Rotavirus Overview
Rotavirus Overview
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DOI：
10.1097/inf.0b013e3181967bee
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发表时间：
2009-03-01
影响因子：
3.6
通讯作者：
Bernstein, David I.
中科院分区：
文献类型：
--
作者：
Bernstein, David I.
轮状病毒胃肠炎在发达国家和发展中国家都是一个严重的公共卫生问题。这种疾病无处不在，几乎影响所有5岁以下的儿童。它是美国儿童肠胃炎住院治疗的最常见原因（30%-70%取决于季节），每年的直接和间接费用约为10亿美元。轮状病毒胃肠炎的症状是非特异性的（如腹泻、呕吐和发烧），疾病严重程度差别很大。轮状病毒胃肠炎的诊断确认需要实验室检查（最常见的是酶免疫测定或乳胶凝集）；然而，由于具体诊断费用昂贵且不影响治疗，因此通常不进行实验室检查。由于目前没有抗病毒治疗，轮状病毒感染的治疗是支持性的，主要目的是补充液体和电解质的损失。根据观察，改善卫生条件并不能降低疾病患病率，尽管有口服补液，但住院率仍然很高，因此针对轮状病毒感染的主要公共卫生干预措施是接种疫苗。目前的疫苗（如RotaTeq，默克公司；Rotarix，葛兰素史克）对减少轮状病毒胃肠炎（特别是严重疾病）、急诊就诊和住院治疗有效。轮状病毒疫苗接种现在被列入美国所有婴儿常规疫苗接种计划的一部分。
Rotaviral gastroenteritis is a serious public health problem in both developed and developing countries. The disease is ubiquitous, affecting nearly all children by the age of 5 years. It is the most common cause of hospitalizations for gastroenteritis among children in the United States (30%-70% depending on the season) and is associated with direct and indirect costs of approximately $1 billion per year. Symptoms of rotaviral gastroenteritis are nonspecific (ie, diarrhea, vomiting, and fever), with disease severity varying considerably. Diagnostic confirmation of rotaviral gastroenteritis requires laboratory tests (most commonly enzyme immunoassay or latex agglutination); however, because specific diagnosis is costly and does not affect treatment, laboratory tests are generally not performed. Because no antiviral therapies are currently available, treatment of rotavirus infection is supportive and primarily aimed at the replacement of fluid and electrolyte losses. Based on the observations that improved sanitation does not decrease disease prevalence and that hospitalizations remain high despite the availability and use of oral rehydrating solutions, the primary public health intervention for rotavirus infection is vaccination. Current vaccines (ie, RotaTeq, Merck and Company; Rotarix, GlaxoSmithKline) are effective for reducing rotaviral gastroenteritis (particularly severe disease), emergency department visits, and hospitalizations. Rotavirus vaccination is now included as part of the routine vaccination schedule for all infants in the United States.