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埃博拉病毒病:流行病学、生态学、诊断、治疗及控制

  • 李昱 ,
  • 任翔 ,
  • 刘翟 ,
  • 程颖 ,
  • 高福 ,
  • 余宏杰
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  • 1. 中国疾病预防控制中心传染病预防控制处, 传染病监测预警中国疾病预防控制中心重点实验室, 北京102206;
    2. 中国科学院微生物研究所病原微生物与免疫学重点实验室, 北京100101;
    3. 中国疾病预防控制中心, 北京102206
李昱,研究实习员,研究方向为传染病流行病学、传播动力学和监测,电子信箱:liyu1@chinacdc.cn

收稿日期: 2014-08-20

  网络出版日期: 2014-08-27

Ebola Virus Disease: Epidemiology, Ecology, Diagnosis, Treatment, and Control

  • LI Yu ,
  • REN Xiang ,
  • LIU Di ,
  • CHENG Ying ,
  • GAO George Fu ,
  • YU Hongjie
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  • 1. Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China;
    2. CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing 100101, China;
    3. Chinese Center for Disease Control and Prevention, Beijing 102206, China

Received date: 2014-08-20

  Online published: 2014-08-27

摘要

埃博拉病毒(Ebolavirus)是埃博拉病毒病(Ebola Virus Disease, EVD)的病原体,1976 年首次在非洲发现,目前确认该病毒包括5 个种,其中苏丹型(Sudan ebolavirus)、扎伊尔型(Zaire ebolavirus)、塔伊森林型(Taï Forest ebolavirus)和本迪布焦型(Bundibugyo ebolavirus)均有感染人发病的记录;莱斯顿型(Reston ebolavirus)可致人隐性感染,并与多起猕猴暴发疫情有关,曾在菲律宾的猪中检出。人类埃博拉病毒病的病死率为25%~90%,疫情均发生在非洲,主要集中在10°N—10°S 的非洲地区,本次西非疫情是规模最大的暴发流行,截至2014 年8 月20 日已报告2615 例病例。该病是动物源性传染病,目前证据支持果蝠可能为病毒的自然储存宿主。该病在人群中主要通过接触传播,有症状的病人才具有传染性。未采取正确防护措施的医护人员、家庭护理人员及接触病人血液、体液,或接触病人血液、体液等污染的物品,或接触病例尸体的人是高风险感染人群。本病起病急,早期表现为发热、厌食、虚弱无力等非特异性症状,可通过检测病毒核酸、抗原、抗体等方法确诊。目前尚无批准上市的特效药和疫苗,以对症和支持治疗为主。预防控制策略主要包括早期发现病例、及时调查处置、追踪和密切观察接触者,以及有效的医院内和社区的感染控制。

本文引用格式

李昱 , 任翔 , 刘翟 , 程颖 , 高福 , 余宏杰 . 埃博拉病毒病:流行病学、生态学、诊断、治疗及控制[J]. 科技导报, 2014 , 32(24) : 15 -24 . DOI: 10.3981/j.issn.1000-7857.2014.24.001

Abstract

Ebolavirus is the causative agent of Ebola Virus Disease (EVD) and was first found in 1976 in Africa. The genus of Ebolavirus includes 5 species, of which the 4 species, i.e., Sudan ebolavirus, Zaire ebolavirus, Taï Forest ebolavirus and Bundibugyo ebolavirus caused human cases of EVD in the history. The additional species, Reston ebolavirus, was associated with several outbreaks among monkeys and was once isolated from domestic pigs of Philippines. EVD has a fatality rate between 25% and 90%, with its outbreaks in humans limited to Africa and mainly happened in central Africa between 10°N and 10°S so far. The ongoing outbreak in West Africa has been the biggest one, with 2615 cases reported as of August 20, 2014. EVD is widely considered to be a zoonosis and its most likely natural reservoirs are fruit bats based on the current evidence. Ebolavirus can spread within human, mainly through contact of blood and secretions of patients presenting symptoms and the contaminated objects as well. So the health care staff, home care person and individuals with contact of corpse of EVD cases are the high risk population for infection. EVD has an abrupt onset of early symptoms such as fever, anorexia and weakness, which are nonspecific. But the disease can be diagnosed through testing RNA, antigen, or antibody. There have been no licensed drugs or vaccine in the market, while the treatment is still limited to treating the symptoms as they appear and supportive care. The current strategy for prevention and control includes early detection of cases, rapid investigation and response, tracing and close observation of high risk contact, and effective infection control in the health care facilities and the community.

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