension is paid.
    • In case of death, funeral fees and lump-sum death allowance of approximately 4,300 million yen (in case of influenza vaccine, lump-sum payment of surviving family of approximately 700 million yen, survivor pension of approximately 240 million yen (up to 10 years)) will be provided.
    • The cost of relief payment is 1/2 for the country, 1/4 for the prefecture, and 1/4 for the municipality.

Incidentally,anyAs for other health hazards due to vaccination, the drug side effect damage relief system is applied. It is based on the Pharmaceuticals and Medical Devices Agency, an incorporated administrative agency, rather than the Vaccinations Act.

  • Established by the Ministry of Health, Labor and Welfare and decided after discussions at the Pharmaceutical Affairs and Food Sanitation Council, which is composed of external experts.
    • Pharmaceuticals and Medical Devices Agency (PMDA) Is provided.
    • If you receive medical treatment in hospital, you will be provided with medical expenses and medical allowance. Payment will be provided in case of disability and death.
    • Benefits are set for each type, and there is also a deadline for billing.
    • Contribution from the licensed drug manufacturing and marketing companies, etc. shall be paid for the relief payment. Half of PMDA's administrative expenses are subsidies from the national government.

Vaccinations and laws (valley problems)

There is a legal structure to remedy victims whose lives and bodies have been seriously damaged by vaccination.ConstitutionIt is a problem above.17 articleTheory,29 articleParagraph 3 Interpretation theory, Article 29 Paragraph 3 Of course, interpretation theory,25 articleTheory,13 articleTheories are claimed.

Recommended vaccination sequence

National Institute of Infectious DiseasesKnow VPD,NPOVaccination schedules have been announced by the Society for the Protection of Children, the Japan Association for Primary Care, and the Japan Society for Pediatrics.

Also, at the NPO Corporation Children's Association,iPhone-AndroidSmartphoneThe vaccination scheduler app for Android is provided free of charge.

Simultaneous inoculation

``Simultaneous vaccination'' in which two or more types of vaccinations are given to one and the same person at the same time in one visit is once recognized as ``not good'' in Japan, and MHLW is "What doctors can do if they find it necessary"[20][21]However, in 2011, the Japanese Academy of Pediatrics proposed that "simultaneous vaccination is considered a necessary medical practice to protect Japanese children from diseases that can be prevented by vaccines".[21], In recent years, the number of doctors giving simultaneous vaccination has increased[22].

There is no limit to the number of combinations and

  1. Regular vaccination and voluntary vaccination
  2. Inactivated and live vaccines
  3. Live vaccines and live vaccines
  4. Injection and drink type vaccine

Can be safely inoculated simultaneously with all combinations of[23].. Some local governments and doctors have different vaccination methodsBCGOnly in the case of single vaccination without simultaneous vaccination with other vaccines[24][25].

Since a mixed vaccine contains several types of vaccine in one injection solution from the beginning, it can be said that it is a simultaneous vaccination in a broad sense.[23].

Italy vaccination

In Italy2017 Than,Compulsory educationBefore receiving (up to 6 years old)Polio,diphtheria,tetanus,Hepatitis B,influenza,,,measles,rubella,Mumps,XNUMX days,chicken poxVaccinations have become mandatory[26].

Vaccination of animals

AnimalからPeopleTo be contagiousInfectious disease of animal origin(Zoonosis:Zoonosis(Also included in) and transmitted from humans to animalsZoonosisThere is vaccination for the purpose of preventing. Useful for wildlife conservation and industry家畜,Pet OfEpidemicThere are also vaccinations to prevent the spread of the disease.

