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狂犬病能被根除吗?

Can rabies be eradicated?

作者信息

Rupprecht C E, Barrett J, Briggs D, Cliquet F, Fooks A R, Lumlertdacha B, Meslin F X, Müler T, Nel L H, Schneider C, Tordo N, Wandeler A I

机构信息

Centers for Disease Control & Prevention, Atlanta, GA 30333, USA.

出版信息

Dev Biol (Basel). 2008;131:95-121.

Abstract

Rabies, an acute progressive encephalitis, is an ancient zoonosis. Its distribution encompasses all continents, except Antarctica. Agents consist of at least 11 species orgenotypes of rhabdoviruses, in the Genus Lyssavirus. Susceptible natural hosts include all mammals. Primary reservoirs reside in the Orders Carnivora and Chiroptera. A plethora of variants, maintained by a diversity of abundant hosts, presents a challenge to a strict concept of true eradication. Globally, the domestic dog remains the most significant species for viral transmission, responsible for millions of suspect human exposures and tens of thousands of fatalities. As such, this single major target provides an ideal opportunity for focused intervention programmes in humane disease prevention and control, driven by laboratory-based surveillance and guided via modern epidemiological insights. Historically, substantial technical progress throughout the 20th century led to the development of safe, affordable and efficacious animal and human vaccines, resulting in declining disease burdens in selected developed and developing countries. Regional and local disease resurgence occurs, due in part to a combination of political and economic instability, environmental perturbations, and shifting government priorities. Society must recall that despite the recent recognition of other important emerging infectious diseases, none exceed the case fatality rate of rabies. Given the clear relevance of rabies in public health, agriculture, and conservation biology, substantive international progress must continue towards enhanced public awareness, human rabies prevention, wildlife rabies control, and canine rabies elimination, with renewed collaborative vigour.

摘要

狂犬病是一种急性进行性脑炎,是一种古老的人畜共患病。其分布范围涵盖除南极洲以外的所有大陆。病原体至少由11种狂犬病病毒属的弹状病毒物种或基因型组成。易感自然宿主包括所有哺乳动物。主要宿主存在于食肉目和翼手目。大量宿主维持着众多病毒变种,这对真正根除狂犬病的严格概念构成了挑战。在全球范围内,家犬仍然是病毒传播的最重要物种,导致数百万疑似人类接触感染,数万人死亡。因此,这个单一的主要目标为基于实验室监测并借助现代流行病学见解指导的人道疾病预防和控制重点干预计划提供了理想机会。从历史上看,整个20世纪取得的重大技术进步导致了安全、经济且有效的动物和人类疫苗的开发,使得部分发达国家和发展中国家的疾病负担有所下降。区域和地方疾病再次出现,部分原因是政治和经济不稳定、环境扰动以及政府优先事项的变化。社会必须牢记,尽管最近认识到其他重要的新兴传染病,但没有一种疾病的病死率超过狂犬病。鉴于狂犬病在公共卫生、农业和保护生物学方面的明显相关性,必须继续在提高公众意识、预防人类狂犬病、控制野生动物狂犬病以及消除犬类狂犬病方面取得实质性国际进展,并重新焕发合作活力。

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