美国CDC关于肠病毒感染的十问十答（已翻译）

David

Non-Polio Enterovirus Infections Q&A
1。What are enteroviruses?
什么是肠病毒？
Enteroviruses are small viruses that are made of ribonucleic acid (RNA) and protein. This group includes the polioviruses, coxsackieviruses, echoviruses, and other enteroviruses. In addition to the three different polioviruses, there are 62 non-polio enteroviruses that can cause disease in humans: 23 Coxsackie A viruses, 6 Coxsackie B viruses, 28 echoviruses, and 5 other enteroviruses.
肠病毒是由RNA和蛋白质组成的小病毒。包括脊髓灰质炎病毒、柯萨奇病毒、埃克病毒等。除了三种不同的脊髓灰质炎病毒，还有62种非脊髓灰质炎肠病毒，其中23种克萨奇A病毒，6种克萨奇B病毒，28种埃克病毒和5种其他病毒，能引起人类疾病。

2。How common are infections with these viruses?
肠病毒感染有多常见？
Non-polio enteroviruses are very common. They are second only to the "common cold" viruses, the rhinoviruses, as the most common viral infectious agents in humans. The enteroviruses cause an estimated 10-15 million or more symptomatic infections a year in the United States. All three types of polioviruses have been eliminated from the Western Hemisphere, as well as Western Pacific and European regions, by the widespread use of vaccines.
非脊髓灰质炎肠病毒十分常见。仅次于“普通感冒病毒”和鼻病毒，为人类最常见的病毒感染之一。在美国，每年大概因肠病毒引起的有症状表现的感染人数多达1000-1500万。三大类脊髓灰质炎病毒由于疫苗的广泛使用而在西半球大幅减少。

3。Who is at risk of infection and illness from these viruses?
病毒感染的高危人群是哪些？
Everyone is at risk of infection. Infants, children, and adolescents are more likely to be susceptible to infection and illness from these viruses, because they are less likely to have antibodies and be immune from previous exposures to them, but adults can also become infected and ill if they do not have immunity to a specific enterovirus.
每个人都有感染的风险。婴儿，儿童和青少年是易感高危人群。因为他们初次感染而无法得到抗体保护，成年人如果没有得到特定类型肠病毒抗体的保护也很容易受到感染。

4。How does someone become infected with one of these viruses?
病毒如何感染人类？
Enteroviruses can be found in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) and stool of an infected person. Other persons may become infected by direct contact with secretions from an infected person or by contact with contaminated surfaces or objects, such as a drinking glass or telephone. Parents, teachers, and child care center workers may also become infected by contamination of the hands with stool from an infected infant or toddler during diaper changes.
病人的呼吸道分泌物（如唾液、痰液和鼻涕）和粪便中含有肠病毒。其他人通过直接接触病人的分泌物或接触受污染的物体表面（如水杯、电话）而感染。父母、老师和儿童监护中心的职员由于接触患病幼儿的粪便或尿布而受到感染。

5。What time of year is someone at risk for infection/illness?
每年的高危易感时段是什么时候？
In the United States, infections caused by the enteroviruses are most likely to occur during the summer and fall.
美国是夏秋季高发。

6。What illnesses do these viruses cause?
肠病毒引起那些疾病？
Most people who are infected with an enterovirus have no disease at all. Infected persons who become ill usually develop either mild upper respiratory symptoms (a "summer cold"), a flu-like illness with fever and muscle aches, or an illness with rash. Less commonly, some persons have "aseptic" or viral meningitis. Rarely, a person may develop an illness that affects the heart (myocarditis) or the brain (encephalitis) or causes paralysis. Enterovirus infections are suspected to play a role in the development of juvenile-onset diabetes mellitus (sugar diabetes). Newborns infected with an enterovirus may rarely develop severe illness and die from infection (see below: "What are the risks of enterovirus infections in pregnancy?").
大部分人感染肠病毒后甚至没有一点症状。患者通常会发展为夏季感冒样的上呼吸道症状，高热和肌肉疼，或皮疹。不太常见的症状如非细菌感染或称病毒性脑膜炎。极为罕见的情况是感染心脏和大脑，发展为心肌炎和脑炎，或导致中风。肠病毒感染被怀疑在儿童糖尿病发病过程中有某些作用。新生儿很少因感染肠病毒而导致重症或死亡。

7。Are there any long-term complications from these illnesses?
肠病毒感染有长期的并发症吗？
Usually, there are no long-term complications from the mild illnesses or from "aseptic" meningitis. Some patients who have paralysis or encephalitis, however, do not fully recover. Persons who develop heart failure (dilated cardiomyopathy) from myocarditis require long-term care for their conditions.
通常来说，轻微的感染或“无菌性”脑膜炎不会导致长期并发症。但是，那些因感染肠病毒而导致中风或脑炎的患者，则不会完全康复。一些因患有心肌炎而导致心衰或扩张性心肌病的病人则需要长期护理。