Ministry of AgricultureVeterinary drug laboratory・Veterinary drug database[27]If you search for “vaccine” in, 2014 cases were registered as of December 12. But,Domestic animal infectious disease prevention methodIs a "law that stipulates the prevention of outbreaks of infectious diseases (infectious diseases) in livestock and the prevention of spread of livestock."And killDisposaldisinfectionHowever, there is no regulation regarding vaccination. "The prefectural governor, when necessary to prevent the spread of livestock infectious diseases, can have livestock quarantine officers inspect, inject, bathe or administer livestock by the methods specified by the Ordinance of the Ministry of Agriculture, Forestry and Fisheries ( Based on the Livestock Infectious Diseases Prevention Law Article 31)", the measures such as vaccination are different for each prefecture.[28].

on the other hand,Rabies Prevention LawSince it is regulated byDogThe owner of the dogRabies vaccineMust be vaccinated once a year (Article 1 of the Rabies Prevention Law).

footnote

[How to use footnotes]
  1. ^ a b c d e f g h Immunization coverage (Report). WHO. (2007-03). http://www.who.int/mediacentre/factsheets/fs378/en/. 
  2. ^ Smallpox prevention[1]
  3. ^ Behbehani AM (1983). “The smallpox story: life and death of an old disease”. Microbiol. Rev. 47 (4): 455-509. PMID 6319980. http://mmbr.asm.org/cgi/pmidlookup?view=long&pmid=6319980. 
  4. ^ a b Plett PC (2006). “[Peter Plett and other discoverers of cowpox vaccination before Edward Jenner”] (German). Sudhoffs Arch 90 (2): 219-32. PMID 17338405. http://lib.bioinfo.pl/meid:4459 NovemberBrowse.. 
  5. ^ a b c Lombard M, Pastoret PP, Moulin AM (2007). “A brief history of vaccines and vaccination”. Rev Sci Tech. 26 (1): 29-48. PMID 17633292. 
  6. ^ Kenji Yoshihara "From Private Rage to Public Rage-Vaccine Evil as a Social Problem" p.112-114
  7. ^ Yomiuri Shimbun February 2000, 2 Article "Expanding hepatitis C, in areas where 9% are "positive""
  8. ^ Department of Veterinary Science & Microbiology at The University of Arizona Archived August 2003, 6, at the Wayback Machine. Vaccines by Janet M. Decker, PhD
  9. ^ Lund, Ole; Nielsen, Morten Strunge and Lundegaard, Claus (2005). Immunological Bioinformatics.MIT Press. ISBN 0262122804
  10. ^ Chaumeton, FP; FV Me`rat de Vaumartoise. Dictionaire des sciences me`dicales.Paris: CLF Panckoucke, 1812-1822, lvi (1821).
  11. ^ Curtin, Phillip (1998). "Disease and Empire: The Health of European Troops in the Conquest of Africa". Cambridge University Press. ISBN 0521598354
  12. ^ Wolfe R, Sharp L (2002). “Anti-vaccinationists past and present”. BMJ 325 (7361): 430-2. two:10.1136 / bmj.325.7361.430. PMID 12193361. http://bmj.bmjjournals.com/cgi/content/full/325/7361/430. 
  13. ^ Salmon, Daniel A et al.(2006) Compulsory vaccination and conscientious or philosophical exemptions: past, present, and future. Lancet 367(9508):436-442.
  14. ^ a b Medical expenses public expenditure system for vaccination accidents(Tokyo Metropolitan Government Health and Welfare Bureau)
  15. ^ "From Ministry of Health, Labor and Welfare to Rota vaccine regular vaccination from October, 20”. Mix online (October 2019, 10). NovemberBrowse.
  16. ^ "What is the vaccination method? Corona vaccine "special case of temporary vaccination"”. Nihon Keizai Shimbun (May 2021, 4). NovemberBrowse.
  17. ^ Tuberculosis Infectious Disease Division, Health Bureau, Ministry of Health, Labor and WelfareOutline of Vaccination Law revision (establishment of new temporary vaccination, etc.)IASR, Vol. 32, National Institute of Infectious Diseases, Infectious Disease Information Center, November 2011, pp. 11-331.
  18. ^ Influenza vaccine strain -National Institute of Infectious Diseases
  19. ^ Vaccination health damage relief systemMinistry of Health, Labor and Welfare
  20. ^ Periodic vaccination procedure -Ministry of Health, Labor and Welfare
  21. ^ a b Japanese Pediatrics Association's approach to simultaneous vaccination
  22. ^ Vaccination> Simultaneous vaccination -Ariake Children's Clinic
  23. ^ a b Necessity and safety of simultaneous vaccination -Know VPD!
  24. ^ Vaccination of children -Koto Ward
  25. ^ vaccination -Hara Pediatric Clinic
  26. ^ Italy vaccinated to attend school AFP (December 2017, 5) Read December 20, 2017
  27. ^ Veterinary drug database -Ministry of Agriculture, Forestry and Fisheries Veterinary Drug Laboratory
  28. ^ About livestock vaccines -Miyagi Prefectural Livestock Association

