猩红热流行及其影响因素研究进展

Research progress on scarlet fever epidemic and associated factors

猩红热是A族链球菌(Group A Streptococcus,GAS)引起的一种急性呼吸道传染病,常侵犯学龄儿童,至今无疫苗可用。在人类历史上,特别是欧洲工业革命、维多利亚时期曾引起较大规模的暴发流行。抗生素问世前,猩红热病死率高达30%~50%,传播力强。二战后随着抗生素的广泛应用,全球猩红热发病率和死亡率迅速下降。20世纪80年代GAS引起的侵袭性感染在欧美复燃。近10年猩红热发病在全球多地呈上升态势。现梳理猩红热流行的历史、现状及最新病原学研究进展,并对近些年各地发病水平上升的发生机制和危险因素进行探讨。

Scarlet fever is a respiratory disease caused by Group A Streptococcus(GAS).It commonly attacks school children and has no available vaccine currently.The human history,especially European Industrial Revolution and Victorian Era,has witnessed large scale scarlet fever epidemics.Before antibiotics were invented,scarlet fever was once a highly transmissible disease with high mortality about 30%-50%.With the wide use of antibiotics after World WarⅡ,the incidence and mortality of scarlet fever decrease significantly.Invasive streptococcal infections resurge in Europe and America in 1980s.In the past ten years,the incidence of scarlet fever kept increasing in several countries around the world.In this article,the latest research progress of scarlet fever epidemiology and pathogenesis was reviewed.Meanwhile,potential mechanisms and risk factors for the recently increasing incidence of scarlet fever in various regions were discussed.