摘 要:西尼罗病毒(West Nile virus,WNV)属黄病毒科,为正单链RNA病毒。它在人类中的感染导致以发热为主要症状的传染性疾病,主要由蚊虫叮咬传播。自20世纪50年代首例报告西尼罗病毒自然感染所致脑炎后的几十年内,西尼罗病毒脑炎在欧洲及中亚地区散在、小规模流行。西尼罗病毒脑炎于1999年在美国的爆发及随后几年在北美的流行引起了极大的关注。这次爆发流行中新出现的种种迹象,如其中间宿主——野生鸟类的大量死亡,人类感染者中中枢神经系统受损比例的增高等,提示近期的遗传变异已使西尼罗病毒感染的病理学与流行病学发生了较显著的变化。另外,随着感染的流行,蚊虫叮咬以外的传播途径,如输血、器官移植、母婴传播等日益受到人们重视。同时,人们对阻止疫情所急需的疫苗的研制也在进行之中。本文就近几年来对西尼罗病毒的感染、免疫与流行病学方面的研究进展进行了综述。 关键词:西尼罗病毒;感染;脑炎;流行病学 中图分类号:S852.659.6 文献标识码:A Progresses in West Nile virus research REN Jun (Key Laboratory of Medical Molecular Virology, Institute of Medical Microbiology,Shanghai Medical College, Fudan University, Shanghai 200032, China) Abstract: West Nile virus (WNV) belongs to Flaviviridae which is positive, single strand RNA virus. It causes infectious disease in human featured by fever. The major transmitting route is by mosquito bites. Since the first report of natural infected encephalitis caused by WNV in 1950s, last century, WNV infection has been endemic in the Europe and middle-west Asia for decades. The outbreak of WNV encephalitis in the United States in 1999 and subsequent epidemic in North America in the following years cause great concerns. The new features demonstrated in this outbreak, e.g. numerous deaths of wild birds and increased incidence of central nervous system damage in human cases suggest that genetic mutation has significantly altered the pathogenesis and epidemiology of the virus. Moreover, with the development of the epidemic, there are more and more concerns on the transmitting routes in addition to mosquito bites, such as blood transfusion, organ transplantation and vertical transmission. On the other hand, efforts have been made in vaccine development to stop this devastating infectious disease. This article reviews the current researches in WNV regarding its infection, immunity and epidemiology. Key words: West Nile virus; infection; encephalitis; epidemiology 任 军 (复旦大学上海医学院病原微生物学研究所,教育部/卫生部医学分子病毒学重点实验室, 上海 200032) 西尼罗病毒(West Nile virus,WNV)因1937 年从乌干达西尼罗地区的一位女性发热患者体内被首次分离而得名。在其后的近三十年里,西尼罗病毒感染导致的以发热为主要症状的传染性疾病—— 西尼罗热在非洲广为流行,但没有引起任何关注。西尼罗病毒导致脑炎的首次记录发生于1952年,美国纽约的Sloan-Kettering 研究所为95 位晚期癌症病人注射了西尼罗病毒以寻求其“溶癌”疗效,但结果是9 位病人因此感染脑炎[1]。首例自然感染导致的西尼罗病毒脑炎发生于20 世纪50 年代的以色列,随后在1962~1963 年小规模流行于法国,在其后的三十年中逐渐蔓延至环地中海以至欧洲各国,向东达到印度和中亚地区。其中,较大规模的暴发流行有1996 年在罗马尼亚、1999 年在俄罗斯和2000 年在以色列。这几次暴发都达到患者数百人,死亡数十人的规模。(全文见附件1) (责任编辑:泉水) |