8。What are the risks of enterovirus infections in pregnancy?
怀孕期间肠病毒感染的风险有多大？

Because enteroviruses are very common, pregnant women are frequently exposed to them, especially during summer and fall months. As for any other adults, the risk of infection is higher for pregnant women who do not have antibodies from earlier exposures to enteroviruses currently circulating in the community, and are exposed to young children - the primary spreaders of these viruses.
因为肠病毒十分常见，所以孕妇也会经常受到病毒暴露，特别在夏秋季节。与其他成年人相比，孕妇如果没有相应的抗体保护受到感染的风险会更加高。

Most enterovirus infections during pregnancy cause mild or no illness in the mother. Although the available information is limited, currently there is no clear evidence that maternal enteroviral infection causes adverse outcomes of pregnancy such as abortion, stillbirth, or congenital defects. However, mothers infected shortly before delivery, may pass the virus to the newborn. Babies born to mothers who have symptoms of enteroviral illness around the time of delivery are more likely to be infected. Newborns infected with an enterovirus usually have mild illness, but rarely they may develop an overwhelming infection of many organs, including liver and heart, and die from the infection. The risk of this severe illness is higher for the newborns infected during the first two weeks of life.
怀孕期间肠病毒感染通常母亲只有轻微的症状，有时甚至毫无症状。尽管目前尚无足够的资料，但现在也没有明确的证据表明妊娠期间感染肠病毒会导致流产、死胎或婴儿先天畸形。但是，如果母亲在临产前短期内被病毒感染，病毒则会通过产道感染婴儿。若母亲有感染症状则婴儿感染机会更大。新生儿感染肠病毒通常症状轻微或无症状，但也有可能（虽然很罕见）会发展为多器官广泛感染，包括肝脏和心脏，甚至导致死亡。在婴儿出生头两个星期发展为重症感染的机会更高。

Strict adherence to generally recommended good hygienic practices (see "Can these infections be prevented?" below) by pregnant women may help to decrease the risk of infection during pregnancy and around the time of delivery.
孕妇如严格执行个人卫生指南可以减少感染的风险。

9。What are the health care costs of these infections?
感染产生的卫生开支有多少？
The health care costs from enterovirus infections are unknown, but a large portion of the costs may come from use of over-the-counter medications to treat symptoms for millions of cases of "summer colds" and "flu" caused by enteroviruses. There are also significant costs associated with the 25,000 to 50,000 hospitalizations for "aseptic" meningitis each year in the United States.
肠病毒感染的卫生开支还不十分清晰，但大部分开支来自患者自己购买的非处方感冒药。在美国，每年25000至5万患无菌性脑膜炎的住院患者也有很多开支。

10。Can these infections be prevented?
感染能够预防吗？
No vaccine is currently available for the non-polio enteroviruses. Because most persons who are infected with enteroviruses do not become sick, it can be difficult to prevent the spread of the virus. General cleanliness and frequent handwashing are probably effective in reducing the spread of these viruses (see "Handwashing" in: An Ounce of Prevention: Keeps the Germs Away). Also, cleaning contaminated surfaces and soiled articles first with soap and water, and then disinfecting them with a dilute solution of chlorine-containing bleach (made by mixing approximately ¼ cup of bleach with 1 gallon of water) can be a very effective way to inactivate the virus, especially in institutional settings such as child care centers. (See more about cleaning and disinfecting in general in CDC's Prevention Resources).
目前尚没有疫苗能够针对非脊髓灰质炎病毒。因为大多数感染患者并不会表现症状，因此很难预防控制病毒的播散。一般的清洁措施和频繁洗手对减少病毒扩散有效果。并且，用皂液首次清洗被污染的物体表面，然后用稀释的含氯漂白液（1加仑水兑1/4勺漂白粉）可以十分有效的灭活病毒，特别在儿童护理中心这些机构内。

楚楚

每个人都有感染的风险。没有疫苗可以预防。一般的清洁措施和手卫生对减少病毒扩散有效果。

1加仑水兑1/4勺漂白粉的有效氯浓度是多少？

星火

目前尚没有疫苗能够针对非脊髓灰质炎病毒。因为大多数感染患者并不会表现症状，因此很难预防控制病毒的播散。
1\没有疫苗预防非脊髓灰质炎病毒,大多数人没有感染过就没有免疫力?
2\大多数感染患者并不会表现症状,但是仍然具有传染性?
所以预防控制播散比较难,爆发或流行就不少见?

谢谢D斑分享!!

依依

大多数感染患者并不会表现症状，因此很难预防控制病毒的播散。看来控制难度还是很大的。我们更要注意标准防护，向百姓宣传良好的卫生习惯。