West Nile virus, first isolated in 1937, is among the earliest arthropod-borne viruses discovered by humans. Its broad geographical distribution, not uncommon infection of humans, transmission by mosquitoes, and association with wild birds as enzootic hosts were well documented by the mid-1960s. However, West Nile virus was not considered to be a significant human pathogen because most infections appeared to result in asymptomatic or only mild febrile disease. Several epidemics had been documented prior to 1996, some involving hundreds to thousands of cases in mostly rural populations, but only a few cases of severe neurological disease had been reported. The occurrence between 1996 and 1999 of three major epidemics, in southern Romania, the Volga delta in southern Russia, and the northeastern United States, involving hundreds of cases of severe neurological disease and fatal infections was totally unexpected. These were the first epidemics reported in large urban populations. A significant factor that appeared in common to all three outbreaks was the apparent involvement of the common house mosquito, Culex pipiens, as a vector. This species had not previously been implicated as important in the transmission of West Nile virus. In addition the epidemic in the northeastern United States was unusual in the association of West Nile virus infection with fatal disease of birds, suggesting a change in the virulence of the virus toward this host. Understanding the risk factors that contributed to these three urban epidemics is important for minimizing the potential for future occurrences. This review will attempt to compare observations on the biology of West Nile virus made over about 60 years prior to the recent epidemics to observations made in association with these urban epidemics.

译文

西尼罗河病毒是最早分离的1937年,是人类发现的最早的节肢动物传播的病毒之一。20世纪60年代中期充分证明了其广泛的地理分布,人类感染,蚊子传播以及与野生鸟类作为动物宿主的关联。然而,西尼罗河病毒不被认为是重要的人类病原体,因为大多数感染似乎导致无症状或仅导致轻度发热性疾病。1996年前已经记录了几起流行病,其中一些涉及大多数农村人口的数百至数千例病例,但仅报告了少数严重的神经系统疾病病例。在罗马尼亚南部,俄罗斯南部的伏尔加河三角洲和美国东北部,涉及数百例严重神经系统疾病和致命感染的三个主要流行病的发生1996年和1999完全出乎意料。这是在大城市人口中首次报告的流行病。所有这三起疫情共同出现的一个重要因素是普通家蚊库蚊 (Culex pipiens) 作为媒介的明显参与。该物种以前从未被认为在西尼罗河病毒的传播中很重要。此外,在美国东北部,西尼罗河病毒感染与鸟类致命疾病的联系是不寻常的,这表明病毒病毒对该宿主的毒力发生了变化。了解导致这三种城市流行病的风险因素对于最大程度地减少未来发生的可能性非常重要。这篇评论将试图将最近流行之前大约60年对西尼罗河病毒生物学的观察结果与与这些城市流行病相关的观察结果进行比较。

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