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[中东呼吸综合征冠状病毒感染的病因、流行病学及临床方面]

[Etiological, epidemiological and clinical aspects of coronavirus infection MERS-CoV].

作者信息

Gańczak Maria

机构信息

Pomeranian Medical University, Szczecin, Poland, Faculty of Health Sciences, Department of Public Health.

出版信息

Pol Merkur Lekarski. 2015 Jan;38(223):46-50.

Abstract

All medical staff and travellers to the Arabian Peninsula should be aware of a new epidemic caused by Middle East respiratory syndrome coronavirus (MERS-CoV), which has emerged in the Arabian Peninsula (2012), secondary cases have been seen in Africa, Europe, Asia and the United States. It seems likely that the outbreak will continue with sporadic adventive cases occurring outside the Middle East, including Poland. Polish medical literature on MERS-CoV is rather scant. Therefore, the article describes etiology, epidemiology, symptoms and diagnostic methods of MERS-CoV infection which are available in Poland. Selected cases of patients infected with MERS-CoV are also presented followed by preventive methods. Comparisons between MERS-CoV and SARS-CoV are briefly described. Epidemiological and genetic studies point at zoonotic transmission of MERS-CoV from camels and possibly bats. Infection is characterized by severe acute respiratory failure with a high fatality rate and the ability to spread from person to person; health care-associated outbreaks have been described. No known vaccine or antiviral therapy has been developed for MERS. The diagnosis is made by demonstrating the MERS-CoV in lower respiratory secretions by RT PCR. General hygiene measures such as regular hand washing before and after touching animals and avoiding contact with sick animals in the epidemic areas, should be adhered to. Health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis due to non-specific symptoms of MERS-CoV in the early stage of infection.

摘要

所有前往阿拉伯半岛的医护人员和旅行者都应了解一种由中东呼吸综合征冠状病毒(MERS-CoV)引发的新型疫情,该病毒于2012年在阿拉伯半岛出现,在非洲、欧洲、亚洲和美国均出现了二代病例。疫情似乎还会持续,中东以外地区,包括波兰,可能会出现散发性输入性病例。波兰关于MERS-CoV的医学文献相当匮乏。因此,本文描述了波兰现有的MERS-CoV感染的病因、流行病学、症状和诊断方法。还介绍了部分MERS-CoV感染患者的病例,并给出了预防方法。简要描述了MERS-CoV与SARS-CoV之间的比较。流行病学和基因研究表明,MERS-CoV可通过骆驼以及可能通过蝙蝠进行人畜共患病传播。该感染的特征为严重急性呼吸衰竭、高病死率以及人际传播能力;已有医护相关疫情的报道。目前尚未研发出针对MERS的已知疫苗或抗病毒疗法。通过逆转录聚合酶链反应(RT PCR)在下呼吸道分泌物中检测出MERS-CoV来进行诊断。应坚持采取一般卫生措施,如接触动物前后定期洗手,以及在疫区避免接触患病动物。医护人员应对所有患者始终如一地采取标准预防措施,因为在感染初期MERS-CoV的症状不具特异性。

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