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猴痘:新冠大流行期间出现的一种新的全球威胁。

Monkeypox: An emerging global threat during the COVID-19 pandemic.

机构信息

Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.

Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.

出版信息

J Microbiol Immunol Infect. 2022 Oct;55(5):787-794. doi: 10.1016/j.jmii.2022.07.004. Epub 2022 Aug 5.

Abstract

The emergence of the monkeypox outbreak in early 2022 has posed a new global health threat. As of July 8, 2022, 9069 laboratory-confirmed cases have been reported, and most of them are from non-endemic countries. The monkeypox virus is an enveloped double-stranded DNA virus, and preliminary genetic data suggest that the 2022 monkeypox virus belongs to the West African clade. In the current outbreak, human-to-human transmission has been the primary transmission mode. Although direct skin-to-skin contact with lesions during sexual activities can spread the virus, it remains unclear whether monkeypox can spread through sexual contact, specifically through contaminated body fluids. The typical presentation of monkeypox includes prodromal symptoms, followed by a rash that usually begins within 1-3 days of symptom onset, and the skin lesions can last for 2-4 weeks and then gradually resolve. However, the monkeypox outbreak in 2022 may exhibit atypical features. A definite diagnosis of monkeypox virus infection requires nucleic acid amplification testing via the polymerase chain reaction method. Supportive care is essential, and antiviral therapy is not considered for all affected patients, but recommended for those at highrisk for severe diseases. The mitigation of monkeypox outbreaks include enhanced case detection, case isolation, contact tracing, and post-exposure vaccination. In conclusion, the current monkeypox outbreak is a new threat during the COVID-19 pandemic. Clinicians should be aware of this new situation, which presents a different scenario from those of prior outbreaks. Global health systems should develop effective strategies to mitigate the spread of monkeypox.

摘要

2022 年初猴痘疫情的爆发带来了新的全球健康威胁。截至 2022 年 7 月 8 日,已报告 9069 例实验室确诊病例,其中大多数来自非流行国家。猴痘病毒是一种包膜的双链 DNA 病毒,初步遗传数据表明,2022 年的猴痘病毒属于西非分支。在目前的疫情中,人际传播是主要的传播途径。虽然在性行为中直接接触病变皮肤可以传播病毒,但目前仍不清楚猴痘是否可以通过性接触传播,特别是通过污染的体液。猴痘的典型表现包括前驱症状,随后出现皮疹,通常在症状出现后 1-3 天内出现,皮肤损伤可持续 2-4 周,然后逐渐消退。然而,2022 年的猴痘疫情可能表现出非典型特征。猴痘病毒感染的明确诊断需要通过聚合酶链反应方法进行核酸扩增检测。支持性护理至关重要,并非所有受影响的患者都需要抗病毒治疗,但建议对有发生严重疾病高风险的患者使用。猴痘疫情的缓解措施包括加强病例检测、病例隔离、接触者追踪和接触后疫苗接种。总之,目前的猴痘疫情是 COVID-19 大流行期间的新威胁。临床医生应该意识到这一新情况,这与以往疫情的情况不同。全球卫生系统应制定有效的策略来减轻猴痘的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d7/9536816/dee019fc3a46/gr1_lrg.jpg

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