紧急感染:猴痘非典型临床病例(最新综述)

Aniuta Sydorchuk, Oksana Horbachova
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引用次数: 0

摘要

摘要猴痘引起的国际紧急情况迫使世界关注这种感染,因为它已蔓延到流行地区以外,而且尚未制定任何控制措施。病毒开始传播给人类,不仅通过接触,而且通过空气飞沫、粪口和垂直传播。已经出现了医院内传播、食用受污染的动物肉类和在水中游泳后爆发的病例。孕妇、8岁以下儿童和艾滋病毒感染者由于并发症的风险需要特别关注。因此,各级医生必须了解感染的新传播途径和疾病的非典型表现,以便鉴别诊断,及时发现和进一步治疗。的目标。对发生非典型病程和并发症风险增加的人群中猴痘临床病例(由于病毒对免疫系统的损害)和8岁以下儿童中猴痘临床病例(由于免疫系统不充分形成)进行最新文献综述。材料和Мethods。分析google scholar数据库中的科学文章,选取7篇文章,9种不同的病例描述,对不同非流行国家免疫力不足人群的临床病例进行深入研究(who专家认为非洲和亚洲国家为流行国家)。结果。大多数非典型病例发生在接受抗逆转录病毒治疗或暴露前预防HIV感染的男同性恋者中。特征性皮疹出现在无保护的口交或肛交后相应的身体部位。对于没有自身免疫力的幼儿,其传播机制主要为接触或垂直传播。结论。我们对文献的分析显示猴痘在具有非传统性取向的男性群体中流行。根据分析,感染艾滋病毒的同性恋者,主要是男性,是感染这种新出现的正痘病毒的主要危险群体。与此同时,患有原发性和继发性免疫缺陷疾病的人仍然特别脆弱。重要的是,非典型的临床病程使及时的临床和实验室诊断甚至开始治疗复杂化,这可能导致严重和致命的并发症(在流行地区的儿童和虚弱的艾滋病毒感染者中)。建议及时采取抗流行病措施,对易受伤害的人群(上面列出的人群以及职业风险群体)实施具体预防措施,同时根据《国际卫生条例》在整个国家边境检查站加强流行病监测和严格的感染控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Emergent infection: atypical clinical cases of monkeypox (updated review)
Abstract. The international emergency caused by monkeypox has forced the world to pay attention to this infection, as it has spread beyond endemic regions and no control measures have been developed. The virus began to be transmitted to humans not only by contact, but also by airborne droplets, fecal-oral, and vertical. There have been cases of in-hospital spread, outbreaks after eating contaminated animal meat, and swimming in water. Pregnant women, children under 8 years of age, and HIV-infected people require special attention due to the risk of complications. Therefore, it is important for doctors of all levels to be aware of new ways of spreading the infection, atypical manifestations of the disease for differential diagnosis, timely detection and further treatment. Aim. To conduct an up-to-date literature review of clinical cases of monkeypox in people at increased risk of developing atypical course and complications - in HIV-infected people (due to the virus's damage to the immune system) and children under 8 years of age (due to insufficiently formed immunity). Materials and Мethods. Scientific articles from the google scholar database were analyzed, among which 7 articles with 9 different case descriptions were selected to conduct an in-depth study of clinical cases among people from different non-endemic countries who have insufficient immunity (WHO experts consider African and Asian countries to be endemic). Results. Most of the atypical cases were observed among homosexual men receiving antiretroviral therapy or pre-exposure prophylaxis for HIV infection. The characteristic rash appeared after unprotected oral or anal sex on the corresponding body parts. As for the disease in young children who do not have their own immunity, the mechanism of transmission was contact or vertical. Conclusions. Our analysis of the literature shows the prevalence of monkeypox in the male gender group with non-traditional sexual orientation. Based on the analysis, HIV-infected homosexuals, mostly men, are the main risk group for infection with this emergent orthopoxvirus. At the same time, people with primary and secondary immunodeficiency conditions remain particularly vulnerable. It is important that the atypical clinical course complicates timely clinical and laboratory diagnosis and even the initiation of treatment, which can lead to severe and fatal complications (in endemic regions among children and debilitated HIV-infected persons). It is advisable to take timely anti-epidemic measures with the implementation of specific prophylaxis for vulnerable categories of persons (listed above, as well as occupational risk groups), along with an increase in epidemic surveillance and strict infection control in compliance with International Health Regulations at checkpoints along the entire state border.
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