全球登革热和基孔肯雅热负担：对美国南部和加利福尼亚州的影响。
The burden of dengue and chikungunya worldwide: implications for the southern United States and California.
机构信息
Department of Microbiology and The Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Microbiology and The Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
出版信息
Ann Glob Health. 2014 Nov-Dec;80(6):466-75. doi: 10.1016/j.aogh.2015.02.006.
BACKGROUND
Dengue virus (DENV) spreads to humans through the bite of an infected Aedes aegypti or Aedes albopictus mosquito and is a growing public health threat to both industrialized and developing nations worldwide. Outbreaks of autochthonous dengue in the United States occurred extensively in the past but over the past 3 decades have again taken place in Florida, Hawaii, and Texas as well as in American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the US Virgin Islands. As the Aedes vectors spread worldwide it is anticipated that DENV as well as other viruses also transmitted by these vectors, such as Chikungunya virus (CHKV), will invade new areas of the world, including the United States.
OBJECTIVES
In this review, we describe the current burden of dengue disease worldwide and the potential introduction of DENV and CHKV into different areas of the United States. Of these areas, the state of California saw the arrival and spread of the Aedes aegypti vector beginning in 2013. This invasion presents a developing situation when considering the state's number of imported dengue cases and proximity to northern Mexico as well as the rising specter of chikungunya in the Western hemisphere.
FINDINGS
In light of the recent arrival of Aedes aegypti mosquito vectors to California, there is now a small but appreciable risk for endemic transmission of dengue and chikungunya within the State. It is likely, however, that if DENV or CHKV were to become endemic that the public health situation would be similar to that currently found along the Texas-Mexico border. The distribution of Aedes vectors in California as well as a discussion of several factors contributing to the risk for dengue importation are discussed and evaluated.
CONCLUSIONS
Dengue and chikungunya viruses present real risks to states where the Aedes vector is now established. Scientists, physicians, and public health authorities should familiarize themselves with these risks and prepare appropriately.
背景
登革热病毒（DENV）通过感染的埃及伊蚊或白纹伊蚊的叮咬传播给人类，是对全球工业化国家和发展中国家的一个日益严重的公共卫生威胁。过去，美国曾广泛爆发本地登革热疫情，但在过去 30 年中，佛罗里达州、夏威夷州和德克萨斯州以及美属萨摩亚、关岛、北马里亚纳群岛、波多黎各和美属维尔京群岛都再次发生了登革热疫情。随着埃及伊蚊等病媒的传播范围扩大，预计 DENV 以及其他通过这些病媒传播的病毒，如基孔肯雅热病毒（CHKV），将入侵世界上包括美国在内的新地区。
目的
在这篇综述中，我们描述了全球登革热疾病的现状，以及 DENV 和 CHKV 可能传入美国不同地区的情况。在这些地区中，加利福尼亚州于 2013 年开始出现埃及伊蚊病媒的入侵和传播。考虑到该州输入性登革热病例数量以及与墨西哥北部的临近程度，以及西半球基孔肯雅热的上升态势，这一入侵情况令人担忧。
发现
鉴于埃及伊蚊病媒最近抵达加利福尼亚州，该州现在存在着蚊媒传播登革热和基孔肯雅热的小而显著的风险。然而，如果 DENV 或 CHKV 成为地方性疾病，公共卫生状况很可能类似于目前在德克萨斯州-墨西哥边境地区发现的情况。本文讨论了加利福尼亚州埃及伊蚊病媒的分布情况以及导致登革热输入风险的几个因素，并对其进行了评估。
结论
埃及伊蚊病媒的传播使 DENV 和 CHKV 对目前已建立病媒传播的州构成了真正的威胁。科学家、医生和公共卫生当局应该熟悉这些风险并做好相应准备。
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