Towards a genomics-informed, real-time, global pathogen surveillance system.
Towards a genomics-informed, real-time, global pathogen surveillance system.
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DOI：
10.1038/nrg.2017.88
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发表时间：
2018-01
期刊：
影响因子：
--
通讯作者：
Loman NJ
中科院分区：
文献类型：
--
作者：
Gardy JL;Loman NJ
尽管许多专家组提出了建议，但公共卫生监测系统尚未得到改善，还无法更好地预测新出现的传染病威胁。埃博拉和寨卡疫情是最新的例证，表明病原体在人群中被诊断出来之前，往往已经在一段时间内未被察觉地传播了。
下一代测序技术，特别是便携式基因组测序仪的使用，为诊断和监测问题提供了一个有趣的解决方案——它能够通过基于扩增子或宏基因组学的方法进行快速的原位诊断，并产生一系列基因组数据，这些数据可以揭示疫情爆发或流行动态的关键流行病学方面的信息。
用于快速应对疫情的基因组流行病学在埃博拉和寨卡疫情中已经取得了一些早期成功，但仍有许多挑战需要克服——一些是技术方面的，一些是文化方面的。数据共享是其中之一，但还必须考虑其他伦理和法律问题。
通过纳入数字疾病检测和“同一健康”的概念，可以扩展基因组流行病学方法的效力。通过将测序与一个强化的监测和应对平台相结合，我们可以对疫情的预防和控制采取一种更具前瞻性的方法。
本文的网络版（doi:10.1038/nrg.2017.88）包含补充材料，授权用户可获取。
下一代测序技术有可能支持公共卫生监测系统，以提高对新出现传染病的早期检测能力。这篇综述阐述了基因组学在快速应对疫情中的作用，以及为使基于基因组学的病原体监测在全球成为现实需要解决的挑战。
本文的网络版（doi:10.1038/nrg.2017.88）包含补充材料，授权用户可获取。
最近的埃博拉和寨卡疫情表明，需要对新出现的传染病进行持续监测、快速诊断和实时追踪。对病原体基因组进行快速、经济的测序——这在资源充足的环境中现在已经是公共卫生微生物学实验室的一项常规工作——能够对上述每个方面产生影响。将基因组诊断和流行病学与创新的数字疾病检测平台相结合，增加了建立一个开放的、全球性的数字病原体监测系统的可能性。当以“同一健康”的方法为指导，即同时考虑人类、动物和环境健康时，这样一个基于基因组学的系统在缺乏强大实验室能力的环境中具有极大的改善公共卫生的潜力。
本文的网络版（doi:10.1038/nrg.2017.88）包含补充材料，授权用户可获取。
Despite the recommendations of many expert groups, public health surveillance systems have not yet improved to the point where emerging infectious threats can be better anticipated. The Ebola and Zika epidemics are the latest to demonstrate that pathogens often spread undetected for some time before being diagnosed in a population. Next-generation sequencing, particularly the use of portable genomic sequencers, offers an intriguing solution to the diagnosis and surveillance problems — it enables rapid in situ diagnostics through amplicon-based or metagenomics approaches and creates a stream of genomic data that can reveal critical epidemiological aspects of an outbreak or epidemic's dynamics. Genomic epidemiology for rapid outbreak response has demonstrated some early successes in Ebola and Zika, but there are a number of challenges to overcome — some technical and some cultural. Data sharing is one of these, but other ethical and legal issues must be considered. The power of a genomic epidemiology approach could be extended by incorporating concepts from digital disease detection and One Health. By coupling sequencing to an enhanced surveillance and response platform, we could take a more anticipatory approach to outbreak prevention and control. The online version of this article (doi:10.1038/nrg.2017.88) contains supplementary material, which is available to authorized users. Next-generation sequencing has the potential to support public health surveillance systems to improve the early detection of emerging infectious diseases. This Review delineates the role of genomics in rapid outbreak response and the challenges that need to be tackled for genomics-informed pathogen surveillance to become a global reality. The online version of this article (doi:10.1038/nrg.2017.88) contains supplementary material, which is available to authorized users. The recent Ebola and Zika epidemics demonstrate the need for the continuous surveillance, rapid diagnosis and real-time tracking of emerging infectious diseases. Fast, affordable sequencing of pathogen genomes — now a staple of the public health microbiology laboratory in well-resourced settings — can affect each of these areas. Coupling genomic diagnostics and epidemiology to innovative digital disease detection platforms raises the possibility of an open, global, digital pathogen surveillance system. When informed by a One Health approach, in which human, animal and environmental health are considered together, such a genomics-based system has profound potential to improve public health in settings lacking robust laboratory capacity. The online version of this article (doi:10.1038/nrg.2017.88) contains supplementary material, which is available to authorized users.
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