Related literature

  • Mikio Watanabe, "A Historical Consideration on Japan's Vaccination System," National Hygiene, Vol. 73, No. 6, Japan Society for National Hygiene, June 2010, pp. 6-243, two:10.3861 / jshhe.73.243.

Related item

外部 リンク

SARS coronavirus 2

SARS coronavirus 2[Note 1](Thirds Coronavirus Two,English: severe acute respiratory syndrome coronavirus 2, Abbreviation: COVID-2) IsNew Coronavirus Infection (COVID-19) [2]CausesSARS-related coronavirus Belongs to (SARSr-CoV)CoronavirusIs[3].Japan OfNational agencyAnd majorNews agencyIs "New coronavirusIs called[4][5],New coronaOr simply "コ ロ ナMay be abbreviated as[5][6][7][8].

January 2019People's Republic of ChinaHubei ProvinceWuhanOccurrence was confirmed for the first time in the vicinity[9],afterwards,COVID-19 pandemic(Pandemic) Is causing.There are different fashion images depending on the country[10].

This virus isSevere acute respiratory syndrome Not the causative virus of (SARS),SARSIs named after SARS-CoV-2, the causative virus of SARS that prevailed between 2002 and 2003.SARS coronavirus(SARS-CoV, orRetro NimThis is because it is the same species as SARS-CoV-1) and is considered to be one of the strains of SARS-related coronavirus (SARSr-CoV).[11][12].

Name

The international official name for this virus is severe acute respiratory syndrome coronavirus 2 (abbreviation: SARS-CoV-2), and the name of the disease is coronavirus disease 2019 (abbreviation: COVID-19).[1].

2020 May 1,who (World Health Organization; WHO) is the virus that causes the disease in Wuhan, China.2019-Ncov(2019 novel coronav(Abbreviation for irus) tentatively named[1][13][14][15][16][Note 2]..This name isMinistry of Health, Labor and WelfareBesides the official website[17],National Institute of Infectious DiseasesCreated `` Pathogen Detection Manual 2019-nCoV''[18], Also used in the "2019-nCoV genetic testing method" based on this[19]..For this reason, it can be found in the names of in vitro drugs and websites created before the official name was decided.[20][21][22][Note 3].

July 2st of the same year,International Virus Classification Committee (ICTV)COVID-2(Severe acute respiratory syndrome coronavVirus 2 OfAcronym) Officially named[3][28][29][30]..As this Japanese translationSARS coronavirus 2[31][32]In addition,SARS Coronavirus-2[33][34],Third Coronavirus 2[35],Severe Acute Respiratory Syndrome Coronavirus 2[36][37],Severe Acute Respiratory Syndrome (SARS) Coronavirus Type 2[38][39]It may be called or written as such.

As of the same year, Japanese national and major media outlets simplyNew coronavirusIs called[4][5][6][16][40].

On the other hand, WHO was affected by this virus on February 2, the same year.diseaseTheCOVID-19(Coronavirus disease 2019 (Abbreviation of)[41].

