UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate®

虫媒性脑炎

Author
Lyle R Petersen, MD, MPH
Section Editor
Martin S Hirsch, MD
Deputy Editor
Jennifer Mitty, MD, MPH
Translators
邢红霞, 主任医师

引言

虫媒性脑炎病毒在世界上大多数地区都会引起显著的公共卫生问题。这些病毒属于黄病毒科、披膜病毒科、布尼亚病毒科和呼肠孤病毒科，通常对特定的储存宿主具有高度适应性，通过被感染性节肢动物(常为特定的蚊子和蜱虫种类)叮咬，在动物之间传播(表 1)。

本专题将总结大多数虫媒病毒性脑炎的主要特点。病毒性脑炎相关的一般问题，包括临床表现、脑脊液检查结果、感染后脑炎与脑膜炎的鉴别以及疑似中枢神经系统感染患者的一般诊断方法将单独讨论。 (参见“成人病毒性脑炎”)

传播循环

蚊子和蜱通过吸食病毒血症动物的血发生感染。随后，病毒在蚊子或蜱的组织中复制，最终感染唾液腺。蚊子和蜱在吸食血液时将被感染的唾液注入新的宿主体内，从而传播病毒。

这些病毒的天然动物宿主通常不受影响，且在发生以下一种事件之前，病毒循环通常不能被检测到：

●人类进入地方性动物病的自然疫区

                          

