临床表现,诊断方法和治疗策略
Boghuma K Titanji1, Aniruddha Hazra2,3, Jason Zucker4
1Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia.
这是一种通过皮肤接触传播的病毒性疾病. 虽然它通常是轻微的,但在免疫受损的人可能是严重的. 疫苗接种和支持性护理是管理mpox疫情的关键.
科学领域:
- 流行病学
- 传染性疾病
- 公共卫生
背景情况:
- 全球爆发的第IIb类麻疹 (麻疹病毒 - MPXV) 被宣布为国际关注的公共卫生紧急情况 (PHEIC),影响了全球超过99,000人.
- 中非最近的第I类MPXV感染增加导致了2024年8月的第二次PHEIC声明.
- 麻疹的传播主要是通过直接的皮肤接触,而IIb类感染通常与与男性发生性关系的男性有关.
研究的目的:
- 总结mpox的流行病学,临床表现,诊断和管理.
- 突出支持性护理,治疗和疫苗接种在控制mpox的重要性.
- 为医疗保健提供者和公共卫生官员提供有关当前mpox趋势和建议的信息.
主要方法:
- 综述全球和美国mopox疫情数据,包括感染率和死亡率.
- 临床表现的描述,包括前兆症状和病变进展.
- 诊断方法 (PCR测试) 和管理策略 (支持性护理,治疗,疫苗接种) 的摘要.
主要成果:
- 克莱德IIbMPXV引起了全球严重的疫情,在美国有超过33,000例病例和60例死亡.
- 目前美国的mopox感染人数平均每月为200人,最近由于I类增加了PHEIC声明.
- 通常会出现发烧,淋巴腺病变和特征性皮肤病变,在2 - 4周内进展. 在免疫受损的个体中,严重的后果更为常见.
结论:
- 对于大多数人来说,mpox是一种自我限制的疾病,但对免疫力低下的人群,尤其是晚期艾滋病患者来说,具有风险.
- 支持性护理是主要的治疗方法,对于严重的病例可提供先进的治疗方法.
- 使用修改后的安卡拉-巴伐利亚北欧疫苗是有效的 (66-86%),并建议高危人群接种.
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