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旋毛虫病的流行病学、诊断、治疗与防控

Epidemiology, diagnosis, treatment, and control of trichinellosis.

作者信息

Gottstein Bruno, Pozio Edoardo, Nöckler Karsten

机构信息

Faculty of Medicine, Institute of Parasitology, University of Bern, Bern, Switzerland.

出版信息

Clin Microbiol Rev. 2009 Jan;22(1):127-45, Table of Contents. doi: 10.1128/CMR.00026-08.

Abstract

Throughout much of the world, Trichinella spp. are found to be the causative agents of human trichinellosis, a disease that not only is a public health hazard by affecting human patients but also represents an economic problem in porcine animal production and food safety. Due to the predominantly zoonotic importance of infection, the main efforts in many countries have focused on the control of Trichinella or the elimination of Trichinella from the food chain. The most important source of human infection worldwide is the domestic pig, but, e.g., in Europe, meats of horses and wild boars have played a significant role during outbreaks within the past 3 decades. Infection of humans occurs with the ingestion of Trichinella larvae that are encysted in muscle tissue of domestic or wild animal meat. Early clinical diagnosis of trichinellosis is rather difficult because pathognomonic signs or symptoms are lacking. Subsequent chronic forms of the disease are not easy to diagnose, irrespective of parameters including clinical findings, laboratory findings (nonspecific laboratory parameters such as eosinophilia, muscle enzymes, and serology), and epidemiological investigations. New regulations laying down rules for official controls for Trichinella in meat in order to improve food safety for consumers have recently been released in Europe. The evidence that the disease can be monitored and to some extent controlled with a rigorous reporting and testing system in place should be motivation to expand appropriate programs worldwide.

摘要

在世界许多地方,旋毛虫属被发现是人类旋毛虫病的病原体,这种疾病不仅通过影响人类患者而构成公共卫生危害,而且在猪的动物生产和食品安全方面也是一个经济问题。由于感染主要具有人畜共患病的重要性,许多国家的主要努力都集中在控制旋毛虫或从食物链中消除旋毛虫。全球范围内人类感染的最重要来源是家猪,但是,例如在欧洲,马肉和野猪肉在过去30年的疫情爆发中发挥了重要作用。人类通过摄入在家养或野生动物肉的肌肉组织中包囊化的旋毛虫幼虫而感染。旋毛虫病的早期临床诊断相当困难,因为缺乏特征性体征或症状。无论包括临床发现、实验室检查结果(如嗜酸性粒细胞增多、肌肉酶和血清学等非特异性实验室参数)以及流行病学调查等参数如何,该病随后的慢性形式都不容易诊断。欧洲最近发布了新的法规,规定了对肉类中旋毛虫进行官方控制的规则,以提高消费者的食品安全。有证据表明,通过建立严格的报告和检测系统,可以对该病进行监测并在一定程度上加以控制,这应该成为在全球范围内扩大适当计划的动力。

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