Monath T P
Research and Medical Affairs, OraVax, Inc., Cambridge, MA 02139.
Proc Natl Acad Sci U S A. 1994 Mar 29;91(7):2395-400. doi: 10.1073/pnas.91.7.2395.
Dengue viruses are members of the Flaviviridae, transmitted principally in a cycle involving humans and mosquito vectors. In the last 20 years the incidence of dengue fever epidemics has increased and hyperendemic transmission has been established over a geographically expanding area. A severe form, dengue hemorrhagic fever (DHF), is an immunopathologic disease occurring in persons who experience sequential dengue infections. The risk of sequential infections, and consequently the incidence of DHF, has risen dramatically, first in Asia and now in the Americas. At the root of the emergence of dengue as a major health problem are changes in human demography and behavior, leading to unchecked populations of and increased exposure to the principal domestic mosquito vector, Aedes aegypti. Virus-specified factors also influence the epidemiology of dengue. Speculations on future events in the epidemiology, evolution, and biological expression of dengue are presented.
登革病毒属于黄病毒科,主要通过涉及人类和蚊媒的循环进行传播。在过去20年中,登革热疫情的发病率有所上升,并且在地理范围不断扩大的地区已形成高度地方性传播。一种严重形式,即登革出血热(DHF),是一种发生在经历过连续登革病毒感染的人群中的免疫病理疾病。连续感染的风险,以及因此导致的登革出血热发病率,已急剧上升,首先在亚洲,现在在美洲。登革热成为一个主要健康问题的根源在于人类人口统计学和行为的变化,导致主要的家蚊媒介埃及伊蚊数量不受控制且人们与之接触增加。病毒特定因素也影响登革热的流行病学。本文还对登革热流行病学、进化和生物学表现的未来发展进行了推测。