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人类猴痘:一种新出现的人畜共患病。

Human monkeypox: an emerging zoonotic disease.

作者信息

Parker Scott, Nuara Anthony, Buller R Mark L, Schultz Denise A

机构信息

Saint Louis University School of Medicine, Department of Molecular Microbiology & Immunology, St Louis, MO 63104, USA.

出版信息

Future Microbiol. 2007 Feb;2(1):17-34. doi: 10.2217/17460913.2.1.17.

Abstract

Zoonotic monkeypox virus is maintained in a large number of rodent and, to a lesser extent, nonhuman primate species in West and central Africa. Although monkeypox virus was discovered in 1958, the prototypic human cases were not witnessed until the early 1970s. Before this time, it is assumed that infections were masked by smallpox, which was then widely endemic. Nevertheless, since the 1970s, reported monkeypox virus infections of humans have escalated, as have outbreaks with reported human-to-human transmission. This increase is likely due to numerous factors, such as enhanced surveillance efforts, environmental degradation and human urbanization of areas where monkeypox virus is maintained in its animal reservoir(s) and, consequently, serve as a nidus for human infection. Furthermore, viral genetic predispositions enable monkeypox virus to infect many animal species, represented in expansive geographic ranges. Monkeypox virus was once restricted to specific regions of Africa, but its environ has expanded, in one case intercontinentally--suggesting that human monkeypox infections could continue to intensify. As a zoonotic agent, monkeypox virus is far less sensitive to typical eradication measures since it is maintained in wild-animal populations. Moreover, human vaccination is becoming a less viable option to control poxvirus infections in today's increasingly immunocompromised population, particularly with the emergence of HIV in Sub-Saharan Africa. An increased frequency of human monkeypox virus infections, especially in immunocompromised individuals, may permit monkeypox virus to evolve and maintain itself independently in human populations.

摘要

人畜共患的猴痘病毒在西非和中非的大量啮齿动物以及少量非人类灵长类动物物种中传播。虽然猴痘病毒于1958年被发现,但直到20世纪70年代初才出现首例典型的人类病例。在此之前,人们认为感染被天花掩盖了,当时天花广泛流行。然而,自20世纪70年代以来,报告的人类猴痘病毒感染病例有所增加,人际传播的疫情也有所增加。这种增加可能是由于多种因素,如监测力度加大、环境退化以及猴痘病毒在其动物宿主中生存的地区的人类城市化,因此这些地区成为人类感染的温床。此外,病毒的遗传易感性使猴痘病毒能够感染许多动物物种,其地理分布范围很广。猴痘病毒曾经局限于非洲的特定地区,但现在其范围已经扩大,甚至跨洲际传播,这表明人类猴痘感染可能会继续加剧。作为一种人畜共患病原体,猴痘病毒对典型的根除措施远不那么敏感,因为它在野生动物种群中传播。此外,在当今免疫功能日益低下的人群中,尤其是在撒哈拉以南非洲地区出现艾滋病毒之后,人类接种疫苗已成为控制痘病毒感染的不太可行的选择。人类猴痘病毒感染频率的增加,尤其是在免疫功能低下的个体中,可能会使猴痘病毒在人类群体中独立进化和存续。

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