Controversy over naming

The United States of AmericaIn such cases, give the name of the place of originWuhan virus (Wuhan Virus),China virus There is controversy such as the opinion that it should be called (Chinese Virus) etc.[42][43][44][45].

発 見

SARS coronavirus 2 was confirmed to occur in Wuhan, China in November 2019, and was first confirmed on December 11, 12.who Reported to (WHO)[46]..After that, it occurred from 2019 to 2020.Outbreak in Wuhan, ChinaInpneumoniapatient'sNucleic acid testWith a positive patient samplegenomeThe sequence was determined[47][48][49].

August 2020, 1,PathogenIs investigatingChugoku-National Hygiene and Health Commission (NHC) ExpertZhong NanshanThe group leader isGuangdongAnnounced that human-to-human transmission (human-human transmission) was confirmed in[50]..There is no specific cure for the new coronavirus, but existingAntiviral drugCan be diverted[51].

However, March 2019スペイン OfUniversity of BarcelonaResearch teamBarcelonaAnnounced that a new type of coronavirus was detected in the wastewater sample collected in[52].

September 2019イタリア OfMilanAccording to a study by the National Cancer Center in Tokyo, antibodies to the new coronavirus were detected in blood samples in September 2019 at the earliest.[53].

Classification and lineage

SARS coronavirus 2genomeAsPositive-strand plus RNAhave,CoronavirusBelongs to.This companion includes a large number of species that infect mammals and birds, but even those that cause infectious diseases in humans are serious.pneumoniaCause ofSARS coronavirus (SARS-CoV)MERS coronavirus (MERS-CoV), seasonalcoldcauseHuman coronavirus 229E (HCoV-229)HCoV-OC43, HCoV-NL63, HCoV-HKU1 and so on. SARS-CoV-2 will be available in 2019Human capitalAgainstPathogenicityIt appeared as the 7th coronavirus with.

This virusInternational Virus Classification Committee (ICTV) considers it to be the same species (sister line) as the SARS coronavirus (SARS-CoV) and belongs to the genus.SARS-related coronavirus It belongs to the species (SARSr-CoV)[3]..However, it is not a direct descendant of the SARS coronavirus[54].. originallyBatSuch asWild animalsIt is believed that the carriers of humans independently transmitted to humans and acquired the ability to infect humans.[54].

On January 2020, 3,Sunda pangolinCoronaviruses with 85-92% of the genome have been found in SARS-CoV-2, which are considered to be closer to the ancestors of SARS-CoV-XNUMX.[55][56].

In July 2020, SARS coronavirus 7 belongsSalvecovirusBat virus in evolutionary history analysis by Maciej Boni et al. Using subgenus genomic dataRaTG13Is the most closely related virus that shares a single ancestral lineage, and SARS-CoV-2 was estimated to have genetically diverged from the bat salvecovirus in 1948, 1969, and 1982.[57].

Genome sequence

Thisウ イ ル スFull ofGenome sequenceIs the Shanghai Public Health Clinical Center,Wuhan City Central Clinic,Huazhong University of Science and Technology,Wuhan City Disease Prevention Control Center,China sickness deposit control centerInfectious Disease Control and Prevention Center, Chinese Center for Disease Control and Prevention,University of SydneyDeciphered in collaboration with the University of Sydney, with the cooperation of Professor Edward C. Holmes of the University of Sydney, by Professor Zhang Yongshin of the Shanghai Public Health Clinical Center on January 2020, 1.Virological.orgPublished above[58].

Then, on January 1, the International Nucleic Acid Sequence DatabaseGenBankOfficially published at[59]..China compared to other coronavirusesZhejiang ProvinceZhoushan City OfBatFound fromSARS virusClosest to, bat SARS virus, human SARS virus,CivetHaving a similarity of nearly 80% with the SARS virus,Hong Kong universityReported by Professor Yuen Kwokoku, who specializes in infectious diseases in the Department of Microbiology[60].

