婴儿与妊娠感染,韩国,蝙蝠传播病毒

Infections in Kids & Pregnancy, South Korea, Spillover from Bats (Lecture 23)

Welcome to another MedCram SARS-COV-2, covid-19, update. We had a good conference, but it’s good to be back. What we’re going to talk about in this update are the new cases in South Korea. The new criteria once again for the diagnosis. A lot of you have been asking questions about infants and mother-infant transmission, and we’ll talk about that. We’ve got some data there that we’ll talk about, and also getting back to the source of where this virus actually came from. We’ll talk about some data there as well.

欢迎使用covid-19的另一个MedCram SARS-COV-2更新。我们举行了一次很好的会议,但是回来很高兴。在此更新中,我们要讨论的是韩国的新案件。新标准再次用于诊断。你们中的许多人一直在问有关婴儿和母婴传播的问题,我们将对此进行讨论。我们在那里将讨论一些数据,并且还会回到这种病毒的实际来源。我们还将在那里讨论一些数据。

Once again, really appreciate all of the comments, all of the questions, and they are very good questions you all have. I’m keeping track of those as we go. So here is again the map, total deaths well over 2000; total recovered is around 18,000, and we can see the graphs here. We go to the WorldOmeter, they have similar numbers. We’ve already talked about how these numbers are underestimating. This we don’t know how much it’s underestimating. But we may have a better understanding once we start doing serologies because that will test for antibodies to the virus, and that will tell us a much better distribution of the population has seen this virus.  We will talk more about that as we go.

再一次,非常感谢所有评论,所有问题,它们是你们所有人都很好的问题。我正在跟踪这些。所以这又是一张地图,总死亡人数超过2000;回收的总数约为18,000,我们可以在此处查看图表。我们去WorldOmeter,他们有相似的数字。我们已经讨论过这些数字如何被低估了。我们不知道它被低估了多少。但是,一旦开始进行血清学检查,我们可能会有更好的理解,因为这将测试该病毒的抗体,并且这将告诉我们看到该病毒的人群的分布情况要好得多。我们将继续讨论。

Active cases and closed cases. Closed cases, 20,000. Looks like 89 percent of those have recovered. In the active cases, they are saying that 43,888 are mild condition. We just don’t know where we’re going with those at this point.

活跃案件和结案案件。结案2万。看起来其中89%的人已经康复。在活跃的情况下,他们说43,888是轻度疾病。我们只是不知道我们现在要和那些人在一起。

If we click on the graph for those active cases, you can see that they’re actually decreasing according to the statistics coming out of China. We’ve got here daily new cases. And remember we had this big jump on February 12th. We’ve talked more about that. Since that time, it’s been decreasing. Total cases outside of China are still continuing to increase, and that is, of course, a concern. If you exclude mainland China, and the daily cases were still seeing some of the highest new case reports here most recently.

如果我们单击这些活动案例的图表,您会发现根据中国的统计数据,这些案例实际上正在减少。我们每天都有新案件在这里。请记住,我们在2月12日经历了一次重大飞跃。我们已经讨论了更多。从那时起,它一直在减少。中国以外的案件总数仍在继续增加,这当然是一个令人担忧的问题。如果将中国大陆排除在外,那么最近的日常案例仍在不断出现。

And that brings us to this BBC News article talking about the South Korean sect that was identified recently as a hotbed. About 30 of the 53 cases identified today in South Korea came from the city of Daegu and was tied to one 61-year-old woman who tested positive for the virus earlier in the week. She belonged to this religious organization and is probably responsible for at least 30 of those cases. So, they are undergoing quarantine. We will put a link in the description below to this article.

这使我们在BBC新闻上发表了有关韩国教派的文章,该教派最近被确定为温床。今天在韩国发现的53例病例中,约有30例来自大邱市,并与一名在本周早些时候对该病毒呈阳性反应的61岁女性有关。她属于这个宗教组织,可能至少负责其中30起案件。因此,他们正在隔离。我们将在下面的描述中添加到本文的链接。

Also, in the news we will talk about the Diamond Princess ship. Two people from Japan who were infected on that ship have died. They were both in their 80s.

