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世界卫生组织大流行和流行病清单中的神经系统表现

Neurologic Manifestations of the World Health Organization's List of Pandemic and Epidemic Diseases.

作者信息

McEntire Caleb R S, Song Kun-Wei, McInnis Robert P, Rhee John Y, Young Michael, Williams Erika, Wibecan Leah L, Nolan Neal, Nagy Amanda M, Gluckstein Jeffrey, Mukerji Shibani S, Mateen Farrah J

机构信息

Massachusetts General Hospital (MGH)-Brigham Neurology Residency Program, Boston, MA, United States.

Massachusetts General Hospital (MGH)-Brigham Pediatric Neurology Residency Program, Boston, MA, United States.

出版信息

Front Neurol. 2021 Feb 22;12:634827. doi: 10.3389/fneur.2021.634827. eCollection 2021.

Abstract

The World Health Organization (WHO) monitors the spread of diseases globally and maintains a list of diseases with epidemic or pandemic potential. Currently listed diseases include Chikungunya, cholera, Crimean-Congo hemorrhagic fever, Ebola virus disease, Hendra virus infection, influenza, Lassa fever, Marburg virus disease, , MERS-CoV, monkeypox, Nipah virus infection, novel coronavirus (COVID-19), plague, Rift Valley fever, SARS, smallpox, tularemia, yellow fever, and Zika virus disease. The associated pathogens are increasingly important on the global stage. The majority of these diseases have neurological manifestations. Those with less frequent neurological manifestations may also have important consequences. This is highlighted now in particular through the ongoing COVID-19 pandemic and reinforces that pathogens with the potential to spread rapidly and widely, in spite of concerted global efforts, may affect the nervous system. We searched the scientific literature, dating from 1934 to August 2020, to compile data on the cause, epidemiology, clinical presentation, neuroimaging features, and treatment of each of the diseases of epidemic or pandemic potential as viewed through a neurologist's lens. We included articles with an abstract or full text in English in this topical and scoping review. Diseases with epidemic and pandemic potential can be spread directly from human to human, animal to human, via mosquitoes or other insects, or via environmental contamination. Manifestations include central neurologic conditions (meningitis, encephalitis, intraparenchymal hemorrhage, seizures), peripheral and cranial nerve syndromes (sensory neuropathy, sensorineural hearing loss, ophthalmoplegia), post-infectious syndromes (acute inflammatory polyneuropathy), and congenital syndromes (fetal microcephaly), among others. Some diseases have not been well-characterized from a neurological standpoint, but all have at least scattered case reports of neurological features. Some of the diseases have curative treatments available while in other cases, supportive care remains the only management option. Regardless of the pathogen, prompt, and aggressive measures to control the spread of these agents are the most important factors in lowering the overall morbidity and mortality they can cause.

摘要

世界卫生组织(WHO)监测全球疾病的传播情况,并维护一份具有流行或大流行潜力的疾病清单。目前列出的疾病包括基孔肯雅热、霍乱、克里米亚-刚果出血热、埃博拉病毒病、亨德拉病毒感染、流感、拉沙热、马尔堡病毒病、中东呼吸综合征冠状病毒(MERS-CoV)、猴痘、尼帕病毒感染、新型冠状病毒(COVID-19)、鼠疫、裂谷热、严重急性呼吸综合征(SARS)、天花、兔热病、黄热病和寨卡病毒病。相关病原体在全球舞台上日益重要。这些疾病大多数都有神经学表现。那些神经学表现不那么常见的疾病也可能产生重要后果。目前,这一点在持续的COVID-19大流行中尤为突出,这进一步表明,尽管全球共同努力,但那些有可能迅速广泛传播的病原体仍可能影响神经系统。我们检索了1934年至2020年8月的科学文献,以汇编从神经科医生角度看待的每种具有流行或大流行潜力疾病的病因、流行病学、临床表现、神经影像学特征和治疗数据。在本次专题和范围界定综述中,我们纳入了英文摘要或全文的文章。具有流行和大流行潜力的疾病可通过人与人、动物与人直接传播,或通过蚊子或其他昆虫传播,或通过环境污染传播。表现包括中枢神经系统疾病(脑膜炎、脑炎、脑实质内出血、癫痫发作)、周围神经和颅神经综合征(感觉神经病变、感音神经性听力损失、眼肌麻痹)、感染后综合征(急性炎症性多发性神经病)和先天性综合征(胎儿小头畸形)等。从神经学角度来看,有些疾病尚未得到充分描述,但所有疾病都至少有关于神经学特征的零散病例报告。有些疾病有可用的治愈性治疗方法,而在其他情况下,支持性护理仍然是唯一的管理选择。无论病原体是什么,迅速且积极地采取措施控制这些病原体的传播是降低它们可能导致的总体发病率和死亡率的最重要因素。

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