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首页> 外文期刊>International Journal of General Medicine >A review of the epidemiological and clinical aspects of West Nile virus
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A review of the epidemiological and clinical aspects of West Nile virus

机译：西尼罗河病毒的流行病学和临床研究综述

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Abstract: The resurgence of West Nile virus (WNV) in North America and Europe in recent years has raised the concerns of local authorities and highlighted that mosquito-borne disease is not restricted to tropical regions of the world. WNV is maintained in enzootic cycles involving, primarily, Culex spp. mosquitoes and avian hosts, with epizootic spread to mammals, including horses and humans. Human infection results in symptomatic illness in approximately one-fifth of cases and neuroinvasive disease in less than 1% of infected persons. The most consistently recognized risk factor for neuroinvasive disease is older age, although diabetes mellitus, alcohol excess, and a history of cancer may also increase risk. Despite the increasing public health concern, the current WNV treatments are inadequate. Current evidence supporting the use of ribavirin, interferon α, and WNV-specific immunoglobulin are reviewed. Nucleic acid detection has been an important diagnostic development, which is particularly important for the protection of the donated blood supply. While effective WNV vaccines are widely available for horses, no human vaccine has been registered. Uncertainty surrounds the magnitude of future risk posed by WNV, and predictive models are limited by the heterogeneity of environmental, vector, and host factors, even in neighboring regions. However, recent history has demonstrated that for regions where suitable mosquito vectors and reservoir hosts are present, there will be a risk of major epidemics. Given the potential for these outbreaks to include severe neuroinvasive disease, strategies should be implemented to monitor for, and respond to, outbreak risk. While broadscale mosquito control programs will assist in reducing the abundance of mosquito populations and subsequently reduce the risks of disease, for many individuals, the use of topical insect repellents and other personal protective strategies will remain the first line of defense against infection.
机译：摘要：近年来，西尼罗河病毒（WNV）在北美和欧洲的复活引起了地方当局的关注，并着重指出蚊媒传播的疾病不仅限于世界热带地区。 WNV维持在主要涉及库蚊（Culex spp）的动物周期中。蚊子和禽类寄主，流行性传播到哺乳动物，包括马和人。人类感染导致约五分之一的症状性疾病，不到1％的感染者导致神经侵袭性疾病。尽管糖尿病，酒精摄入过多和有癌症史也可能增加风险，但最公认的神经入侵疾病风险因素是老年。尽管公众对健康的担忧日益增加，但目前的西尼罗病毒治疗仍不足。综述了支持利巴韦林，干扰素α和WNV特异性免疫球蛋白使用的最新证据。核酸检测已成为重要的诊断技术，对保护捐赠的血液供应尤其重要。尽管有效的WNV疫苗可广泛用于马匹，但尚未注册任何人类疫苗。不确定性围绕WNV带来的未来风险的大小，即使在邻近地区，预测模型也受到环境，媒介和宿主因素异质性的限制。但是，最近的历史证明，对于存在合适的蚊媒和水库宿主的地区，将存在重大流行病的风险。考虑到这些暴发可能包括严重的神经侵袭性疾病，应实施策略来监测暴发风险并对其做出反应。虽然大规模的蚊子控制计划将有助于减少蚊子种群的数量，从而减少疾病的风险，但对于许多个人而言，使用局部驱虫剂和其他个人防护策略仍将是抵抗感染的第一道防线。

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