此外,在新闻中,我们将谈论钻石公主号飞船。在该船上被感染的两名日本人死亡。他们俩都八十多岁。

Let’s move to this confusion mounts over China’s counting methods as coronavirus numbers swing wildly. And this is interesting because as it mentions here in the article, we have Hubei Province reporting 349 cases. That’s in the entire Province, and yet at the same time in the capital of that Province, Wuhan, there are 605 new cases all by itself. So what is it that is going on here?

随着冠状病毒数量的急剧波动,让我们转移到XX计数方法上的困惑。这很有趣,因为正如本文中提到的,XX报告了349例。那是在整个省内,但与此同时,在该省的省会XX,仅此就有605例新病例。那么,这是怎么回事?

It seems as though the provincial government is not confirming cases unless they actually have genetic testing. Whereas what’s going on in the city of Wuhan is they’re still going by the newly updated criteria, which is allowing physicians to diagnose. Even though they don’t have genetic testing, they still have these scans which show pneumonia in these patients with clinical signs that make it suspicious. If you read the article, it does go into the fact that there was a sudden spike, and the case numbers on February 12, which we discussed in a previous video was most likely due to the relaxing of the very stringent diagnostic criteria.

除非省级政府实际进行了基因检测,否则似乎没有确认该案。武汉市正在发生的事情仍然是按照新近更新的标准进行的,这使医生能够进行诊断。即使他们没有进行基因检测,也仍然可以进行这些扫描,这些扫描显示这些患者的肺炎具有可疑的临床体征。如果您阅读了这篇文章,它的确会出现一个突然的高峰,我们在上一个视频中讨论的2月12日的病例数很可能是由于放宽了非常严格的诊断标准所致。

It’s not a coincidence that the new officials from the XX took over on the 12th, or around that time, and there’s been this thought that perhaps they wanted to clear the slate. Get as many diagnoses on the books as possible. And there’s this quote from the article, which basically states that the party boss of Wuhan was saying if there’s one more case where to be found in a household, that district party secretary would be held accountable. And that’s to show that there is probably a real push to try to get the numbers down. Now that the new policymakers in Wuhan have taken over. Anyway, we will put a link to this article also in the description below, so you can read it for yourself.

XX的新XX在12日或该时间左右接任并不是巧合,并且有这样的想法,即他们也许想清除名单。在书上获得尽可能多的诊断。文章中引用了这句话,基本上是说XX市的XX说,如果再有一个家庭可以找到家庭的话,那将由XX负责。这表明可能确实在努力降低数字。现在,XX的新决策者已经接管了。无论如何,我们还将在下面的描述中放置指向本文的链接,因此您可以自己阅读。

Okay, let’s move to an article that was published back on the 14th of February in JAMA, which is the Journal of the American Medical Association title. Novel coronavirus infection in hospitalized infants under one-year of age in China. So here the N number was only 9 patients, but it’s because they’re not really seeing a lot of covid-19 infections in these patients. Out of 75,000, they’ve only got about a hundred or so on the books in the pediatric population. So that could be because maybe the pediatric population isn’t as susceptible.

好的,让我们转到2月14日在JAMA上发表的一篇文章,这是《美国医学会杂志》的标题。中国一岁以下住院婴儿的新型冠状病毒感染。因此,这里的N人数只有9名患者,但这是因为他们并未真正在这些患者中看到很多covid-19感染。在75,000名儿童中,他们在小儿科人口中只有大约100本书。那可能是因为也许儿科人群不那么容易受到影响.

And when they looked at these nine, first of all, they found that only four of them had fever, only two of them had upper respiratory infection symptoms. One of them was completely asymptomatic, and they were tested because the family had tested positive. They wanted to make sure. In terms of the number of infants with severe complications, or on the ventilator in the ICU, the number was 0. Again I will leave a link to this article in the description as well, so you can read it for yourself.

