Sands L, Kioski C, Komatsu K
Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix 85015.
J Am Osteopath Assoc. 1993 Dec;93(12):1279-85.
In May of this year, an outbreak of sudden, unexplained, and highly fatal respiratory illness of unknown etiology was identified in the four-corners region of the southwestern United States. Within 3 weeks after the collaborative response launched by the state and local health agencies in the affected area, laboratory studies from the federal Centers for Disease Control and Prevention suggested that an acute infection with a previously unrecognized Hantavirus species was responsible for the reported cluster of cases. The hantavirus associated with this outbreak has since been isolated in tissue culture, and diagnostic test systems specific for the newly identified hantavirus have been developed. This article summarizes the history of the outbreak as experienced by investigators from the Arizona Department of Health Services and reviews the epidemiologic and clinical aspects of both the current epidemic and hantaviruses in general. The sudden occurrence of acute illnesses in the Southwest due to a previously unrecognized hantavirus reaffirms that the potential for the emergence of new infectious diseases exists at any place or time in the United States. The response to the outbreak also illustrates how community clinicians and federal, state, and local health agencies work together to promptly identify the emergence of new disease threats, rapidly determine new etiologic agents, and develop and swiftly implement appropriate disease prevention and control strategies.
今年5月，美国西南部四角地区发现了一种病因不明、突然出现且极具致命性的呼吸道疾病疫情。在受灾地区的州和地方卫生机构联合采取应对措施后的3周内，联邦疾病控制与预防中心的实验室研究表明，一种此前未被识别的汉坦病毒急性感染是报告的病例群的病因。与此次疫情相关的汉坦病毒随后在组织培养中被分离出来，并且已经开发出针对新发现的汉坦病毒的诊断检测系统。本文总结了亚利桑那州卫生服务部的调查人员所经历的疫情历史，并回顾了当前疫情以及一般汉坦病毒的流行病学和临床方面。由于一种此前未被识别的汉坦病毒，西南部突然出现急性疾病，这再次证明在美国的任何地点或任何时间都存在出现新传染病的可能性。对此次疫情的应对还展示了社区临床医生以及联邦、州和地方卫生机构如何共同努力，迅速识别新的疾病威胁的出现，快速确定新的病原体，并制定和迅速实施适当的疾病预防和控制策略。
