Dengue haemorrhagic fever--a public health problem and a field for research.
Dengue haemorrhagic fever--a public health problem and a field for research.
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DOI：
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发表时间：
1980
影响因子：
11.1
通讯作者：
S. Halstead
中科院分区：
文献类型：
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作者：
S. Halstead
登革出血热/登革休克综合征(登革出血热/登革休克综合征)是一个神秘且日益严重的公共卫生问题，目前仅限于东南亚国家。自1956年以来，已有超过35万名患者住院，据报告有近12000人死亡。登革热病毒是一组由四种黄病毒组成的病毒，由埃及伊蚊传播给人类。目前，登革热病毒在61个国家中活跃传播，这些国家在热带地区环绕全球，人口总数为1500亿。由于DHF/DSS的确切发病因素尚不清楚，因此这种综合征对公众健康的危害可能是全球性的。东南亚的流行病学研究清楚地将登革出血热/登革热与以前感染过登革热或感染过母体登革热抗体的人联系在一起。这种抗体可以作为调味素，增强登革热病毒对单核吞噬细胞的感染--登革热感染可能局限于人类体内的这类细胞。抗体介导的这些细胞的感染是免疫感染增强假说的核心概念。这一假设为未来研究的设计提供了一个概念性的框架。迫切需要全面确定DHF/DSS中的“风险因素”。这项研究可以通过在有和没有登革热/登革热综合征的登革热流行区进行前瞻性比较流行病学研究来进行。尽管针对每种登革热类型的减毒登革热疫苗的开发取得了重要进展，但可能需要更清楚地了解DHF/DSS的发病机制，以便为人类安全和持久的免疫预防提供指南。
Dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) is an enigmatic and growing public health problem which is confined at present to countries of South-East Asia. Since 1956, over 350 000 patients have been hospitalized and nearly 12 000 deaths have been reported. Dengue viruses, a group of four flaviviruses, are transmitted to man by Aedes aegypti. Currently, dengue viruses are actively transmitted in 61 countries which circle the globe in the tropical zone and have a combined population of 1500 million. Because the precise antecedents to DHF/DSS are unknown, the public health hazard posed by this syndrome is potentially worldwide. Epidemiological studies in South-East Asia clearly link DHF/DSS to individuals who have had a previous dengue infection or who have acquired maternal dengue antibody. Such antibody may serve as an opsonin, enhancing dengue virus infection of mononuclear phagocytes-the type of cell in man to which dengue infection may be confined. Antibody-mediated infection of these cells is the central concept in the hypothesis of immune infection enhancement. This hypothesis provides a conceptual framework for design of future research. There is an urgent need for a comprehensive identification of "risk factors" in DHF/DSS. This research could be approached by undertaking comparative prospective epidemiological studies in dengue-endemic areas with and without DHF/DSS. Although important progress is being made in the development of attenuated dengue vaccines for each dengue type, a clearer understanding of the pathogenesis of DHF/DSS may be required to provide guidelines for safe and lasting immunoprophylaxis in man.