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[风疹(德国麻疹)——仍然是一种主要的传染病]

[Rubella (German measles)--still a major infectious disease].

作者信息

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机构信息

Institut für Medizinische Mikrobiologie, Immunologie. und Parasitologie, Abteilung Pharmazeutische Mikrobiologie, Universität Bonn, Meckenheimer Allee 168, 53115 Bonn.

出版信息

Med Monatsschr Pharm. 2012 Jan;35(1):14-22; quiz 23-4.

Abstract

Rubella viruses are single-stranded ribonucleic acid viruses, which are surrounded by a lipid-containing membrane. From the taxonomic point of view, these serologically uniform viruses belong to the family of Togaviridae, and to the genus Rubivirus. After birth, infection with rubella virus occurs through inhalation of contaminated droplets. In children infected after birth, rubella viruses usually cause uncomplicated diseases that are associated with an unspecific rash (postnatal rubella). Rubella virus infections in adults might be more severe and can be accompanied by complications such as joint pain and inflammation in the joints. Rubella virus infection during pregnancy can lead to the infection of the fetus. In the first and second trimester of pregnancy, fetal rubella infection often lead to severe abnormalities of the newborn, which are summarized as rubella embryopathy or congenital rubella syndrome. One of these disorders, the Gregg syndrome, is associated with serious damage to heart, ears and eyes of the newborn. Therefore, in suspected cases of rubella virus infection during pregnancy, or after contact of a pregnant woman with an infected person, a serological diagnosis must be performed. The diagnosis of an acute rubella virus infection usually consists of the detection of rubella-specific IgM. Critical to avoiding a rubella virus infection is the immune prophylaxis, for which a live attenuated vaccine, usually given as trivalent vaccine against measles, mumps and rubella (MMR vaccine), is available. Since the introduction of the rubella vaccination in the 1970s, in many areas of the world the number of rubella diseases has declined dramatically. Nevertheless, rubella is still widespread in some countries, and still occurs in Germany. Postnatal rubella virus infections can be treated symptomatically. A specific (antiviral) therapy is not available.

摘要

风疹病毒是单链核糖核酸病毒,被含脂质的膜所包围。从分类学角度来看,这些血清学特征一致的病毒属于披膜病毒科风疹病毒属。出生后,风疹病毒通过吸入受污染的飞沫而感染。在出生后感染的儿童中,风疹病毒通常引起与非特异性皮疹相关的无并发症疾病(产后风疹)。成人感染风疹病毒可能更为严重,并可能伴有关节疼痛和关节炎症等并发症。孕期感染风疹病毒可导致胎儿感染。在妊娠的前三个月和第二个月,胎儿风疹感染常导致新生儿严重异常,这些异常统称为风疹胚胎病或先天性风疹综合征。其中一种病症,格雷格综合征,与新生儿心脏、耳朵和眼睛的严重损害有关。因此,在怀疑孕期感染风疹病毒的病例中,或孕妇与感染者接触后,必须进行血清学诊断。急性风疹病毒感染的诊断通常包括检测风疹特异性IgM。避免风疹病毒感染的关键是免疫预防,有减毒活疫苗可供使用,通常作为麻疹、腮腺炎和风疹三联疫苗(MMR疫苗)接种。自20世纪70年代引入风疹疫苗以来,世界上许多地区风疹疾病的数量已大幅下降。然而,风疹在一些国家仍然广泛存在,在德国也仍有发生。产后风疹病毒感染可进行对症治疗。目前尚无特异性(抗病毒)治疗方法。

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