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: 2017-06 . | This topic last updated: 2015-05-04.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
References
Top
  1. Johnson BW, Kosoy O, Martin DA, et al. West Nile virus infection and serologic response among persons previously vaccinated against yellow fever and Japanese encephalitis viruses. Vector Borne Zoonotic Dis 2005; 5:137.
  2. Arrigo NC, Adams AP, Weaver SC. Evolutionary patterns of eastern equine encephalitis virus in North versus South America suggest ecological differences and taxonomic revision. J Virol 2010; 84:1014.
  3. Centers for Disease Control and Prevention (CDC). Eastern equine encephalitis--New Hampshire and Massachusetts, August-September 2005. MMWR Morb Mortal Wkly Rep 2006; 55:697.
  4. Deresiewicz RL, Thaler SJ, Hsu L, Zamani AA. Clinical and neuroradiographic manifestations of eastern equine encephalitis. N Engl J Med 1997; 336:1867.
  5. Silverman MA, Misasi J, Smole S, et al. Eastern equine encephalitis in children, Massachusetts and New Hampshire,USA, 1970-2010. Emerg Infect Dis 2013; 19:194.
  6. Centers for Disease Control and Prevention. National notifiable diseases surveillance system (NNDSS). Case definitions. http://wwwn.cdc.gov/nndss/script/casedefDefault.aspx. (Accessed on April 28, 2015).
  7. Golomb MR, Durand ML, Schaefer PW, et al. A case of immunotherapy-responsive eastern equine encephalitis with diffusion-weighted imaging. Neurology 2001; 56:420.
  8. Calisher CH. Medically important arboviruses of the United States and Canada. Clin Microbiol Rev 1994; 7:89.
  9. Erwin PC, Jones TF, Gerhardt RR, et al. La Crosse encephalitis in Eastern Tennessee: clinical, environmental, and entomological characteristics from a blinded cohort study. Am J Epidemiol 2002; 155:1060.
  10. Centers for Disease Control and Prevention (CDC). Arboviral infections of the central nervous system--United States, 1996-1997. MMWR Morb Mortal Wkly Rep 1998; 47:517.
  11. McJunkin JE, de los Reyes EC, Irazuzta JE, et al. La Crosse encephalitis in children. N Engl J Med 2001; 344:801.
  12. McJunkin JE, Khan R, de los Reyes EC, et al. Treatment of severe La Crosse encephalitis with intravenous ribavirin following diagnosis by brain biopsy. Pediatrics 1997; 99:261.
  13. Centers for Disease Control and Prevention (CDC). Possible congenital infection with La Crosse encephalitis virus--West Virginia, 2006-2007. MMWR Morb Mortal Wkly Rep 2009; 58:4.
  14. Mackenzie JS, Lindsay MD, Coelen RJ, et al. Arboviruses causing human disease in the Australasian zoogeographic region. Arch Virol 1994; 136:447.
  15. Burrow JN, Whelan PI, Kilburn CJ, et al. Australian encephalitis in the Northern Territory: clinical and epidemiological features, 1987-1996. Aust N Z J Med 1998; 28:590.
  16. Kienzle N, Boyes L. Murray Valley encephalitis: case report and review of neuroradiological features. Australas Radiol 2003; 47:61.
  17. Case definitions for infectious conditions under public health surveillance. Centers for Disease Control and Prevention. MMWR Recomm Rep 1997; 46:1.
  18. Kaiser R. Tick-borne encephalitis. Infect Dis Clin North Am 2008; 22:561.
  19. Süss J. Epidemiology and ecology of TBE relevant to the production of effective vaccines. Vaccine 2003; 21 Suppl 1:S19.
  20. Lindquist L, Vapalahti O. Tick-borne encephalitis. Lancet 2008; 371:1861.
  21. Kaiser R, Holzmann H. Laboratory findings in tick-borne encephalitis--correlation with clinical outcome. Infection 2000; 28:78.
  22. Kindberg E, Mickiene A, Ax C, et al. A deletion in the chemokine receptor 5 (CCR5) gene is associated with tickborne encephalitis. J Infect Dis 2008; 197:266.
  23. Holzmann H. Diagnosis of tick-borne encephalitis. Vaccine 2003; 21 Suppl 1:S36.
  24. Haglund M, Günther G. Tick-borne encephalitis--pathogenesis, clinical course and long-term follow-up. Vaccine 2003; 21 Suppl 1:S11.
  25. Kaiser R. The clinical and epidemiological profile of tick-borne encephalitis in southern Germany 1994-98: a prospective study of 656 patients. Brain 1999; 122 ( Pt 11):2067.
  26. Barrett PN, Schober-Bendixen S, Ehrlich HJ. History of TBE vaccines. Vaccine 2003; 21 Suppl 1:S41.
  27. Heinz FX, Stiasny K, Holzmann H, et al. Vaccination and tick-borne encephalitis, central Europe. Emerg Infect Dis 2013; 19:69.
  28. Centers for Disease Control and Prevention (CDC). Tick-borne encephalitis among U.S. travelers to Europe and Asia - 2000-2009. MMWR Morb Mortal Wkly Rep 2010; 59:335.
  29. Ebel GD. Update on Powassan virus: emergence of a North American tick-borne flavivirus. Annu Rev Entomol 2010; 55:95.
  30. Gholam BI, Puksa S, Provias JP. Powassan encephalitis: a case report with neuropathology and literature review. CMAJ 1999; 161:1419.
  31. Centers for Disease Control and Prevention (CDC). Outbreak of Powassan encephalitis--Maine and Vermont, 1999-2001. MMWR Morb Mortal Wkly Rep 2001; 50:761.
  32. Powassan virus. Statistics and maps. Centers for Disease Control and Prevention. http://cdc.gov/powassan/statistics/html. (Accessed on April 23, 2015).
  33. Lessell S, Collins TE. Ophthalmoplegia in Powassan encephalitis. Neurology 2003; 60:1726.
  34. Hinten SR, Beckett GA, Gensheimer KF, et al. Increased recognition of Powassan encephalitis in the United States, 1999-2005. Vector Borne Zoonotic Dis 2008; 8:733.
  35. Transmission of Colorado tick fever virus by blood transfusion--Montana. MMWR Morb Mortal Wkly Rep 1975; 24:422.
  36. Goodpasture HC, Poland JD, Francy DB, et al. Colorado tick fever: clinical, epidemiologic, and laboratory aspects of 228 cases in Colorado in 1973-1974. Ann Intern Med 1978; 88:303.
  37. Spruance SL, Bailey A. Colorado Tick Fever. A review of 115 laboratory confirmed cases. Arch Intern Med 1973; 131:288.
  38. Johnson AJ, Karabatsos N, Lanciotti RS. Detection of Colorado tick fever virus by using reverse transcriptase PCR and application of the technique in laboratory diagnosis. J Clin Microbiol 1997; 35:1203.
  39. Rao BL, Basu A, Wairagkar NS, et al. A large outbreak of acute encephalitis with high fatality rate in children in Andhra Pradesh, India, in 2003, associated with Chandipura virus. Lancet 2004; 364:869.
  40. Jacob John T. Chandipura virus - what we know & do not know. Indian J Med Res 2010; 132:125.
  41. Chadha MS, Arankalle VA, Jadi RS, et al. An outbreak of Chandipura virus encephalitis in the eastern districts of Gujarat state, India. Am J Trop Med Hyg 2005; 73:566.
  42. Gurav YK, Tandale BV, Jadi RS, et al. Chandipura virus encephalitis outbreak among children in Nagpur division, Maharashtra, 2007. Indian J Med Res 2010; 132:395.
  43. Charrel RN, Gallian P, Navarro-Mari JM, et al. Emergence of Toscana virus in Europe. Emerg Infect Dis 2005; 11:1657.
  44. Di Nicuolo G, Pagliano P, Battisti S, et al. Toscana virus central nervous system infections in southern Italy. J Clin Microbiol 2005; 43:6186.