SARS-CoV-2 传播的独特特征:与 SARS-CoV、MERS-CoV 和 2009 年 H1N1 大流行性流感病毒的比较。

The unique features of SARS-CoV-2 transmission: Comparison with SARS-CoV, MERS-CoV and 2009 H1N1 pandemic influenza virus.

机构信息

Ningxia Center for Disease Control and Prevention, Yinchuan, Ningxia, China.

College of Public Health, Ningxia Medical University, Yinchuan, Ningxia, China.

出版信息

Rev Med Virol. 2021 Mar;31(2):e2171. doi: 10.1002/rmv.2171. Epub 2020 Sep 18.

Abstract

From 2002 to 2019, three deadly human coronaviruses (hCoVs), severe acute respiratory syndrome coronavirus (SARS-CoV), Middle Eastern respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged to produce outbreaks of SARS, MERS and coronavirus disease 2019 (Covid-19), respectively. All three hCoVs are members of the Betacoronavirus genus in the subfamily Orthocoronavirinae and share many similarities in virology and epidemiology. However, the pattern and scale of Covid-19 global spread is similar to 2009 pandemic H1N1 influenza (H1N1pdm09), rather than SARS or MERS. Covid-19 exhibits high viral shedding in the upper respiratory tract at an early stage of infection, and has a high proportion of transmission competent individuals that are pre-symptomatic, asymptomatic and mildly symptomatic, characteristics seen in H1N1pdm09 but not in SARS or MERS. These two traits of Covid-19 and H1N1pdm09 result in reduced efficiency in identification of transmission sources by symptomatic screening and play important roles in their ability to spread unchecked to cause pandemics. To overcome these attributes of Covid-19 in community transmission, identifying the transmission source by testing for virus shedding and interrupting chains of transmission by social distancing and public masking are required.

摘要

自 2002 年至 2019 年,三种致命的人类冠状病毒(hCoVs)——严重急性呼吸综合征冠状病毒(SARS-CoV)、中东呼吸综合征冠状病毒(MERS-CoV)和严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)相继出现,分别引发了严重急性呼吸综合征(SARS)、中东呼吸综合征(MERS)和 2019 冠状病毒病(COVID-19)疫情。这三种 hCoVs 均属于冠状病毒科β属,在病毒学和流行病学方面有许多相似之处。然而,COVID-19 在全球范围内的传播模式和规模与 2009 年大流行的 H1N1 流感(H1N1pdm09)相似,而与 SARS 或 MERS 不同。COVID-19 在感染早期在上呼吸道有很高的病毒脱落量,且具有高比例的传播能力个体,这些个体处于潜伏期、无症状和轻度症状状态,这一特征在 H1N1pdm09 中可见,但在 SARS 或 MERS 中不可见。COVID-19 和 H1N1pdm09 的这两个特征导致通过症状筛查识别传播源的效率降低,这在它们不受控制传播引发大流行的能力中发挥了重要作用。为了克服 COVID-19 在社区传播中的这些特性,需要通过检测病毒脱落来确定传播源,并通过社交距离和公众戴口罩来中断传播链。

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