Foxman Betsy
University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
IARC Sci Publ. 2011(163):421-40.
Molecular tools have enhanced our understanding of the epidemiology of infectious diseases by describing the transmission system, including identifying novel transmission modes and reservoirs, identifying characteristics of the infectious agent that lead to transmission and pathogenesis, identifying potential vaccine candidates and targets for therapeutics, and recognizing new infectious agents. Applications of molecular fingerprinting to public health practice have enhanced outbreak investigation by objectively confirming epidemiologic evidence, and distinguishing between time-space clusters and sporadic cases. Clinically, moleculartools are used to rapidly detect infectious agents and predict disease course. Integration of molecular tools into etiologic studies has identified infectious causes of chronic diseases, and characteristics of the agent and host that modify disease risk. The combination of molecular tools with epidemiologic methods provides essential information to guide clinical treatment, and to design and implement programmes to prevent and control infectious diseases. However, incorporating molecular tools into epidemiologic studies of infectious diseases impacts study design, conduct, and analysis.
分子工具通过描述传播系统,包括识别新的传播模式和宿主、确定导致传播和发病机制的传染源特征、确定潜在的疫苗候选物和治疗靶点以及识别新的传染源,增强了我们对传染病流行病学的理解。分子指纹技术在公共卫生实践中的应用通过客观地确认流行病学证据以及区分时空聚集性病例和散发病例,加强了疫情调查。在临床上,分子工具用于快速检测传染源并预测疾病进程。将分子工具整合到病因学研究中,已经确定了慢性病的感染原因以及改变疾病风险的病原体和宿主特征。分子工具与流行病学方法的结合提供了指导临床治疗以及设计和实施预防与控制传染病计划的基本信息。然而,将分子工具纳入传染病流行病学研究对研究设计、实施和分析都有影响。