猴痘的流行病学及防治进展

Advances in the epidemiology and prevention of monkeypox

猴痘是一种由猴痘病毒引起的人兽共患病,其作为一种自限性疾病,以往缺乏特异性药物。自2022年5月以来,在全球不同区域内人类猴痘病例明显增加。已有国家将针对天花的抗病毒药物(如替考韦马、布林西多福韦、西多福韦等)和痘苗免疫球蛋白作为猴痘特异性治疗药物,主要用于重症和高危人群。虽然天花疫苗接种可能对猴痘病毒具有保护作用,并可能改善临床症状,然而是否需要接种疫苗,需要根据易感者或者暴露者个体的免疫状态、被感染的风险、可能发生感染的严重程度以及是否可以获取抗病毒药物来综合决定。目前不同国家可获取的天花疫苗共有3种:JYNNEOSTM、ACAM2000■和安万特巴斯德天花疫苗,其中前两种目前被推荐用于猴痘的预防接种。疫苗接种策略包括暴露前接种、暴露后预防和密切接触者的环形疫苗接种。本文就猴痘的背景知识、流行病学、预防治疗等方面进行综述,以期能为猴痘的防治和应急管理工作提供帮助。

Monkeypox(MPX)is a zoonotic disease caused by monkeypox virus(MPXV),mostly self-limited and lacks specific drugs in the past.Since May 2022,there has been a remarkable increase in human monkeypox cases in different regions of the world.Some countries have used antiviral drugs against smallpox(such as tecovirimat,brincidofovir,cidofovir,etc.)and vaccinia immune globulin as MPX specific treatment drugs,mainly for severe and high-risk groups.Although smallpox vaccination may have a protective effect against MPXV and may improve clinical symptoms,the need for vaccination depends on the immune status of susceptible or exposed individuals,the risk of infection,the severity of infection that may occur,and availability of antiviral drugs to make a comprehensive decision.There are three smallpox vaccines currently available in different countries:JYNNEOSTM,ACAM2000®and Aventis Pasteur smallpox vaccine,the first two of which are currently recommended for MPX vaccination.Vaccination strategies include pre-exposure vaccination,post-exposure prophylaxis,and ring vaccination of close contacts.We reviewed the background knowledge,epidemiology,preventive treatment and other aspects of MPX,hoping to provide help for MPX prevention and emergency management.