Ebola virus outbreaks in Africa: Past and present
Ebola virus outbreaks in Africa: Past and present
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DOI：
10.4102/ojvr.v79i2.451
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发表时间：
2012-01-01
影响因子：
2.7
通讯作者：
Paweska, Janusz T.
中科院分区：
文献类型：
--
作者：
Muyembe-Tamfum, J. J.;Mulangu, S.;Paweska, Janusz T.
埃博拉出血热(EHF)是一种同时影响人类和非人类灵长类动物的人畜共患疾病。非洲的疫情主要发生在刚果和尼罗河流域。1976年，流行性出血热首次暴发几乎同时发生在刚果民主共和国(刚果民主共和国，前扎伊尔)和苏丹，病死率非常高，分别为88%和53%。这两起疫情是由两种不同的埃博拉病毒引起的，分别是扎伊尔埃博拉病毒(ZEBOV)和苏丹埃博拉病毒(Sebov)。传播源仍不清楚。在长时间的沉默之后(1980-1993年)，由这两个物种引起的非洲流行性出血热暴发频率增加，并发现了新物种，即1994年在象牙海岸的科特迪瓦埃博拉病毒(CIEBOV)和2007年在乌干达的本迪布乔埃博拉病毒(Bebov)。在加蓬和刚果共和国再次出现流行性出血热疫情的同时，感染ZEBOV的大猩猩和黑猩猩的死亡率也有所增加。人类疫情与多个与死亡大猩猩或黑猩猩有过接触的无关指示病例有关。然而，在国家卫生计划稀有或没有的地区，如1995年的基克维特(刚果民主共和国)、2007年的姆韦卡(刚果民主共和国)、2000年的古鲁(乌干达)和2004年的延比奥(苏丹)，捕猎和食用果蝠可能导致了埃博拉病毒向人类的初次传播。人与人之间的传播与直接接触受感染对象或受污染物体的体液或组织有关。尽管进行了几次实地调查，但埃博拉病毒的流行病学和生态学，包括确定其天然宿主，仍然是公共卫生和科学界面临的一项艰巨挑战。
Ebola haemorrhagic fever (EHF) is a zoonosis affecting both human and non-human primates (NHP). Outbreaks in Africa occur mainly in the Congo and Nile basins. The first outbreaks of EHF occurred nearly simultaneously in 1976 in the Democratic Republic of the Congo (DRC, former Zaire) and Sudan with very high case fatality rates of 88% and 53%, respectively. The two outbreaks were caused by two distinct species of Ebola virus named Zaire ebolavirus (ZEBOV) and Sudan ebolavirus (SEBOV). The source of transmission remains unknown. After a long period of silence (1980-1993), EHF outbreaks in Africa caused by the two species erupted with increased frequency and new species were discovered, namely Cote d'Ivoire ebolavirus (CIEBOV) in 1994 in the Ivory Coast and Bundibugyo ebolavirus (BEBOV) in 2007 in Uganda. The re-emergence of EHF outbreaks in Gabon and Republic of the Congo were concomitant with an increase in mortality amongst gorillas and chimpanzees infected with ZEBOV. The human outbreaks were related to multiple, unrelated index cases who had contact with dead gorillas or chimpanzees. However, in areas where NHP were rare or absent, as in Kikwit (DRC) in 1995, Mweka (DRC) in 2007, Gulu (Uganda) in 2000 and Yambio (Sudan) in 2004, the hunting and eating of fruit bats may have resulted in the primary transmission of Ebola virus to humans. Human-to-human transmission is associated with direct contact with body fluids or tissues from an infected subject or contaminated objects. Despite several, often heroic field studies, the epidemiology and ecology of Ebola virus, including identification of its natural reservoir hosts, remains a formidable challenge for public health and scientific communities.