McIntosh K, Halonen P, Ruuskanen O
Department of Pediatrics, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Clin Infect Dis. 1993 Jan;16(1):151-64. doi: 10.1093/clinids/16.1.151.
An international workshop to review the epidemiology, diagnosis, treatment, and prevention of respiratory viral infections was held in Turku, Finland, in May 1991. This workshop emphasized the following points. (1) In epidemiological studies of influenza virus, serological, clinical, and gene-sequencing methods have been used to produce a full picture of genetic evolution. Less complete information exists about other viruses, although new data on respiratory syncytial virus are emerging. (2) Tools for the diagnosis of respiratory viral infections have been developed in conjunction with the use of solid-phase immunoassays. A role remains for tissue culture in surveillance and epidemiological studies. Detection of bacterial involvement in respiratory infections has been more difficult. (3) Treatment of infections due to respiratory viruses has advanced with the use of amantadine and aerosolized ribavirin. On the other hand, many viruses remain refractory to treatment. Means for preventing influenza are established, but barriers to the development of other viral vaccines--including the existence of multiple serotypes, imperfect natural immunity, and paradoxical hypersensitivity--have proven difficult to surmount.
1991年5月,一场旨在回顾呼吸道病毒感染的流行病学、诊断、治疗及预防的国际研讨会在芬兰图尔库举行。本次研讨会强调了以下几点:(1)在流感病毒的流行病学研究中,血清学、临床及基因测序方法已被用于全面呈现其基因进化情况。关于其他病毒的信息则不太完整,不过呼吸道合胞病毒的新数据正在不断涌现。(2)随着固相免疫测定法的应用,呼吸道病毒感染的诊断工具得以开发。组织培养在监测和流行病学研究中仍发挥着作用。检测呼吸道感染中细菌的参与情况则更为困难。(3)使用金刚烷胺和气雾利巴韦林使得呼吸道病毒感染的治疗取得了进展。另一方面,许多病毒对治疗仍具抗性。预防流感的方法已经确立,但开发其他病毒疫苗面临诸多障碍,包括存在多种血清型、自然免疫不完善以及矛盾的超敏反应,事实证明这些障碍难以克服。