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麻疹病史。

History of measles.

作者信息

Berche Patrick

机构信息

Pr emeritus, Université Paris Cité, Paris, France.

出版信息

Presse Med. 2022 Sep;51(3):104149. doi: 10.1016/j.lpm.2022.104149. Epub 2022 Nov 20.

Abstract

Measles is a highly contagious viral disease transmitted by aerosols through human-to-human contact. It is often considered as a benign disease, although mortality remains high in developing countries (>5%). Frequent complications (diarrhea, otitis, pneumonia, encephalitis) can be observed. The disease mainly affects young children from 5 to 6 months of age with a mortality peak in the first three years of life. The Persian physician Rhazes gave the first clinical description of the disease in the 10th century, clearly differentiating it from smallpox. Measles spread worldwide from the Renaissance. Its epidemiology was remarkably studied in 1846 by a Danish physician, Peter Panum, during an epidemic in the Faroe Islands. The viral nature of this disease was demonstrated in 1911 and the virus was identified in 1954 by Thomas Peebles and John Enders. It is a morbillivirus (family Paramyxoviridae), also responsible for rinderpest (ovine, bovine), distemper (canine, feline), and epidemic diseases of dolphins, porpoises and seals. The current measles virus appeared recently from the rinderpest virus around the 6th century BCE. It has adapted perfectly to the human species, becoming strictly human, without animal reservoirs. A live attenuated vaccine was developed in 1958 by Enders' team after numerous passages in cell cultures. The vaccine was licensed in the United States in 1963 and is used on a large scale by the WHO throughout the world. This highly effective and well-tolerated vaccine has greatly reduced the number of measles cases and saved millions of lives. Measles remains a major public health concern, causing over 100,000 deaths per year worldwide. Today, the most affected continents remain Africa, South America and Asia.

摘要

麻疹是一种极具传染性的病毒性疾病,通过气溶胶在人与人之间传播。尽管在发展中国家死亡率仍然很高(>5%),但它通常被认为是一种良性疾病。可以观察到频繁出现并发症(腹泻、中耳炎、肺炎、脑炎)。该疾病主要影响5至6个月大的幼儿,在生命的头三年死亡率最高。波斯医生拉齐斯在10世纪首次对该疾病进行了临床描述,明确将其与天花区分开来。麻疹自文艺复兴时期开始在全球传播。1846年,丹麦医生彼得·帕努姆在法罗群岛的一次疫情期间对其流行病学进行了显著研究。1911年证明了这种疾病的病毒性质,1954年托马斯·皮布尔斯和约翰·恩德斯鉴定出了该病毒。它是一种麻疹病毒(副粘病毒科),也导致牛瘟(绵羊、牛)、犬瘟热(犬、猫)以及海豚、鼠海豚和海豹的流行病。当前的麻疹病毒大约在公元前6世纪最近从牛瘟病毒演变而来。它已经完美地适应了人类,变得严格局限于人类,没有动物宿主。1958年,恩德斯团队在细胞培养中多次传代后研制出了一种减毒活疫苗。该疫苗于1963年在美国获得许可,世界卫生组织在全球广泛使用。这种高效且耐受性良好的疫苗大大减少了麻疹病例数量,拯救了数百万人的生命。麻疹仍然是一个重大的公共卫生问题,全球每年导致超过10万例死亡。如今,受影响最严重的大陆仍然是非洲、南美洲和亚洲。

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