Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
Unidad de Investigaciones Biomédicas, Asociación Benéfica PRISMA, Iquitos, Peru.
Lancet. 2024 Mar 2;403(10429):862-876. doi: 10.1016/S0140-6736(23)02037-8. Epub 2024 Feb 7.
Since the discovery of norovirus in 1972 as a cause of what was contemporarily known as acute infectious non-bacterial gastroenteritis, scientific understanding of the viral gastroenteritides has continued to evolve. It is now recognised that a small number of viruses are the predominant cause of acute gastroenteritis worldwide, in both high-income and low-income settings. Although treatment is still largely restricted to the replacement of fluid and electrolytes, improved diagnostics have allowed attribution of illness, enabling both targeted treatment of individual patients and prioritisation of interventions for populations worldwide. Questions remain regarding specific genetic and immunological factors underlying host susceptibility, and the optimal clinical management of patients who are susceptible to severe or prolonged manifestations of disease. Meanwhile, the worldwide implementation of rotavirus vaccines has led to substantial reductions in morbidity and mortality, and spurred interest in vaccine development to diminish the impact of the most prevalent viruses that are implicated in this syndrome.
自 1972 年发现诺如病毒是当时被称为急性传染性非细菌性胃肠炎的病因以来，科学界对病毒性胃肠炎的认识不断发展。现在人们认识到，在高收入和低收入环境中，少数病毒是全世界急性胃肠炎的主要病因。尽管治疗方法仍然主要限于补液和电解质替代，但改进的诊断方法已经能够确定疾病的病因，从而能够对个体患者进行有针对性的治疗，并为全球人群确定干预措施的优先级。关于宿主易感性的特定遗传和免疫因素，以及对易发生严重或持续疾病表现的患者进行最佳临床管理的问题仍然存在。与此同时，全球范围内轮状病毒疫苗的实施导致发病率和死亡率大幅下降，并促使人们对疫苗开发产生兴趣，以减轻与该综合征有关的最常见病毒的影响。
