小说冠状病毒(2019-NCOV):我们现在在哪里,我们应该去哪里?

"As I write these lines, the novel coronavirus epidemic that started in Wuhan, China on December 8, 2019, has infected more people than the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome coronavirus (MERS-CoV) combined." In this Blog, written by Dr Ghazi Kayali, a member ofBMC传染病编辑委员会,我们讨论了新颖的2019年冠状病毒及其重大公共卫生影响的兴起。

As of the 32020年2月17,489 cases已在中国和其他24个国家s, of which, 362 patients have died. This has sparked an overwhelming response by the Chinese government placing more than 60 million people under orders of restricted movement, mandated wearing of masks in public (at the threat of arrest), and increase of their healthcare capacity by, for example, construction of a 1200-bed hospital in just 10 days. The epidemic rages on with an average of 2000 new cases reported daily.

全球,30Th2020年1月世界卫生组织联合国(WHO)宣布流行病是国际关注的公共卫生紧急情况。这定义了一次爆发“通过国际疾病的传播,决心构成对其他州的公共卫生风险,并有可能需要协调的国际反应”。几个国家和航空公司立即暂停了从受影响地区的旅行,与中国的一些边界关闭,并在机场开始了全面的预防筛查。

on the 30Th2020年1月,联合国世界卫生组织(WHO)宣布流行病是国际关注的公共卫生紧急情况

Early on, the Chinese authorities revealed that the outbreak was caused by a novel beta-coronavirus, named 2019-nCoV. This was soon found to be significantly genetically related to SARS-CoV and other bat coronaviruses. The initial cases were associated with a seafood market in Wuhan where live animals were sold. This suggested a possible animal reservoir for this virus and suggested zoonotic (animal to human) transmission. Later on, environmental samples obtained from this market were found to be positive for 2019-nCoV, strengthening the hypothesis that this is a zoonotic virus. However, whilst the virus was found to have originally started among infected animals, most of the subsequently reported cases were shown to be caused by human-to-human transmission.

Beta-coronaviruses have caused major epidemics in the last 2 decades. In 2003,SARS-COVwas discovered in China before being spread globally, infecting 8,098 people and killing 774. This was later found to be zoonotic in origin and thought to have started amongst a bat reservoir before later infecting wild civet cats and raccoon dogs that were being sold at live wild animal markets destined for human consumption. In 2012,mers-cov在沙特阿拉伯发现,在全球范围内传播,导致2506例确认的案件并杀死了全球862人。同样,这开始是一种人畜共患病毒,该病毒被证明从骆驼转移到人类,并再次被认为最初是从蝙蝠出来的。

对这种流行病的反应不仅需要巨大的公共卫生和医疗反应,而且还需要巨大的研究反应。需要迅速回答重要的科学问题,以便将其指导其回应能力和期望的何处告知决策者。从流行病学上讲,需要计算病毒的传输速率,以模拟预期的病例数。需要描述传输方式,以便采取适当的预防动作。该病例需要进行表征,以使最严重和最有可能死的患者首先得到照顾。实验室研究人员将需要该病毒的副本,以研究其传播和致病性,并致力于寻找疫苗或治愈方法。重要的是,必须确定人类感染的动物储层,以打破初始传输周期。

When MERS was discovered, a group of witty scientists led by Dutch investigators were able to associate the new virus with camels by showing that存档的骆驼血清具有针对这种新病毒的抗体。这个小组应该赢得科学勺,但通过向其他冠状病毒研究人员提醒他们的发现,甚至在发表论文发表之前就做了正确的事情。借此提示,我的小组开始对骆驼进行采样,并确认骆驼确实与香港大学的研究人员合作采用了针对MERS-COV的抗体。后来,我们能够隔离骆驼。确定动物水库允许将暴露于骆驼的人识别为处于危险中的人群,并允许有针对性的公共卫生预防运动。2019-NCOV的动物水库尚未确定。我希望研究人员将这个重中之重,我希望他们能在第一个可用的机会中向其他潜在动物储层的其他研究小组提醒其他研究小组,以效仿荷兰科学家。可以合理的是,动物水库不仅限于中国,而在其他地方的动物可能含有相同的病毒。尽快找到动物储层将提高我们打破传输链的机会。

I call on research funding agencies to give priority to coronavirus research by providing long-term, large-scale funding for emerging coronaviruses that have thus far caused three major epidemics within the last sixteen years alone. A large portion of this funding should be dedicated towards conducting surveillance for coronaviruses in their natural hosts, allowing researchers to understand the ecology of those viruses. In addition, conducting risk-assessment studies to understand which viruses may pose the greatest risk to human health, inevitably aiding the design of future prevention strategies.

I also call on researchers and responders to adapt the “One Health”概念在他们的努力中。一遍又一遍地,诸如冠状病毒,动物流感病毒,埃博拉病毒和其他人等新兴的人畜共患病毒被证明是重要的全球公共卫生关注,这强调了人,动物和生态系统的健康固有地交织在一起的事实。

查看BMC系列博客主页上的最新帖子188宝金博备用网址

Comments