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馬爾堡病毒(又譯:馬爾病毒馬堡病毒)是馬爾堡出血热的致病源。其與伊波拉病毒相近,為人畜共患傳染病。罹患此病的人會出現發高燒腹瀉嘔吐出血的現象。病毒來源不明。馬爾堡病毒可以透過體液(包括血液唾液)、排泄物及嘔吐物傳播,並曾造成間歇性的爆發。[1]目前沒有任何疫苗或醫治的方法。

 
馬爾堡病毒
馬爾堡病毒,放大约~10万倍
馬爾堡病毒,放大约~10万倍
病毒分類
組: Group V(-)ssRNA
目: 單股反鏈病毒目 Mononegavirales
科: 絲狀病毒科 Filoviridae
屬: 馬爾堡病毒屬 Marburgvirus
種: 维多利亚湖馬爾堡病 Lake Victoria marburgvirus

目录

馬爾堡病毒编辑

馬爾堡病毒結構為典型的丝狀病毒,形似絲線,直徑通常一樣,但長度介於800至14,000納米(nm),通常感染力最強時長度約為790 nm。病毒物質由七種已知蛋白質組成。馬爾堡病毒結構與伊波拉幾乎一樣,但兩者的抗原反應不一。換言之,兩者在引致感染者體內產生的抗體不同。馬爾堡病毒是第一種被發現的丝狀病毒。

感染编辑

馬爾堡出血熱初期的病徵與其他傳染病如瘧疾傷寒相似,因此有時斷症因難,特別是零星出現時。

馬爾堡的潛伏期為3至9天。發病特徵是突然出現的發燒頭痛肌肉痛。一星期內,皮膚出現紅疹,然後有嘔吐、胸及腹痛,及腹瀉。之後病者可能出現黃疸,神志不清,肝衰竭,嚴重出血。患者復原過程十分漫長,並且經常出現陰囊收縮、復發肝炎脊髓炎、眼睛、腮腺(又称耳下腺)感染等等後遺症。不同地區的醫療設備及救治對生還率影響很大,部分發達國家出現時死亡率只有25%,發展中國家中的個別個案死亡率可高達100%。[2][3]

一般相信病毒是透過與染病的人畜緊密接觸,通過體液傳播。日常接觸相信不會傳染。病患者危急時,體內的病毒傳染力最強。部分非洲地區的殮葬風俗應該是導致疾病傳播的原因之一。

不少研究機構正嘗試研製對抗馬爾堡藥物及疫苗。2004年美國的研究人員已發現豚鼠注入不活躍的病毒後不會被感染。

早期爆發编辑

馬爾堡出血熱最先有記載的爆發是在1967年的德國馬爾堡,31人獲病,病症亦因此而以該地命名,之後在法蘭克福贝尔格莱德亦有病例。31人中,25 是直接感染,當中七人死亡。直接染病的人多是因為接觸當地實驗室內染有馬爾堡病的猴子而致病。另外六人是二次感染,當中包括兩名醫生,一名護士,一名解剖助理,及一名獸醫的妻子。他們都是與直接感染的病人,有緊密接觸。兩名醫生是在抽血時不慎接觸病者血液染病。這次爆發的來源經調查後,發現是來自非洲烏干達一種品種為 Cercopithecus aethiops猴子。德國的一家公司进口了該批染有病毒的猴子,原意是用來研制小兒麻痹症的疫苗。

1975年,一名從津巴布韋回到南非的人,感染了另外三名南非人。但該次小規模爆發只引致了一人死亡。之後1980年及1987年在肯亞亦有發現馬爾堡出血病,但亦沒有大規模爆發。之後最大的爆發發生在1998年至2000年的剛果民主共和國。149宗個案中123人死亡。

流行概況编辑

馬爾堡病毒疫症
年份 地區 感染個案 死亡個案 致死率
1967[4][5][6][7][8][9]   西德
  南斯拉夫
31 7 23%
1975[10][11][12]   南非 3 1 33%
1980[13]   肯尼亚 2 1 50%
1987(個別案例)[14][15]   肯尼亚 1 1 100%
1988(個別案例;實驗室意外)[16]   蘇聯 1 1 100%
1990(個別案例)[17]   蘇聯 1 0 0%
1998–2000   刚果(金) 154 128 83%
2004–2005[18][19][20][21][22][23][24]   安哥拉 252 227 90%
2007[25][26]   乌干达 4 1 25%
2008[27]   乌干达
  荷蘭
  美國
2 1 50%
2012[28]   乌干达 18 9 50%
2014(個別案例)[29][30]   乌干达 1 1 100%

參考資料编辑

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外部連結编辑