尼帕病毒感染综述:分类、流行病学、治疗和预防

Avantika Dhadwal, Ankita Rana, Sakshi Sharma, Gaurav Bhardwaj
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摘要

自 1999 年被确认为副粘病毒科成员后,NiV 已与孟加拉国、马来西亚、新加坡、菲律宾和印度的脑炎流行病联系在一起。NiV 的病死率高达 100%,可引起发热性脑炎和严重的呼吸道疾病。除了支持性护理外,目前还没有获得授权的疫苗或疗法。组织病理学、IgG/IgM/抗原酶联免疫吸附试验(ELISA)、免疫荧光试验、核酸扩增试验(NAAT)、病毒分离和中和试验等实验室检测方法都可用于检测尼罗河病毒。根据使用热传感器进行的研究,蝙蝠会利用椰枣树液植物,并在采集树液时将其吃掉。尼帕病毒被认为是下一个流行病病原体,而科罗娜病毒安全措施有助于减少其在喀拉拉邦的传播。这是一种呼吸道疾病,不会导致味觉或嗅觉丧失,但死亡率很高(40%-45%)。NiV 患者在无症状阶段具有最高的传染性,接触感染者的体液似乎是人际传播的可行途径。NiV 流行病通过病原微生物和人畜共患病机制迅速传播,因此具有很强的传染性。利巴韦林被认为是第一种用于治疗 NiV 的抗病毒药物,但利巴韦林使死亡率降低了 36%。使用嘌呤类似物法非匹韦(T-705)阻断 RNA 依赖性 RNA 聚合酶治疗埃博拉病毒的临床研究已经展开,不同的流感抗病毒药物也已在叙利亚仓鼠动物模型中证实对 NiV 有效。临床前研究表明,这些药物具有全面的保护作用。
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A Comprehensive Review on Nipah Virus Infection: Classification, Epidemiology, Treatment and Prevention
After being identified as a Paramyxoviridae member in 1999, NiV has been linked to encephalitis epidemics in Bangladesh, Malaysia, Singapore, the Philippines, and India. NiV has a case-fatality rate of 100% and can cause fever encephalitis and severe respiratory disease in people. In addition to supportive care, there are no authorised vaccinations or therapies. Histopathology, IgG/IgM/antigen ELISA, immunofluorescence assay, nucleic acid amplification testing (NAAT), viral isolation, and neutralisation testing are among the laboratory tests used to detect NiV. According to research done with thermal sensors, P. giganteus bats use date palm sap plants and consume the sap as it is being gathered. Nipah virus is believed to be the next pandemic agent, and Corona virus safety measures have helped to reduce its spread in Kerala. It is a respiratory illness that does not cause loss of taste or smell, but has a high death rate (40-45%). NiV patients have highest infectious potential during symptomatic phases, and exposure to the bodily fluids of infected individuals appears to be a viable route for human-to-human transmission. NiV epidemics are highly effective due to their rapid transmission through nosocomial and zoonotic mechanisms. Ribavirin was considered as the first antiviral medication which is used in the treatment of NiV, but ribavirin decreased mortality toll by 36%. Clinical studies with the purine analogue favipirivir (T-705) blocking RNA-dependent RNA polymerase have been conducted for the treatment of Ebola, and different influenza antiviral medications have also demonstrated effectiveness against NiV in Syrian hamster animal models. Preclinical research has demonstrated full protection.
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