Clinical manifestations of human monkeypox influenced by route of infection
Clinical manifestations of human monkeypox influenced by route of infection
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DOI：
10.1086/505880
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发表时间：
2006-09-15
影响因子：
6.4
通讯作者：
Damon, Inger K.
中科院分区：
文献类型：
--
作者：
Reynolds, Mary G.;Yorita, Krista L.;Damon, Inger K.
背景资料。2003年4月，在一批来自西非的外来宠物进口猴痘病毒(MPXV)感染的动物后，美国爆发了猴痘疫情。在人类疾病之前，病毒传播到非非洲圈养物种，包括草原土拨鼠。我们评估了人类猴痘确诊病例和疑似病例感染途径对临床疾病的影响。暴露被归类为“非侵入性”(例如，接触受感染动物的人，清洁受感染动物的笼子，和/或站在受感染动物的6英尺以内)或“复杂”(例如，侵入性咬伤或被患病的草原犬咬伤或抓伤加上潜在的非侵入性暴露)，并评估暴露、疾病表现和疾病进展之间的联系(即，从第一次接触患病的草原犬到经过各种疾病基准所经过的时间)。与非侵入性暴露的患者相比，复杂暴露的患者更有可能经历明显的全身疾病迹象(49.1%比16.7%；P=.041)，并在患病期间住院(68.8%比10.3%；)。复合暴露也与较短的潜伏期有关(复合暴露为9天，非侵入性暴露为13天)，并且没有明显的发热征兆。这项研究的结果表明，感染途径会影响猴痘的疾病表现。
Background. In April 2003, an outbreak of monkeypox occurred in the United States following the importation of monkeypox virus (MPXV)-infected animals in a consignment of exotic pets from West Africa. Transmission of the virus to non-African captive species, including prairie dogs, preceded human disease.Methods. We evaluated the influence of the route of infection on clinical illness for persons with confirmed and probable cases of human monkeypox. Exposures were categorized as being "noninvasive" ( e. g., the person touched an infected animal, cleaned an infected animal's cage, and/or stood within 6 feet of an infected animal) or "complex" ( e. g., invasive bite or scratch from an ill prairie dog plus potential noninvasive exposure), and associations between exposure, illness manifestation, and illness progression (i.e., elapsed time from first exposure to an ill prairie dog through various benchmarks of illness) were assessed.Results. Patients with complex exposures were more likely than patients with noninvasive exposures to have experienced pronounced signs of systemic illness (49.1% vs. 16.7%; P = .041) and to have been hospitalized during illness (68.8% vs. 10.3%;). Complex exposures were also associated with shorter incubation periods ( 9 < .001 days for complex exposures vs. 13 days for noninvasive exposures) and the absence of a distinct febrile prodrome.Conclusions. The findings of this study indicate that route of infection can influence monkeypox illness manifestations.