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首页> 外文期刊>The Lancet >West africa struggles to contain ebola outbreak: Health workers in west Africa are trying to control an ebola outbreak that started in guinea and has already spread to neighbouring liberia. Andrew green reports
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West africa struggles to contain ebola outbreak: Health workers in west Africa are trying to control an ebola outbreak that started in guinea and has already spread to neighbouring liberia. Andrew green reports

机译：西非努力遏制埃博拉疫情：西非的卫生工作者正在努力控制始于几内亚的埃博拉疫情，该疫情已蔓延至邻近的利比里亚。安德鲁·格林报道

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Infection with dengue, the most prevalent mosquito-borne virus, manifests as dengue fever (DF) or the more fatal dengue haemorrhagic fever (DHF). DHF occurs mainly when an individual who has acquired antibodies to one serotype is inoculated with another serotype. It was reported that mosquito control may have increased the incidence of DF and DHF due to age-dependency in manifesting these illnesses or an immunological mechanism. Tetravalent dengue vaccine is currently being tested in clinical trials. However, seroconversions to all four serotypes were achieved only after three doses. Therefore, vaccines may predispose vaccinees to the risk of developing DHF in future infections. This study employed an individual-based computer simulation, to emulate mosquito control and vaccination, incorporating seroconversion rates reported from actual clinical trials. It was found that mosquito control alone would have increased incidence of DF and DHF in areas of high mosquito density. A vaccination programme with very high coverage, even with a vaccine of suboptimal seroconversion rates, attenuated possible surges in the incidence of DF and DHF which would have been caused by insufficient reduction in mosquito abundance. DHF cases attributable to vaccine-derived enhancement were fewer than DHF cases prevented by a vaccine with considerably high (although not perfect) seroconversion rates. These predictions may justify vaccination programmes, at least in areas of high mosquito abundance. In such areas, mosquito control programmes should be conducted only after the vaccination programme with a high coverage has been initiated.
机译：登革热是最普遍的蚊媒病毒，感染表现为登革热（DF）或更致命的登革出血热（DHF）。 DHF主要是在为一种血清型获得抗体的人接种另一种血清型时发生的。据报道，由于年龄相关性或疾病的免疫机制，控制蚊子可能增加了DF和DHF的发病率。四价登革热疫苗目前正在临床试验中进行测试。然而，仅在三剂之后才实现了向所有四种血清型的血清转化。因此，疫苗可能会使疫苗易于在将来的感染中发展DHF。这项研究采用了基于个人的计算机模拟，以模拟蚊子控制和疫苗接种，并结合了实际临床试验中报告的血清转化率。发现在高蚊密度的地区，单独进行灭蚊将增加DF和DHF的发生。即使是次优血清转换率很高的疫苗，覆盖率很高的疫苗接种计划也可以减少由于蚊子丰度降低不足而导致的DF和DHF发病率的激增。可归因于疫苗的增强作用的DHF病例少于血清转化率相当高（尽管不是完美的）的疫苗所预防的DHF病例。这些预测可以证明至少在蚊子高发地区的疫苗接种计划是合理的。在此类地区，仅应在覆盖率高的疫苗接种计划启动后才执行蚊子控制计划。

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