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脊髓灰质炎和前角感染性疾病

Author
Burk Jubelt, MD
Section Editor
Jeremy M Shefner, MD, PhD
Deputy Editor
John F Dashe, MD, PhD
Translators
李玮, 主任医师

引言

尽管脊髓灰质炎不再像以前那样对全球公众健康造成威胁，但亚洲和非洲仍存在小范围流行性野生型脊髓灰质炎病毒。了解脊髓灰质炎病毒和其他肠道病毒，对于急性弛缓性麻痹患者的评估非常重要。

肠道病毒分类

人类肠道病毒含有一个单链RNA基因组，该病毒可分为4个种：人类肠道病毒A、B、C和D。脊髓灰质炎病毒属于人类肠道病毒C群[1]。

人类肠道病毒有64个血清型。3种脊髓灰质炎病毒血清型简称为1、2和3型。所有这些血清型的病毒均能引起运动神经元病，不过在疫苗接种时代前，大多数麻痹性疾病是由脊髓灰质炎病毒1型所致。非脊髓灰质炎肠道病毒包括柯萨奇A和B组病毒，以及各类埃可病毒和肠道病毒。 (参见“肠道病毒及副肠弧病毒感染的流行病学、发病机制、治疗及预防”)

脊髓灰质炎病毒和脊髓灰质炎

流行病学 — 具有讽刺意味的是，20世纪上半叶发生在美国的脊髓灰质炎流行是由环境卫生改善引起的。1900年以前，脊髓灰质炎在美国是地方病。大多数婴儿在6个月龄之前就感染了脊髓灰质炎病毒。虽然一些患儿发生了小儿麻痹症，但许多患儿受到母体抗体的保护而存在隐性感染，导致美国儿童中形成广泛的免疫。环境卫生的改善导致许多婴儿较少暴露于脊髓灰质炎病毒，形成了大量易感个体。当这些个体随后暴露于脊髓灰质炎病毒，且不再受母体抗体保护时，就会发生脊髓灰质炎流行。

同样地，在进入20世纪后，在世界上工业化程度较低的地区，脊髓灰质炎是地方病。随着这些国家卫生状况的改善，他们也开始经历脊髓灰质炎的流行[2,3]。

                  

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Literature review current through: 2017-06 . | This topic last updated: 2017-04-06.
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