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流行性腮腺炎:以急诊医学为重点的最新进展

Mumps: An Emergency Medicine-Focused Update.

作者信息

Bockelman Chelsea, Frawley Thomas C, Long Brit, Koyfman Alex

机构信息

Department of Emergency Medicine, San Antonio Military Medical Center, Fort Sam Houston, Texas.

Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.

出版信息

J Emerg Med. 2018 Feb;54(2):207-214. doi: 10.1016/j.jemermed.2017.08.037. Epub 2017 Oct 27.

DOI:10.1016/j.jemermed.2017.08.037
PMID:29110978
Abstract

BACKGROUND

Mumps is a Paramyxoviridae virus. This disease was rampant prior to introduction of the measles, mumps, and rubella vaccine, resulting in decreased incidence. This disease has demonstrated several outbreaks.

OBJECTIVE

This review provides a focused evaluation of mumps, an update on outbreaks, management recommendations, and ways to decrease transmission.

DISCUSSION

Clusters of mumps outbreaks continue to occur. The virus is a paramyxovirus, a single-stranded RNA virus. The vaccine can provide lifelong immunity if administered properly, though prior to 1967 and introduction of the vaccine, the virus was common. In the past decade, there have been several notable outbreaks. Humans are the only known hosts, with disease spread through exposure to droplets and saliva. Factors affecting transmission include age, compromised immunity, time of year, travel, and vaccination status. Upper respiratory symptoms, fever, and headache are common, with unilateral or bilateral parotitis, and the virus may spread to other systems. Diagnosis is clinical, though polymerase chain reaction and immunoglobulin testing are available. This review provides several recommendations for vaccine in pregnancy, patients living in close quarters, health care personnel, and those immunocompromised. Treatment is generally supportive, with emphasis on proper isolation to prevent widespread outbreaks. Although reporting regulations and procedures vary by state, mumps is reportable in most states.

CONCLUSIONS

Mumps is an easily spread virus. Although vaccination is the most effective way to prevent transmission, early recognition of the disease is crucial. As an emergency physician, it is important to recognize the clinical presentation, recommended testing, treatment, and isolation procedures.

摘要

背景

腮腺炎是一种副粘病毒科病毒。在麻疹、腮腺炎和风疹疫苗引入之前,这种疾病很猖獗,发病率因此下降。该疾病已出现多次暴发。

目的

本综述对腮腺炎进行重点评估,更新疫情暴发情况、管理建议以及减少传播的方法。

讨论

腮腺炎疫情仍在持续发生。该病毒是一种副粘病毒,为单链RNA病毒。如果接种得当,疫苗可提供终身免疫,不过在1967年疫苗引入之前,该病毒很常见。在过去十年里,出现了几次引人注目的疫情暴发。人类是唯一已知的宿主,疾病通过接触飞沫和唾液传播。影响传播的因素包括年龄、免疫力低下、一年中的时间、旅行和疫苗接种状况。上呼吸道症状、发热和头痛很常见,伴有单侧或双侧腮腺炎,病毒可能传播到其他系统。诊断依靠临床症状,不过也可进行聚合酶链反应和免疫球蛋白检测。本综述针对孕妇、居住在封闭空间的人群、医护人员以及免疫功能低下者的疫苗接种提出了多项建议。治疗通常为支持性治疗,重点是进行适当隔离以防止疫情广泛暴发。尽管各州的报告规定和程序有所不同,但在大多数州腮腺炎都需上报。

结论

腮腺炎是一种易于传播的病毒。尽管接种疫苗是预防传播的最有效方法,但早期识别该疾病至关重要。作为一名急诊医生,认识到临床表现、推荐的检测方法、治疗方法和隔离程序非常重要。

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