Plemper Richard K, Snyder James P
Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA.
Curr Opin Investig Drugs. 2009 Aug;10(8):811-20.
Infection by measles virus (MV) is a major cause of human morbidity and mortality worldwide. In 2001, the WHO, UNICEF and their partners launched the Measles Initiative, the goals of which are to interrupt the transmission of MV in large geographic areas by increasing vaccination coverage and to assess the feasibility of eradicating MV worldwide. An estimated 74% reduction in mortality resulting from measles was achieved between 2000 and 2007, equivalent to a reduction of approximately 200,000 deaths annually. Despite this progress in the control of measles, the highest number of measles cases in more than a decade was observed in 2008 in several European countries and the US, and the virus was again declared endemic in the UK. In the light of this resurgence in the UK and the limitations associated with the current live-attenuated vaccine, this review discusses the means by which safe and effective measles antivirals could augment vaccination and strengthen global efforts to control measles. Important aspects of treatment are the potential to prevent infection effectively after exposure to MV, the improvement of case management, the amelioration of complications that frequently follow MV infection and the influence of antivirals on a potential strategy for global measles eradication.
麻疹病毒(MV)感染是全球人类发病和死亡的主要原因。2001年,世界卫生组织、联合国儿童基金会及其合作伙伴发起了麻疹倡议,其目标是通过提高疫苗接种覆盖率在大片地理区域内阻断MV传播,并评估在全球根除MV的可行性。2000年至2007年间,麻疹导致的死亡率估计降低了74%,相当于每年减少约20万例死亡。尽管在麻疹控制方面取得了这一进展,但2008年在几个欧洲国家和美国观察到了十多年来最高的麻疹病例数,并且该病毒在英国再次被宣布为地方病。鉴于英国的这种疫情复发以及当前减毒活疫苗存在的局限性,本综述讨论了安全有效的麻疹抗病毒药物可通过何种方式增强疫苗接种并加强全球控制麻疹的努力。治疗的重要方面包括在接触MV后有效预防感染的潜力、改善病例管理、减轻MV感染后经常出现的并发症以及抗病毒药物对全球麻疹根除潜在策略的影响。