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2022年人类猴痘疫情:临床综述与管理指南

The 2022 human monkeypox outbreak: Clinical review and management guidance.

作者信息

Aldhaeefi Mohammed, Rungkitwattanakul Dhakrit, Unonu Jacqueise, Franklin Careen-Joan, Lyons Jessica, Hager Katherine, Daftary Monika N

机构信息

Department of Clinical and Administrative Pharmacy Sciences, College of Pharmacy, Howard University, Washington, DC, USA.

Division of Infectious Diseases, Department of Medicine, Howard University College of Medicine, Washington, DC, USA.

出版信息

Am J Health Syst Pharm. 2023 Jan 5;80(2):44-52. doi: 10.1093/ajhp/zxac300.

Abstract

PURPOSE

The objective of this clinical review is to provide an overview of antiviral therapies for monkeypox treatment and summarize the role of vaccines in monkeypox prevention.

SUMMARY

The human monkeypox virus is a double-stranded DNA virus of the Orthopoxvirus genus of the Poxviridae family. The estimated case fatality rate for monkeypox ranges between 0% and 11%. The first human monkeypox infection was reportedly due to an unidentified animal reservoir. Per the Centers for Disease Control and Prevention, isolation and infection control procedures should be followed in the care of those infected with monkeypox virus. Monkeypox virus infection symptoms include rash, fever, chills, headache, muscle aches, backache, and fatigue that may progress to exhaustion. Severe complications such as encephalitis, pneumonia, and retropharyngeal abscess could appear in immunocompromised or critically ill patients. There are currently no specific Food and Drug Administration (FDA)-approved therapies for monkeypox. As with most viral infections, supportive care is the backbone of monkeypox clinical management. However, therapies effective for smallpox, such as cidofovir, brincidofovir, and tecovirimat, have previously been reported to be effective in the management of monkeypox. Pre- and postexposure prophylaxis to prevent monkeypox transmission are recommended in the US for those at high risk for disease transmission.

CONCLUSION

There are no FDA-approved treatments for monkeypox infection. Surveillance and detection of monkeypox among high-risk populations should be implemented to help understand the epidemiology of this disease.

摘要

目的

本临床综述的目的是概述用于治疗猴痘的抗病毒疗法,并总结疫苗在预防猴痘中的作用。

总结

人类猴痘病毒是痘病毒科正痘病毒属的双链DNA病毒。据估计,猴痘的病死率在0%至11%之间。据报道,首例人类猴痘感染是由一种不明动物宿主引起的。根据疾病控制与预防中心的建议,在护理感染猴痘病毒的患者时应遵循隔离和感染控制程序。猴痘病毒感染症状包括皮疹、发热、寒战、头痛、肌肉疼痛、背痛和疲劳,严重时可能发展为衰竭。免疫功能低下或重症患者可能会出现严重并发症,如脑炎、肺炎和咽后脓肿。目前美国食品药品监督管理局(FDA)尚未批准用于治疗猴痘的特定疗法。与大多数病毒感染一样,支持性护理是猴痘临床管理的基础。然而,此前有报道称,对天花有效的疗法,如西多福韦、布林西多福韦和替考韦玛,在治疗猴痘方面有效。在美国,建议对疾病传播高危人群进行暴露前和暴露后预防,以防止猴痘传播。

结论

FDA尚未批准用于治疗猴痘感染的疗法。应在高危人群中开展猴痘监测和检测,以帮助了解该疾病的流行病学情况。

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