미래 판데믹 위험 바이러스에 대한 감염관리 전략: 조류인플루엔자 중심

초록

Influenza viruses are the most plausible candidates for future pandemics. Recent evolutionary trends show that genetically evolved influenza viruses continue to emerge, some of which can infect humans and cause severe disease; however, sustained human-to-human transmission has not yet been observed. Among these, the highly pathogenic avian influenza (HPAI) H5N1, first identified in 1996, has persisted in avian ecosystems for over two decades. More recently, the emergence and global spread of the 2.3.4.4b clade has raised serious concerns due to its enhanced ability to cross species barriers, resulting in widespread outbreaks among wild birds, poultry, and mammals. Other H5 subtypes have also caused sporadic human infections. H7N9, despite being geographically limited to China and not reported since 2017, remains a notable example of an avian influenza virus that caused a large number of human infections within a short period, characterized by strong human receptor affinity and a high case fatality rate. In addition, the H9N2 subtype, which is typically less pathogenic, has consistently contributed internal genes that enhance viral adaptation in humans through reassortment. These evolving trends underscore the pandemic potential of zoonotic influenza viruses, and highlight the need for proactive surveillance and preparedness. Strategies to mitigate future risks can be broadly grouped into four core components: (1) cross-sectoral collaboration through a One Health approach encompassing veterinary, public health, and environmental domains; (2) robust and integrated surveillance systems incorporating epidemiological and genomic data; (3) development and strategic use of medical countermeasures, including antivirals and candidate vaccines; and (4) stringent infection control measures to minimize exposure and prevent further transmission. Strengthening interdisciplinary cooperation and frontline readiness are critical for reducing the threat posed by emerging zoonotic influenza viruses. This review provides a consolidated overview of current challenges and practical strategies for preparedness.

키워드