Caraballo Hector, King Kevin
Emerg Med Pract. 2014 May;16(5):1-23; quiz 23-4.
Up to 700 million people are infected and more than a million die each year from mosquito-borne illness. While the vast majority of cases occur in endemic tropical and subtropical regions, international travel and migration patterns have increased their prevalence in North America. This review discusses the diagnosis and treatment of the 3 most common mosquito-borne illnesses seen in the United States: Plasmodium falciparum malaria, dengue, and West Nile virus. With no pathognomonic findings, it is critical that emergency clinicians in nonendemic areas maintain a high index of suspicion, conduct a thorough history/travel history, and interpret indirect findings to initiate prompt and appropriate treatment. This review gathers the best evidence from international public health resources, surveillance studies, guidelines, and academic research to give emergency clinicians tools to combat these potentially lethal infections.
每年有多达7亿人感染蚊媒疾病,100多万人死于蚊媒疾病。虽然绝大多数病例发生在热带和亚热带流行地区,但国际旅行和移民模式增加了这些疾病在北美的流行率。本综述讨论了在美国最常见的三种蚊媒疾病的诊断和治疗:恶性疟原虫疟疾、登革热和西尼罗河病毒。由于没有特征性表现,非流行地区的急诊临床医生必须保持高度怀疑,进行全面的病史/旅行史询问,并解读间接发现,以便及时进行适当治疗。本综述收集了国际公共卫生资源、监测研究、指南和学术研究的最佳证据,为急诊临床医生提供对抗这些潜在致命感染的工具。