The estimated base substitution rate is 0.00084 / base / year, which is about 1/6 to 1/2 times the base substitution rate of influenza.[61].

Construction

Virus particles (Virion) Is 50-200 nm (nanometer)Is about the size[63]..Similar to common coronaviruses, S (peplomer) protein, N (Nucleocapsid) Protein, M (membrane) protein, E (envelope) It is composed of four proteins known as proteins and RNA.Of these, N protein binds to RNANucleocapsidS, E and M proteins that form and bind to lipids surround itenvelopeTo form.The outermost S protein in the envelope is on the cell surface.ACE2Bind to the receptor細胞Allows infection to[64]..The point of using the ACE2 receptor for infecting humansSARS coronavirus It is common with (SARS-CoV) andDPP-4Utilize receptorsMERS coronavirus (MERS-CoV) and(English edition Different from human coronavirus 229E using (APN)[65]..The viral genome is 29,903 baseso,Single-stranded plus-strand RNA virusIs[66].

The primary structure of the protein and the homology of the RNA sequence with SARS coronavirus are 76.0% for S protein, 90.6% for N protein, 90.1% for M protein, and 94.7% for E protein.[67], RNA is 80%[64][68]..On the other hand, another species in the same beta coronavirus[3]MERS coronavirus is 4.6%, 7.6%, 6.3%, 30.5%, respectively.[67], 50%[64]Only match.

Cleavage activation of peplomer

コロナウイルスのSタンパク質は、大きく分けてS1、S2という2つのサブユニットでできており、S1はACE2受容体との結合を、S2は宿主細胞膜と融合を担っている。Sタンパク質は宿主細胞内で合成された直後は1つの連続したタンパク質であるが、次の宿主細胞に感染するためには、どこかのタイミングで、S1サブユニットとS2サブユニットの境界であるS1/S2部位と、S2内部にあるS2'という2箇所の部位が、宿主の持つProteaseIt is believed that it needs to be cleaved by.

Unlike SARS coronavirus, SARS-CoV-2 enhances infectivity and pathogenicity to S protein.FoorinThere is a cutting site[69]..This is unique among salvecoviruses, but it is not uncommon in the entire coronaviridae family, and many (MHV-JHM, MHV-A59) and human coronaviruses (MHV-JHM, MHV-AXNUMX) and human coronavirus (MERS-CoV, HCoV-OC43) Etc. have similar parts[70].

One of the distinguishing features of SARS-CoV-2 is the insertion of four amino acid sequences [PRRA] not found in the closely related coronavirus at the S1 / S2 site.As a result, the amino acid sequence at the boundary site is S [PRRA] R ↓ SVAS, and it is thought that immediately after the S protein is synthesized in the host cell, the "↓" part is cleaved by the host cell's furin. Has been done.

In viruses with S protein that have undergone S1 / S2 cleavage by furin, when the S protein binds to the ACE2 receptor of the next host cell, the TMPRSS2 protease of the host cell on the cell membrane near the receptor causes the S2'site. It is cleaved and the infection is established as it is.

In contrast, in normal coronaviruses such as SARS-CoV with S protein that has not undergone S1 / S2 cleavage, the virus itself binds to the ACE2 receptor of the next host cell after the S protein binds to the ACEXNUMX receptor in the next host cell.EndocytosisIs taken up into the host cellEndosomesThe cathepsin L protease in the cell cleaves the two border sites and fuses with the cell membrane of the endosome to infect. [71] [72] [73] [74]

In 2020, riceUniversity of TexasA research team led by the Faculty of Medicine to verify how much the amino acid sequence [PRRA] contributes to S2 / S1 cleavage of SARS-CoV-2 and, as a result, enhances the infectivity of the virus. , SARS-CoV-2 Wild type Synthesized a variant named ΔPRRA in which only the genetic information corresponding to [PRRA] of S protein was deleted from the original RNA sequence.Calu-3Using cells (human lung hematoma cells cultured for experiments), infection experiments with three types of viruses, SARS-CoV, SARS-CoV-2 wild type, and SARS-CoV-2ΔPRRA mutant strain, were conducted and comparative studies were conducted. bottom. [75]