当他们查看这九个时,首先,他们发现只有四个发烧,只有两个有上呼吸道感染症状。其中一个是完全无症状的,由于他们的家庭测试呈阳性,因此进行了测试。他们想确定。就严重并发症或在ICU中的呼吸机上的婴儿数而言,该数字为0。同样,我还将在说明中留下与本文的链接,因此您可以自己阅读。

So with all of these infections going on, the CDC has put out some answers to questions about pregnant women. One of the questions was “are infants born to mothers at increased risk?” And so that’s an interesting question. It looks as though based on limited case report, adverse infant outcomes, or preterm birth, have been reported among infants born to mothers positive for covid-19 during pregnancy. However, it is not clear that these outcomes were related to maternal infection. And at this time, the risk of adverse infant outcomes is not known.

因此,随着所有这些感染的进行,疾病预防控制中心已经对有关孕妇的问题给出了一些答案。问题之一是“母亲所生婴儿的风险增加了吗?”所以这是一个有趣的问题。似乎基于有限的病例报告,在怀孕期间对covid-19呈阳性的母亲所生的婴儿中,已有不良婴儿结局或早产的报道。但是,尚不清楚这些结果与孕产妇感染有关。目前,尚不清楚婴儿不良结局的风险。

Here’s another question: can pregnant women with covid-19 pass the virus to their fetus or newborn? And it seems as though in limited recent case series, none of the infants have tested positive for the virus that caused covid-19. And additionally, when they looked at the amniotic fluid, they were not able to find virus in there either. Of course, when the birthing process occurs, there can be a mixing of bodily fluids, and that could be the source of infection in an infant’s after the birthing process. With zika virus, that can cross the placenta. It appears as though coronavirus does not at this point.

这是另一个问题:携带covid-19的孕妇能否将病毒传播给胎儿或新生儿?似乎在最近的病例系列中,没有一个婴儿对引起covid-19的病毒呈阳性反应。此外,当他们查看羊水时,也无法在其中找到病毒。当然,当发生分娩过程时,可能会有体液混合,这可能是分娩过程后婴儿感染的来源。使用寨卡病毒,可以穿过胎盘。似乎冠状病毒目前还没有。

Well, that brings us to one of the last stories that we want to talk about. This was a really kind of concerning article that I saw here on NPR: New Research: Bats Harbor Hundreds of Coronaviruses, And Spillovers Aren’t Rare. We will put a link to this in the description below.

好吧,这使我们进入了我们想要谈论的最后一个故事。这是我在NPR上看到的一种真正令人关注的文章:新研究:蝙蝠港上百种冠状病毒,而溢溢物并不稀少。我们将在下面的描述中添加一个链接。

So what is this? Here, you can see these researchers actually taking samples of saliva from bats and actually taking a rectal sample. And when were they doing this? Not recently, but three years ago when they were doing studies because of the SARS outbreak from 2002, which was linked to bats. So the story talks about an organization called Eco Health Alliance, that was going out in Borneo, but they also did research in China at the time, and they collected specimens from bats, and what they found was actually quite disturbing.

那是什么在这里,您可以看到这些研究人员实际上是从蝙蝠中采集唾液样本,并实际上是从直肠中采集样本。他们什么时候做的?不是最近,而是三年前,当他们在做研究时,因为2002年爆发的SARS与蝙蝠有关。因此,这个故事谈到了一个名为“生态健康联盟”的组织,该组织正在婆罗洲成立,但当时他们也在中国进行研究,他们从蝙蝠身上采集了标本,发现的结果实际上令人不安。

They found that there were over 400 different species of coronaviruses in these bats. Now, remember these bats live in caves; they live together and they commune together, and so there’s a lot of crossovers that can occur.

他们发现这些蝙蝠中有超过400种不同的冠状病毒。现在,请记住这些蝙蝠生活在洞穴中。他们生活在一起,彼此交流,所以可能发生很多交叉。

Previous thinking on this was that these coronaviruses could not really jump into humans because they had to go into something that was closer to humans or that had to get a mutation, so it could bind to human receptors, for instance, the ACE2 receptor that we see in SARS, and actually the virus that causes covid-19.

