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[脊髓灰质炎:走向终结的漫长征程]

[Polio, the long walk to the endgame].

作者信息

García-Sánchez José Elías, García-Sánchez Enrique, García-Merino Enrique, Fresnadillo-Martínez María José

机构信息

Departamento de Medicina Preventiva, Salud Pública y Microbiología Médica, Facultad de Medicina, Universidad de Salamanca, Salamanca, España.

Departamento de Medicina Preventiva, Salud Pública y Microbiología Médica, Facultad de Medicina, Universidad de Salamanca, Salamanca, España.

出版信息

Enferm Infecc Microbiol Clin. 2015 Dec;33(10):e69-78. doi: 10.1016/j.eimc.2014.10.005. Epub 2015 Jan 13.

Abstract

Although the WHO original target date for the global eradication of poliomyelitis was the year 2000 -thanks to vaccination and institutional, public and private, resources for that purpose-, in 2013 the disease remained endemic in three countries, Afghanistan, Pakistan and Nigeria, and some cases were described in five others. The circulation of wild type 1 poliovirus in Israel, Gaza and the West Bank and the cases in Syria were a wakeup call, as at that time there were polioviruses derived from the oral vaccine that are still circulating among the human population and can cause the development of the disease. Travelling "from" and "to" endemic areas are factors to consider in poliovirus exportation and in its spread when it reaches areas with poor immunogenicity. Wars, terrorism, intolerance, lack of culture and proliferation of anti-vaccine groups and the rise of the anti-vaccination movement are important factors in the maintenance and expansion of the virus and in the "non-vaccination" against it. Based on the international situation to date, the Emergency Committee of WHO met in May 2014 to address the problem. It is still necessary to enhance the knowledge of the disease and its agent. In the first case to perform a differential diagnosis of flaccid paralysis and to continue vaccination programs, and in the second case to keep studying and looking for the poliovirus in environmental samples, which is a model for the study of many other viruses.

摘要

尽管世界卫生组织最初设定的全球根除脊髓灰质炎的目标日期是2000年——多亏了疫苗接种以及为此投入的机构、公共和私人资源——但在2013年,该疾病在阿富汗、巴基斯坦和尼日利亚这三个国家仍然流行,并且在其他五个国家也发现了一些病例。以色列、加沙和西岸地区野生1型脊髓灰质炎病毒的传播以及叙利亚的病例敲响了警钟,因为当时源自口服疫苗的脊髓灰质炎病毒仍在人群中传播,并且可能引发疾病。往返于流行地区是脊髓灰质炎病毒输出以及其传播至免疫原性较差地区时需要考虑的因素。战争、恐怖主义、不宽容、文化缺失、反疫苗团体的激增以及反疫苗运动的兴起是病毒持续存在和传播以及“不接种疫苗”的重要因素。基于目前的国际形势,世界卫生组织紧急委员会于2014年5月召开会议以解决该问题。仍然有必要加强对该疾病及其病原体的了解。一方面要对弛缓性麻痹进行鉴别诊断并继续推行疫苗接种计划,另一方面要持续研究并在环境样本中寻找脊髓灰质炎病毒,这为研究许多其他病毒树立了典范。

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