Epidemiology of dengue: past, present and future prospects.
Epidemiology of dengue: past, present and future prospects.
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DOI：
10.2147/clep.s34440
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发表时间：
2013
影响因子：
3.9
通讯作者：
Wilder-Smith A
中科院分区：
文献类型：
--
作者：
Murray NE;Quam MB;Wilder-Smith A
登革热是目前全球最重要的蚊媒病毒性疾病。与登革热症状相符的历史可以追溯到公元265-420年的秦朝。该病毒及其载体现已广泛分布于世界各地的热带和亚热带地区，特别是在过去半个世纪。显著的地理扩张伴随着发病病例、流行病和高流行性的迅速增加，导致登革热的形式更加严重。登革热的传播现在存在于世界上每个世界卫生组织（世卫组织）区域，已知有超过125个国家是登革热地方病。由于疾病监测不足、误诊和报告水平低等因素，很难确定登革热在全球的真正影响。目前可用的数据可能严重低估了社会、经济和疾病负担。据估计，全球每年登革热感染人数在5 000万至2亿之间;然而，最近使用制图方法进行的估计表明，这一数字接近4亿。由于气候变化、全球化、旅行、贸易、社会经济、定居以及病毒进化等现代动态因素，预计登革热的扩张将增加。目前还没有疫苗或特异性抗病毒疗法来应对登革热日益增长的威胁。及时发现病例和适当的临床管理可以降低重症登革热的死亡率。有效的病媒控制是登革热预防和控制的支柱。监测和改进登革热病例的报告对于衡量《2012-2020年世卫组织登革热预防和控制全球战略》目标所述的全球真实情况也至关重要。更准确的数据将为研究、卫生政策和财政资源的优先次序提供信息，以减少这种控制不力的疾病。本文的目的是回顾世界范围内登革热的历史和当前流行病学，此外，还反映了登革热扩展到未来的一些潜在原因。
Dengue is currently regarded globally as the most important mosquito-borne viral disease. A history of symptoms compatible with dengue can be traced back to the Chin Dynasty of 265–420 AD. The virus and its vectors have now become widely distributed throughout tropical and subtropical regions of the world, particularly over the last half-century. Significant geographic expansion has been coupled with rapid increases in incident cases, epidemics, and hyperendemicity, leading to the more severe forms of dengue. Transmission of dengue is now present in every World Health Organization (WHO) region of the world and more than 125 countries are known to be dengue endemic. The true impact of dengue globally is difficult to ascertain due to factors such as inadequate disease surveillance, misdiagnosis, and low levels of reporting. Currently available data likely grossly underestimates the social, economic, and disease burden. Estimates of the global incidence of dengue infections per year have ranged between 50 million and 200 million; however, recent estimates using cartographic approaches suggest this number is closer to almost 400 million. The expansion of dengue is expected to increase due to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement and also viral evolution. No vaccine or specific antiviral therapy currently exists to address the growing threat of dengue. Prompt case detection and appropriate clinical management can reduce the mortality from severe dengue. Effective vector control is the mainstay of dengue prevention and control. Surveillance and improved reporting of dengue cases is also essential to gauge the true global situation as indicated in the objectives of the WHO Global Strategy for Dengue Prevention and Control, 2012–2020. More accurate data will inform the prioritization of research, health policy, and financial resources toward reducing this poorly controlled disease. The objective of this paper is to review historical and current epidemiology of dengue worldwide and, additionally, reflect on some potential reasons for expansion of dengue into the future.