您好,欢迎访问洪震南博客!
  • 如果您觉得本站非常有看点,那么赶紧使用Ctrl+D 收藏吧
  • 网站所有资源均来自网络,如有侵权请联系站长删除!

古龙小说集新一轮寨卡威胁将至!-SIFIC感染官微

全部文章 admin 2019-01-30 386 次浏览
网站分享代码
新一轮寨卡威胁将至!-SIFIC感染官微

检索丨唐文瑞(湘潭市中心医院)
翻译丨唐文瑞(湘潭市中心医院)
审核丨李元叶(济宁市第一人民医院)
陈志锦(东莞市厚街医院)
寨卡是一种蚊媒传播病毒,彭小盛 在去年夏天曾敲响了公共卫生预警,尽管已经从聚光灯下退去,但是,专家称,预计今年病毒将再次构成威胁。
威胁到底有多大?这正是寨卡的棘手之处。
今年在美国没有报道过本地感染寨卡病毒的病例。但当公共卫生机构为蚊子到来季节而做准备的时候,仍不确定需要哪些资源,古龙小说集 以及是否获得联邦足够的支持。此外,研究人员仍未能确定寨卡病毒的作用机制和长期效应。这些不可抗因素可能会使追踪疫情以及为预防和管理疾病提供准确信息等工作变得复杂化。
寨卡病毒主要是通过一种蚊子传播的,这种蚊子通常出现在美国南部的一些地区,如墨西哥湾沿岸,若孕妇感染,会导致出生缺陷。德克萨斯州、弗罗里达州、加利福利亚州南部以及路易斯安那州去年都是高风险区,寨卡病毒于2015年袭击美洲张伊明 ,并通过受感染的旅行者到达了美国。我国广东省、海南省以及云南省的西双版纳州、德宏州及临沧市等地区有埃及伊蚊,这些地区是登革热的高发地区,也是未来发生寨卡病毒本地传播风险较高的地区。
据报道,去年美国有5102人感染了寨卡病毒,大多数人在美国南部和中部旅游时被感染。自从去年六月政府开始报道暴发以来,美国已有64名婴儿感染。在极少数情况下,没有出国旅行的人会通过当地的蚊子或性接触感染寨卡病毒。属于美国领土的波多黎各去年寨卡病例数达34963例。
今年再次确定,如果地区正在经历活跃的寨卡传播,将需要主动监测和检测 蚊子和潜在暴露者。大多数感染病毒的人不会出现明显的症状重生法医 ,专家表示实施这种检测是具有挑战性的。
长期的监测可能需要大量的资金。利用产前护理来推进寨卡检测也有其自身的缺陷,因为许多面临风险的女性都是低收入者。当寨卡病毒流行时,这一问题会削弱当局发现寨卡病毒出现以及暴发的能力;去年在南佛罗里达州发现寨卡病毒暴发的唯一途径仅仅是意外发现。
检测是另一个问题。想要在先感染了如登革热等相关病毒的患者中发现寨卡病毒郝昭文,目前的检测不可靠。初步研究表明,母亲病毒携带者所生的没有小头畸形的儿童,可能会在以后的生活中出现发育问题。但这些问题的严重程度以及它们实际表现出来的可能性目前均尚不清楚。关于寨卡病毒与类似病毒相互作用信息的局限性意味着可用的检测的准确性并不高鼎级理财网 。
New Zika Threat Hovers as Summer's
Mosquitoes Get Bzzzzy
Zika, the mosquito-borne virus that triggered public health alarm bells last summer, has receded from the spotlight. But, experts say, expect the virus to pose a renewed threat this year.
How great of a threat? That's where it gets tricky.
No locally acquired cases of the virus have been reported in theUnited Statesthis year. But as public health agencies gear up for mosquito season, uncertainty remains around what resources states may need and whether they will receive adequate federal support. In addition, researchers still have questions about how the virus works and its long-term effects. These forces could complicate efforts to track outbreaks and provide accurate information about prevention and disease management.
"We still have much to learn. And much remains to be done潘若瑶 ," Lyle Petersen, director of the Centers for Disease Control and Prevention's Division of Vector-Borne Diseases, said last week at a House Energy and Commerce subcommitteehearing.
Zika, which can cause birth defects if contracted by pregnant women, is primarily transmitted by a mosquito more commonly found in southern areas of the country such as the Gulf Coast. Texas, Florida, Southern California and Louisiana were all deemed high-risk areas last year. It hit theAmericas in 2015and reached theUnited Statesvia infected travelers.
Last year,5,102 people in the United States were reportedwith the disease — most contracted the virus while traveling in South and Central America. Sixty-four babies in theU.S.have been affected since the government began reporting outcomes last June. In rare cases, people who had not traveled abroad contracted Zika through a local mosquito or through sexual contact. Puerto Rico, aU.S.territory, had34,963cases in 2016.
Again this year, determining if areas are experiencing active Zika transmission will require active surveillance and testing — both of mosquitoes and of people potentially exposed. Most people who contract the virus don't show visible symptoms.
Implementing that testing is challenging, experts said.
"Should you begin universal screenings in communities that are at risk?" asked Jeff Engel, executive director of the Council of State and Territorial Epidemiologists, which represents the specialists working in public health departments. "That is a tough resource question and probably is not feasible."
Last year, Congress appropriated $1.1 billion toward fighting Zika. Thatwas splitamong research, overseas response and state public health efforts.In April闪光灵程 , the CDC warned state officials those federal dollars were running out. Theyare projectedto last through the end of this fiscal year, in September.
Meanwhile, the White House budget released Tuesday proposes establishing an emergency fund to finance responses to outbreaks like Zika. But it also calls for a $1.3 billion cut to the CDC and slashes $838 million from the National Institute of Allergy and Infectious Diseases皮普保罗, the agency behind vaccine development. So far, there has been little talk from Congress of approving extra funding.
"Funding from Congress has been critical for our response to Zika. However, additional support will be needed," said Rick Bright, director of the federal Biomedical Advanced Research and Development Authority, a subsidiary of the U.S. Department of Health and Human Services, at the hearing.
Some advocates also warnan ongoing hiring freezeat HHS could limit the agency's capacity to support a Zika response.
"Obviously we live in tough times when it comes to budget constraints童启华 ," said Tom Skinner, a CDC spokesman. "And we have to find creative ways to do the best we can with what we're given."