According to this study, the S1 / S2 cleavage rate of daughter virus released from infected cells was 1.4% for SARS-CoV, 2% for SARS-CoV-87.3 wild type, 33.1% for ΔPRRA mutants, and ΔPRRA. In the mutant strain, it was considered that there is a mechanism to promote S1 / S2 cleavage other than [PRRA].Virus titerA comparison of infectivity based on the wild type showed that the infectivity was about 10 times higher than that of the ΔPRRA mutant strain.

Report "THE ORIGIN OF COVID-2021: An Investigation of the Wuhan Institute of Virology" by the House of Representatives Foreign Affairs Committee and Republican Party, released on August 8, 1. [76] So, citing this University of Texas-centered study and showing further circumstantial evidence, SARS-CoV-2 is from China.Wuhan Institute of VaseIt claims to be an artificially created virus by inserting [PRRA] and other genetic modifications using the bat-hosted coronavirus RaTG13 as a source.

Pathogen

Basic reproduction number

SARS-CoV-2Basic reproduction number (R0Many unpeer-reviewed studies on estimates in) have different numbers and different ratings, but R0Is estimated to be 1.4 to 3.9[77][78][79][80]..This means that in the unprotected state, SARS-CoV-2 usually gives rise to 1 to 1.4 newly infected individuals per infected person.This confirms that SARS-CoV-3.9 infects at least 2 people in a chain reaction.[81].

In other unpeer-reviewed studies, R0From 3.30 to 5.47[82], 2.13[83]To 4.82[84][85]There is something to do.

Infection of animals

ベルギーHealth officials from infectedCatThere was a case where the virus was transmitted to[86].. Other,dog[87],Dora[88]There is also a case where SARS-CoV-2 was detected from.

Cats are highly susceptible to SARS-CoV-2, and in some cases, droplet infections can cause cat-to-cat transmission, according to a report by a Chinese research team.Besides catsferretAlso sensitive, but dogs andDream Pork,Chicken,duckDid not multiply[89]..Being a virologistYoshihiro KawaokaIt is,mousethanhamsterThe result is that the symptoms of infection to[90].

Ability to infect immune cells

Healthy human(English editionIn in vitro experiments usingCD4PositiveT cellsWas suggested to be infected with a virus.No viral replication has been identified, the receptor is unknown, and the effects have not been evaluated.[91]..No other types of immune cells were found to be infected in this report.There was a similar report using a cell line, but this paper was withdrawn due to a defect in the method.[92].

Secondary lymphoid tissue of the deceased patient (Lymph node-spleen)ofMacrophageIs expressing the ACE2 receptor, and it has been reported that the nucleoprotein antigen of the virus was detected.It is unclear whether this is due to viral infection or uptake of infected cells.[93]..In this report, T cells andB cellsNo nucleoprotein antigen was identified.

Expresses human ACE2 receptor proteinTransgenicIn experiments using mice, it has been reported that viral antigens were detected in lung macrophages.[94].

Existence of multiple types

Report from China

In March 2020, this virus (3 cases in China and abroad) was released.Beijing UniversityChinese research teamgeneAs a result of analysisBatIt is called S type (3% of the total), which is close to the virus of origin and seems to have been around for a long time, and L type, whose virulence is unknown but seems to be high.Nucleotide sequenceIt turns out that it can be classified into two different types of[95][96][97][98].

It has been confirmed that many patients are infected with only one type but both types, and it is reported that once infected with the virus and the symptoms are cured, the other type is "re-infected". There is also[95][97], The possibility and cause of reinfection are debated and require further research and verification[99].

As of March 2020, 3, the following has been found.The major strains of this virus areL type(L subtype) andS typeDivided into (S subtype)[100][101]..28,144th and XNUMXth of viral RNAbaseThe amino acids specified by the difference inLeucine(L type)SerineDistinguished by (S type)[102].