以前对此的想法是,这些冠状病毒无法真正跳入人类,因为它们必须进入更接近人类或必须发生突变的事物,因此它可以与人类受体结合,例如我们所连接的ACE2受体。在SARS中看到,实际上是引起covid-19的病毒。

They thought that spillovers were rare. What they found was concerning because they looked at these viruses, and they found that these things could infect human cells. In fact, they took some of these coronaviruses that they found in these bats; they put them on a petri dish that were lined with human cells, and the coronavirus is, at least some of them, could infect these human cells without a problem.

他们认为溢出很少。他们发现的东西令人担忧,因为他们研究了这些病毒,并且发现这些东西可以感染人类细胞。实际上,他们采取了一些在这些蝙蝠中发现的冠状病毒。他们将它们放在装有人类细胞的培养皿中,并且冠状病毒至少可以感染其中的一些人类细胞,而不会产生问题。

So then they decided to go visit some humans that were living around these caves where the bats were to see if in fact these coronavirus has already jumped into humans, and when they went into the caves to do the research, they found water bottles around the caves because in the summertime, it’s kind of cool, and humans tend to go in there. And also the people that were living in the area said oh, yeah bats fly into the house, and sometimes we kill them. So there is this crossover.

因此,他们决定去拜访居住在这些洞穴周围的一些人类,蝙蝠在那里观察它们是否实际上已经跳入人类,当他们进入洞穴进行研究时,他们发现了周围的水瓶。洞穴,因为在夏天,这很凉爽,人类倾向于去那里。居住在该地区的人们也说,哦,是的,蝙蝠飞进了房子,有时我们杀死了它们。因此,存在这种交叉。

Well, when they did test the humans for signs, symptoms, genetic traces of these coronaviruses, they found them, and so they concluded that spillover does occur. Of course, this is kind of in a rural area. And so this may not explode into an epidemic because it’s not in a city centre, and the symptoms may be very mild.

好吧,当他们确实测试了人类这些冠状病毒的体征,症状,遗传痕迹时,他们发现了它们,因此他们得出结论确实发生了溢出。当然,这是在农村地区。因此,这可能不会爆发,因为它不在市中心,并且症状可能非常轻微。

Okay, now fast-forward here. Three or four years later, of course, when this new coronavirus breaks out, what they did was they took the RNA from this coronavirus, and they compared it to the 400 different strains of the coronavirus that they identified earlier in China and says here they found an extremely close match. They said in fact that a viral taxonomist would probably call it the same virus species.

好的,现在在这里快进。当然,三到四年后,当这种新的冠状病毒爆发时,他们所做的是从该冠状病毒中提取了RNA,并将其与他们在中国早期发现的400种不同的冠状病毒株进行了比较,并说在这里找到了非常接近的比赛。他们说,事实上,病毒分类学家可能将其称为相同的病毒种类。

They say that suggests that this current outbreak, which has infected tens of thousands of people, could have come, here’s the word “could,” have come directly from bats. There is a larger takeaway. He says that these bat SARS-related coronaviruses are actively spilling over into the human population. Not all of them will spark a deadly pandemic, but the more frequently spillovers, the greater the chances that this could potentially be happening.

他们说,这表明这次疫情可能已经来临,已经感染了成千上万的人,这里的“可能”一词直接来自蝙蝠。有一个更大的外卖。他说,这些蝙蝠与SARS相关的冠状病毒正在积极蔓延到人群中。并非所有这些因素都会引发致命的大流行,但溢出越频繁,潜在发生的可能性就越大。

In future updates, we’re going to talk about the molecular biology of coronavirus. How it infects the cell. Let’s get down to the nitty-gritty. Compare it to the behavior of other viruses. Other viruses that have been brought up in this discussion. For instance, HIV.,etc. And how is it that these viruses do different things? What is it that they do? What are their targets? That’s we’re going to try to answer. Thanks for joining us.

在将来的更新中,我们将讨论冠状病毒的分子生物学。它如何感染细胞。让我们开始讲究细节。将其与其他病毒的行为进行比较。在此讨论中提出的其他病毒。例如,HIV等。这些病毒如何做不同的事情?他们是做什么的?他们的目标是什么?那就是我们要尝试回答的问题。感谢您加入我们。

MedCramChina

View all posts

Add comment

error: Content is protected !!