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病毒性疾病根除的历史与前景

History and prospects for viral disease eradication.

作者信息

de Quadros Ciro A

机构信息

Pan American Health Organization, 525, 23rd Street, NW, Washington, DC 20037, USA.

出版信息

Med Microbiol Immunol. 2002 Oct;191(2):75-81. doi: 10.1007/s00430-002-0120-7. Epub 2002 Sep 21.

Abstract

Edward Jenner first articulated the concept of eradication when he first inoculated the vaccinia. Before considering a disease for eradication some factors should be considered, such as the biological characteristics of the infectious agent: does the infectious agent infects only humans? Does it have a non-human reservoir and induce long-life immunity after infection? Is there a tool or intervention that effectively interrupts the chain of transmission from one individual to another? The first disease to be eradicated was smallpox. This extraordinary initiative set the example for any future disease eradication program. The eradication of polio from the Americas was launched in May 1985 and the Region of the Americas was certified polio-free in September 1994. At this same year, the Pan American Health Organization (PAHO) launched an initiative to eradicate measles from the Americas. Only 1,500 cases have been reported during the year 2000, and transmission was interrupted in most countries of the Region. Tremendous progress has been achieved in disease eradication efforts, which resulted in the global eradication of smallpox, the eradication of poliomyelitis from the Americas and its nearly global eradication, and the nearly complete eradication of measles from the Americas. The biotechnology revolution is providing us with many new vaccines and we have to continue the search for those diseases that could eventually be eradicated. Eradication of a disease brings the greatest health benefit, which is the absence of the health threat. It is also the quintessential example of health equity, as all mankind reaps the benefits, bringing eternal cost savings. As Louis Pasteur pointed out, "it is within the power of man to eradicate infection from the earth".

摘要

爱德华·詹纳首次接种牛痘时,首次阐述了根除的概念。在考虑根除一种疾病之前,应考虑一些因素,如传染源的生物学特性:传染源是否仅感染人类?它是否有非人类宿主,感染后是否能诱导长期免疫?是否有工具或干预措施能有效阻断从一个人到另一个人的传播链?第一种被根除的疾病是天花。这一非凡的举措为未来任何疾病根除计划树立了榜样。1985年5月发起了从美洲根除脊髓灰质炎的行动,1994年9月美洲区域被认证为无脊髓灰质炎地区。同年,泛美卫生组织发起了从美洲根除麻疹的行动。2000年全年仅报告了1500例病例,该区域大多数国家的传播已被阻断。在疾病根除工作方面取得了巨大进展,这导致天花在全球范围内被根除,脊髓灰质炎在美洲被根除且几乎在全球范围内被根除,麻疹在美洲几乎被完全根除。生物技术革命为我们提供了许多新疫苗,我们必须继续寻找那些最终可能被根除的疾病。根除一种疾病带来最大的健康益处,即消除健康威胁。它也是健康公平的典型例子,因为全人类都能从中受益,带来永久性的成本节约。正如路易斯·巴斯德所指出的,“人类有能力从地球上根除感染”。

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