Yellow fever: an update.
Yellow fever: an update.
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DOI：
10.1016/s1473-3099(01)00016-0
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发表时间：
2001-08-01
期刊：
影响因子：
--
通讯作者：
Monath, T P
中科院分区：
文献类型：
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作者：
Monath, T P
黄热病，即最初的病毒性出血热，在研制出有效的疫苗之前是最令人恐惧的致命疾病之一。今天，在非洲和南美洲的热带地区，每年仍有多达20万人受到这种疾病的影响，并对前往这些地区的未接种疫苗的旅行者构成重大危险。黄热病是在猴子和蚊子的循环中传播的，但人类也可以作为蚊子感染的病毒宿主。最近，城市蚊媒埃及伊蚊的密度和分布增加，以及空中旅行的增加，增加了黄热病传入和传播到北美和中美洲、加勒比和亚洲的风险。本文就该病的临床特点、发病机制及病理生理学进行综述。疾病机制知之甚少，也没有现代临床研究的主题。由于没有特定的治疗方法，而且对患者的管理也存在极大的问题，因此重点是预防性接种。作为一种人畜共患病，黄热病无法根除，但通过在流行国家进行常规儿童疫苗接种，可以减少人类疾病负担，而且所获得的益处成本较低。本文综述了黄热病17D减毒活疫苗的生物学特性、安全性和有效性。黄热病17D病毒作为外源基因载体的新应用，作为开发针对其他病毒甚至可能针对癌症的新疫苗的手段，具有相当大的前景。
Yellow fever, the original viral haemorrhagic fever, was one of the most feared lethal diseases before the development of an effective vaccine. Today the disease still affects as many as 200,000 persons annually in tropical regions of Africa and South America, and poses a significant hazard to unvaccinated travellers to these areas. Yellow fever is transmitted in a cycle involving monkeys and mosquitoes, but human beings can also serve as the viraemic host for mosquito infection. Recent increases in the density and distribution of the urban mosquito vector, Aedes aegypti, as well as the rise in air travel increase the risk of introduction and spread of yellow fever to North and Central America, the Caribbean and Asia. Here I review the clinical features of the disease, its pathogenesis and pathophysiology. The disease mechanisms are poorly understood and have not been the subject of modern clinical research. Since there is no specific treatment, and management of patients with the disease is extremely problematic, the emphasis is on preventative vaccination. As a zoonosis, yellow fever cannot be eradicated, but reduction of the human disease burden is achievable through routine childhood vaccination in endemic countries, with a low cost for the benefits obtained. The biological characteristics, safety, and efficacy of live attenuated, yellow fever 17D vaccine are reviewed. New applications of yellow fever 17D virus as a vector for foreign genes hold considerable promise as a means of developing new vaccines against other viruses, and possibly against cancers.