If those constraints thwart surveillance efforts this year, experts warned, it will make it harder to know precisely when Zika hits. That blind spot puts women of childbearing age — for whom the virus' consequences are most dramatic — at greater risk. Reports highlight microcephaly as a significant consequence, but a burgeoning field of research suggests its impact on children may bebroader, and may manifest years after a child is born.
"Without active surveillance — I'm worried we missed [many cases of] Zika last year and we'll miss Zika this year," said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, in Houston. "If you're a woman of reproductive age, living on the Gulf Coast of the United States, or Arizona or Southern California, and you're pregnant or might be pregnant — you don't really know if Zika's in your area or not."
Texas, which experienced six cases of local Zika transmission last year, has identified counties it deems most vulnerable. All pregnant women in those areas are advised to get Zika screenings as part of their routine prenatal care. The state works with the CDC to monitor how many pregnant women test positive and intends to monitor babies born to mothers who experienced infection.
But long-term follow-up will probably require more funding, noted Chris Van Deusen, a spokesman for Texas' Department of State Health Services. And leveraging prenatal care to push Zika testing has its own shortcomings. Many women most at risk are low-income, Van Deusen noted, and therefore less likely to interact with the health care system, or get prenatal care. Those people won't be tested or accounted for in the state's Zika tracking efforts.
That, Hotez said卢六六, compromises authorities' ability to discover Zika when it hits and then get the word out. "The only way we identify Zika outbreaks like [last year's] in South Florida is through serendipity," he said.
Testing is another concern. Current tests are unreliable in identifying Zika among patients previously infected with related viruses, such as dengue.
Limited resources could also strain the states' ability to process tests efficiently. Last year, the volume of patient samples sent for Zika testing overwhelmed laboratories in some affected areas, noted Kelly Wroblewski, director of infectious disease at the Association of Public Health Laboratories.
The surge translated to delays in determining if women had Zika. That could continue this year, since universal testing in affected areas is a burden that many of these labs don't have the resources to meet.
If the virus spreads, Wroblewski said, "we may find a capacity gap."
Many states also lack the infrastructure to adequately address an outbreak. Surveillance of mosquito-borne diseases is virtually nonexistent in many states,according to a 2014 report from the Council of State and Territorial Epidemiologists. Mosquito surveillance among states dropped from 96 percent in 2004 to 80 percent in 2012. In many areas, mosquito eradication has shrunk along with dwindling public health budgets.
"We need better mosquito control methods, we need better surveillancepivix ," Petersen said at last week's hearing. "We need to develop more of a nationally standard approach to vector control and laboratory testing. … This will require a sustained effort to rebuild infrastructure."
The scarcity of resources is compounded by scientists' limited knowledge of the virus.
Experts are "discovering new things every day," particularly regarding how the virus plays out after birth, Engel said. Beyond an obvious condition like microcephaly — which results in an abnormally small head and brain impairment — it's tough to say just how consequential the disease can be. Preliminary work suggests children without microcephaly whose mothers carried the virus may have developmental issues later in life. But the extent of those issues — and the odds they do in fact manifest — is unclear. And limited knowledge about how Zika interacts with similar viruses means available tests aren't always accurate.
"Unfortunately, it's the problem with these rapidly emerging diseases; you can't get the research up quickly enough to get the best answers刘焕荣 ," said Scott Weaver, director of the Institute for Human Infections and Immunity at the University of Texas Medical Branch in Galveston.
Because Zika's long-term consequences remain murky, states are trying to keep tabs on children whose mothers tested positive. Beyond Texas, Louisiana is also tracking children for at least three years after birth, even if they don't show obvious symptoms. But that assumes a surveillance system is robust enough to track all mothers who carried the virus. It also assumes sufficient resources to keep monitoring children. Those, experts said, are hardly guaranteed. And they still might not be enough.
"It's going to take a generation of pediatric neurologists to study and sort this out," Hotez said. "This is just the beginning."

图文编辑:刘欢
审稿:孙庆芬 赵静