Warrell M J, Warrell D A
Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Oxford OX3 9DU, UK.
Lancet. 2004 Mar 20;363(9413):959-69. doi: 10.1016/S0140-6736(04)15792-9.
The full scale of the global burden of human rabies is unknown, owing to inadequate surveillance of this fatal disease. However, the terror of hydrophobia, a cardinal symptom of rabies encephalitis, is suffered by tens of thousands of people each year. The recent discovery of enzootic European bat lyssavirus infection in the UK is indicative of our expanding awareness of the Lyssavirus genus. The main mammalian vector species vary geographically, so the health problems created by the lyssaviruses and their management differ throughout the world. The methods by which these neurotropic viruses hijack neurophysiological mechanisms while evading immune surveillance is beginning to be unravelled by, for example, studies of molecular motor transport systems. Meanwhile, enormous challenges remain in the control of animal rabies and the provision of accessible, appropriate human prophylaxis worldwide.
由于对这种致命疾病的监测不足，全球人类狂犬病负担的全貌尚不清楚。然而，每年有数万人遭受恐水症这一狂犬病脑炎主要症状带来的恐惧。最近在英国发现欧洲蝙蝠狂犬病病毒地方性感染，表明我们对狂犬病病毒属的认识在不断扩大。主要的哺乳动物传播媒介物种因地域而异，因此狂犬病病毒造成的健康问题及其管理在世界各地也有所不同。例如，通过对分子运动运输系统的研究，这些嗜神经病毒在逃避免疫监测的同时劫持神经生理机制的方式正开始被揭示。与此同时，在全球范围内控制动物狂犬病以及提供可及、适当的人类预防措施方面，仍然存在巨大挑战。
