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狂犬病病毒通过实体器官或组织同种异体移植传播。

Rabies virus transmission via solid organs or tissue allotransplantation.

机构信息

National Institute For Viral Disease Control and Prevention, Chinese Center For Disease Control and Prevention, 155 Changbai Road Changping District, Beijing, People's Republic of China.

出版信息

Infect Dis Poverty. 2018 Aug 15;7(1):82. doi: 10.1186/s40249-018-0467-7.

Abstract

BACKGROUND

Rabies, for which the mortality rate is almost 100%, is a zoonotic viral disease that can be transmitted via solid organs or tissue allotransplantation. Dozens of deaths from rabies via solid organs or tissues allotransplantation (ROTA) have been documented during the last decades. In 2015 and 2016, two cases of rabies virus transmission via solid organs or tissue allotransplantation were reported in China, which further underscore the risk and importance of this special type of rabies for organ transplant recipients.

MAIN TEXT

From 1978 to 2017, at least 13 cases of ROTA, causing dozens of deaths, have been reported worldwide, whether in the high-risk or low-risk countries of rabies. The reported incubation period of ROTA ranges from 11 days to more than 17 months, while the historical incubation period of rabies is generally considered to range from ~ 1 week to several years. The pathogenesis of ROTA is not clear, but the use of post-exposure prophylaxis (PEP) can play a protective role in the transplant recipients. We also summarize reports about ROTA in China, combined with the actual situation regarding work on rabies surveillance and elimination, and suggest countermeasures for the prevention and control of ROTA in the future.

CONCLUSIONS

Understanding the significance of ROTA, screening the suspected organs, assessing the risk and protecting the related population will be effective way to prevent and control further occurrence of ROTA.

摘要

背景

狂犬病的死亡率几乎为 100%,是一种可通过实体器官或组织移植传播的人畜共患病毒性疾病。在过去几十年中,已有数十例通过实体器官或组织移植(ROTA)传播狂犬病的死亡病例记录。2015 年和 2016 年,中国报告了两例通过实体器官或组织移植传播狂犬病病毒的病例,这进一步凸显了这种特殊类型的狂犬病对器官移植受者的风险和重要性。

正文

从 1978 年到 2017 年,全球至少有 13 例 ROTA 病例报告,导致数十人死亡,无论是在狂犬病高风险还是低风险国家。ROTA 的报告潜伏期从 11 天到 17 个月以上不等,而狂犬病的历史潜伏期通常被认为在 1 周至数年之间。ROTA 的发病机制尚不清楚,但在移植受者中使用暴露后预防(PEP)可以发挥保护作用。我们还总结了中国关于 ROTA 的报告,并结合狂犬病监测和消除工作的实际情况,提出了未来预防和控制 ROTA 的对策。

结论

了解 ROTA 的意义,筛查疑似器官,评估风险并保护相关人群,将是预防和控制进一步发生 ROTA 的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cb3/6092857/e14189a58cc9/40249_2018_467_Fig1_HTML.jpg

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