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面对黄病毒交叉反应时西尼罗河病毒的监测与诊断

Surveillance and Diagnosis of West Nile Virus in the Face of Flavivirus Cross-Reactivity.

作者信息

Lustig Yaniv, Sofer Danit, Bucris Efrat Dahan, Mendelson Ella

机构信息

Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Ramat Gan, Israel.

School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Front Microbiol. 2018 Oct 11;9:2421. doi: 10.3389/fmicb.2018.02421. eCollection 2018.

Abstract

West Nile Virus (WNV) is an arthropod-borne flavivirus whose zoonotic cycle includes both mosquitoes and birds as amplifiers and humans and horses as dead-end hosts. In recent years WNV has been spreading globally and is currently endemic in Africa, The Middle East, India, Australia, central and southern Europe, and the Americas. Integrated surveillance schemes and environmental data aim to detect viral circulation and reduce the risk of infection for the human population emphasizing the critical role for One Health principles in public health. Approximately 20% of WNV infected patients develop West Nile Fever while in less than 1%, infection results in West Nile Neurological Disease. Currently, the diagnosis of WNV infection is primarily based on serology, since molecular identification of WNV RNA is unreliable due to the short viremia. The recent emergence of Zika virus epidemic in America and Asia has added another layer of complexity to WNV diagnosis due to significant cross-reactivity between several members of the Flaviviridae family such as Zika, dengue, Usutu, and West Nile viruses. Diagnosis is especially challenging in persons living in regions with flavivirus co-circulation as well as in travelers from WNV endemic countries traveling to Zika or dengue infected areas or vise-versa. Here, we review the recent studies implementing WNV surveillance of mosquitoes and birds within the One Health initiative. Furthermore, we discuss the utility of novel molecular methods, alongside traditional molecular and serological methods, in WNV diagnosis and epidemiological research.

摘要

西尼罗河病毒(WNV)是一种节肢动物传播的黄病毒,其人畜共患病循环包括蚊子和鸟类作为扩增宿主,人类和马匹作为终末宿主。近年来,西尼罗河病毒一直在全球传播,目前在非洲、中东、印度、澳大利亚、欧洲中部和南部以及美洲流行。综合监测计划和环境数据旨在检测病毒传播并降低人群感染风险,强调了“同一健康”原则在公共卫生中的关键作用。约20%的西尼罗河病毒感染患者会出现西尼罗河热,而不到1%的感染会导致西尼罗河神经疾病。目前,西尼罗河病毒感染的诊断主要基于血清学,因为由于病毒血症持续时间短,西尼罗河病毒RNA的分子鉴定并不可靠。最近美洲和亚洲出现的寨卡病毒疫情给西尼罗河病毒的诊断增加了另一层复杂性,因为黄病毒科的几个成员之间存在显著的交叉反应,如寨卡病毒、登革热病毒、乌苏图病毒和西尼罗河病毒。对于生活在黄病毒共同传播地区的人以及从西尼罗河病毒流行国家前往寨卡或登革热感染地区的旅行者,或者反之亦然,诊断尤其具有挑战性。在此,我们回顾了最近在“同一健康”倡议下对蚊子和鸟类进行西尼罗河病毒监测的研究。此外,我们还讨论了新型分子方法与传统分子和血清学方法在西尼罗河病毒诊断和流行病学研究中的效用。

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