L type

L-type is dominant in the early epidemic in Wuhan, China[102]..Initial reports stated that the L-type was more aggressive and spread more rapidly.[Note 4]..Therefore, it is thought that the selection pressure was applied and the proportion decreased due to human intervention by epidemic countermeasures.[101]..However, the point that "strong infectivity" was later corrected, and the expression was changed to "high frequency".[103].

S type

It is evolutionarily old and is considered to be pre-mutated (ancestral).Since the aggression is low, the selection pressure is weak, and it seems that the ratio has increased relatively.[100][101].

Type K

S-type mutated virus.Although it was not detected and spread by infectious disease surveillance in China, the influx of K-virus was observed due to the large lack of the influenza epidemic curve in Japan.

G type

A type that is thought to have caused an explosive infection in the United States and Italy after many deaths in Wuhan, China.[49]..Strong infectivity and toxicity[100].

Report from Cambridge University, England

2020 Year of 4 MonthBritishEngland・ According to a report by the University of Cambridge and others, this virus can be divided into three types: A, B, and C. A is ChineseBatIt is close to the virus of origin and was found in infected people in China and Japan, but in the United States andAustraliaThere were many infected people. B, which was mutated from A, seems to have increased explosively in China and neighboring countries, centering on Wuhan City, and there were few cases of fire in Europe and the United States. C mutated from B was common in Europe such as Italy, France, and the United Kingdom.[104][105].

Report from Japan Biodata

In the pre-reviewed paper by Nippon Biodata Co., Ltd., we focused on the 8,782th, 28,144th, 29,095th, and 3th,XNUMXth bases of the virus's RNA sequence, and classified this virus into three types: TCC, TCT, and CTC.[106].. TCC and TCT correspond to type S indicated by the Chinese group and type A indicated by the British group.CTC corresponds to the L type shown by the Chinese group and the B type and C type shown by the British group.

footnote

[How to use footnotes]

注 釈

  1. ^ In Japanese nameNotationThere is no fixed.An example of notation is#nameSee.
  2. ^ As will be described later, it is officially named "SARS-CoV-2" by ICTV, but to avoid confusion, the WHO materials released before that will remain "2019-nCoV".In addition, the name "SARS" became popular in 2003 in Asia and other countries.Severe acute respiratory syndromeFor the sake of convenience, WHO also uses the name "COVID-19 virus" or "COVID-19 virus".[1].
  3. ^ In addition, a small number of "2019-nCoV" notations remain on the English notation page of the Ministry of Health, Labor and Welfare official website, and previously used 2019-nCoV as the official name.[17]..The National Institute of Infectious Diseases is referred to by the "2019-nCoV Genetic Testing Method" created by the Institute.[19], Also described as "New Coronavirus 2019-nCoV (SARS-CoV-2)" in the official text.[23]..Miyagi Prefecture wrote "New Coronavirus (2019-nCoV)" in the guidance for opening a general telephone consultation service regarding this virus.[24]..Similarly, Aomori Prefecture described the number of infected people as "new coronavirus (2019-nCoV): XX people" in the "Weekly Aomori Prefecture Infected Persons Outbreak Information".[25]..The Tokyo Metropolitan Government links the National Institute of Infectious Diseases "New Coronavirus (2019-nCoV)" in the "New Coronavirus Infectious Disease FAQ".[26], Aichi Prefecture's "New Coronavirus Infectious Disease Control Site" has a similar link.[27]..However, as of August 2020, the linked page has been renamed to "New Coronavirus Infectious Disease (COVID-8) Related Information Page".In addition, some in-vitro drugs are labeled only as 19-nCoV on the main body.[20][21][22].
  4. ^ "L type, which might be more aggressive and spread more quickly." From "ABSTRACT" in doi: 10.1093 / nsr / nwaa036.

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