Hyperinfectivity: a critical element in the ability of V. cholerae to cause epidemics?
Hyperinfectivity: a critical element in the ability of V. cholerae to cause epidemics?
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高感染力：V.霍乱引起流行病的能力的关键要素？
DOI：
10.1371/journal.pmed.0030007
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发表时间：
2006-01
期刊：
影响因子：
15.8
通讯作者：
Smith DL
中科院分区：
文献类型：
--
作者：
Hartley DM;Morris JG Jr;Smith DL
霍乱是一种古老的疾病，尽管正在努力限制其传播，但它仍在继续引起流行病和大流行病。数学模型为评估各种拟议干预措施的效用提供了一种手段。然而，迄今为止开发的霍乱模型存在局限性，这表明我们仍然不了解霍乱传播的基本要素。最近的实验室研究结果表明，霍乱弧菌O1 Inaba El Tor通过胃肠道导致生物体的短寿命，高感染性状态，在几个小时内衰减到低感染性状态。将这种高传染性状态纳入我们的疾病模型，可以更好地拟合观察到的霍乱流行模式。这些发现有助于证实实验室观察的高感染状态的临床相关性，并强调了人与人之间的传播与环境与人之间的传播在流行病和大流行病的产生中的至关重要性。为了最大限度地限制霍乱的流行性传播，干预措施应针对最大限度地减少短寿命、高感染性的致炎性霍乱弧菌的传播风险。还需要评估其他主要流行病出现类似高度传染状态的可能性，并酌情将其纳入疾病预防模式。调整霍乱模型，以考虑到最近的实验数据提出的短暂的高传染性状态，提高了它们与真实的爆发数据的拟合。
Cholera is an ancient disease that continues to cause epidemic and pandemic disease despite ongoing efforts to limit its spread. Mathematical models provide one means of assessing the utility of various proposed interventions. However, cholera models that have been developed to date have had limitations, suggesting that there are basic elements of cholera transmission that we still do not understand. Recent laboratory findings suggest that passage of Vibrio cholerae O1 Inaba El Tor through the gastrointestinal tract results in a short-lived, hyperinfectious state of the organism that decays in a matter of hours into a state of lower infectiousness. Incorporation of this hyperinfectious state into our disease model provides a much better fit with the observed epidemic pattern of cholera. These findings help to substantiate the clinical relevance of laboratory observations regarding the hyperinfectious state, and underscore the critical importance of human-to-human versus environment-to-human transmission in the generation of epidemic and pandemic disease. To have maximal impact on limiting epidemic spread of cholera, interventions should be targeted toward minimizing risk of transmission of the short-lived, hyperinfectious form of toxigenic Vibrio cholerae. The possibility of comparable hyperinfectious states in other major epidemic diseases also needs to be evaluated and, as appropriate, incorporated into models of disease prevention. Adjusting cholera models to take into account a short-lived hyperinfectious state proposed by recent experimental data improves their fit with real outbreak data.
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DOI：
10.4269/ajtmh.2001.65.788
发表时间：
2001-12-01
影响因子：
3.3
作者：
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通讯作者：
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作者：
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