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拉沙热:批判性综述与控制前景

Lassa Fever: Critical Review and Prospects for Control.

作者信息

Besson Marianne E, Pépin Michel, Metral Pierre-Alexandre

机构信息

Department of Public Health, Royal Veterinary College, London NW1 0TU, UK.

Department of Virology and Infectiology, VetAgro Sup Lyon University, 69280 Marcy L'Etoile, France.

出版信息

Trop Med Infect Dis. 2024 Aug 14;9(8):178. doi: 10.3390/tropicalmed9080178.

Abstract

Lassa Fever is a deadly viral haemorrhagic disease, causing annually several hundreds of deaths in West Africa. This zoonotic disease is primarily transmitted to humans by rodents of the genus , even though other rodents reportedly carry the Lassa virus, while secondary interhuman transmission accounts for approximately 20% of cases. Although this disease has been endemic in rural zones of Nigeria, Sierra Leone, Liberfia, and Guinea for hundreds of years, it is also characterised by epidemic outbreaks in the dry season, responsible for heavy death tolls. No licensed vaccine or satisfying treatment is currently available. Disease management is hindered by the incomplete knowledge of the epidemiology and distribution of the disease, resulting from an inadequate health and surveillance system. Additional scientific constraints such as the genetic diversity of the virus and the lack of understanding of the mechanisms of immune protection complexify the development of a vaccine. The intricate socio-economic context in the affected regions, and the lack of monetary incentive for drug development, allow the disease to persist in some of West Africa's poorest communities. The increase in the number of reported cases and in the fatality rate, the expansion of the endemic area, as well as the threat Lassa Fever represents internationally should urge the global community to work on the disease control and prevention. The disease control requires collaborative research for medical countermeasures and tailored public health policies. Lassa Fever, created by the interconnection between animals, humans, and ecosystems, and embedded in an intricate social context, should be addressed with a 'One Health' approach. This article provides an overview of Lassa Fever, focusing on Nigeria, and discusses the perspectives for the control of disease.

摘要

拉沙热是一种致命的病毒性出血热疾病,每年在西非导致数百人死亡。这种人畜共患疾病主要通过 属的啮齿动物传播给人类,尽管据报道其他啮齿动物也携带拉沙病毒,而人际间的二次传播约占病例的20%。尽管这种疾病在尼日利亚、塞拉利昂、利比里亚和几内亚的农村地区已经流行了数百年,但它也有在旱季爆发疫情的特点,造成大量人员死亡。目前尚无获得许可的疫苗或令人满意的治疗方法。由于卫生和监测系统不完善,对该疾病的流行病学和分布了解不全面,阻碍了疾病管理。病毒的遗传多样性以及对免疫保护机制缺乏了解等其他科学限制因素,使疫苗研发变得更加复杂。受影响地区复杂的社会经济背景以及药物研发缺乏资金激励,使得这种疾病在西非一些最贫困社区持续存在。报告病例数和死亡率的增加、流行区域的扩大,以及拉沙热在国际上构成的威胁,都应促使全球社会致力于该疾病的控制和预防。疾病控制需要开展医学应对措施的合作研究以及制定针对性的公共卫生政策。拉沙热是由动物、人类和生态系统之间的相互联系所引发,并植根于复杂的社会背景之中,应以 “同一健康” 的方法加以应对。本文概述了拉沙热,重点介绍了尼日利亚,并讨论了疾病控制的前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c6a/11359316/bcd4e672bef5/tropicalmed-09-00178-g001.jpg

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