当地时间29日,世界卫生组织发布疾病信息通报,将猴痘的全球公共卫生风险评估为“中等”。通报称,5月13日至26日期间,已有23个非猴痘流行国家和地区向世卫组织上报了257例猴痘确诊病例,还有约120例疑似病例,尚未报告发现死亡病例。世卫组织补充说,随着监测范围扩大,还将发现更多猴痘病例。在新冠肺炎大流行的背景下,猴痘疫情的跨境暴发以及表现出较高人际传播的特性引发全球广泛关注。

本报记者 樊 巍 张常悦 尹野平
北京协和医院感染内科主任李太生30日告诉《环球时报》记者,此次猴痘出现跨洲境流行,潜在原因较为多样。除了因为个体特征及行为模式导致特定人群中的暴发流行,以及病毒变异导致传染力增强因素之外,还可能因为天花疫苗停止接种后人群猴痘病毒免疫力降低。李太生介绍称,随着全球天花疫苗接种计划停止,近40年来天花疫苗未接种人群在逐渐扩大,而已接种天花疫苗人群的特异性免疫力也随时间逐渐降低,因此猴痘易感人群不断扩大。
我国目前尚无猴痘病例报告,也未在野生动物或入境检疫中检出猴痘病毒。此前,中国疾控中心病毒病预防控制所研究员、国家重点研发项目“重要人兽共患病毒病跨种感染与传播机制”首席科学家谭文杰在接受媒体采访时表示,我国未报告发现猴痘病例,也没有报告在动物宿主发现该病毒,因此目前的重点是外防输入。
谭文杰介绍称,美国2003年暴发猴痘后,为防止疫情输入,原国家质量监督检验检疫总局发出通知,对来自疫区的人员进行严格检疫,对可疑猴痘病人采取必要的防控措施,例如禁止来自疫区的可能传播猴痘病毒的啮齿类动物和灵长类动物入境;对来自疫区的货物要实施严格的检疫查验、卫生监督和必要的除鼠处理。因此,猴痘由入境旅客携带的动物传入的可能性不大。但口岸检疫人员不能因此放松,要对来自猴痘疫区的人员、动物、交通工具、集装箱、货物、邮包进行严格检疫。
李太生认为,随着全球旅行及贸易恢复,不排除我国发现输入病例的可能性,因此必须加强边境检疫,同时制定规范的监测体系。“猴痘在密切接触及高危人群传播风险大,但普通人群传播风险低,全球大流行的可能性极低。”
5月30日,海关总署发布通报称,近期全球多个国家相继报告猴痘病例,全国海关口岸卫生检疫将持续做好“多病共防”,防止疫情叠加。将对入境人员严格落实健康申报等各项卫生检疫措施;加强进境携带、寄递物检疫和啮齿动物检疫,强化多部门联防联控,严防疫情输入风险。
据《环球时报》记者了解,目前,我国已建立多种可用于猴痘早期诊断的基因检测技术,能够快速实现对猴痘病毒的筛查。谭文杰介绍称,比如荧光定量实时聚合酶链式反应检测技术,可在3小时内对痘病毒做出早期筛查诊断,结合新一代测序方法,不仅可在24小时内鉴别样品是否为猴痘病毒或其他痘病毒(如天花病毒、牛痘病毒等),而且可对猴痘病毒的来源与传播链进行分子溯源。此外,谭文杰还透露,中国疾控中心已制订了《猴痘疫情应急处置技术方案》,储备了猴痘分子检测试剂并对各省市疾控专业人员开展了猴痘核酸PCR检测培训。
从事诊断试剂研发的中国生物科技公司硕世生物研发的猴痘病毒核酸检测试剂盒(荧光PCR法)于近日取得欧盟CE准入资质。该公司相关负责人在接受《环球时报》记者采访时表示,该产品将在欧盟27个成员国及认可欧盟CE资质的国家和地区上市销售。目前,该产品已收到多个国家的紧急订单问询,近10万人份试剂即将发往全球50多个国家和地区。同时,该产品也已启动在多个猴痘流行区域的注册申请工作。
另一家检验试剂盒研发公司圣湘生物则向《环球时报》记者表示,目前西班牙、阿联酋、南非等多国对该公司研发的猴痘病毒核酸检测试剂盒有订单意向,也有部分国家已有确定性订单,订购的试剂盒主要用于应急储备。
面对在抗原性、生物学特性、形态、结构等方面与天花病毒十分相似的猴痘病毒,我们过往用于对付天花病毒的疫苗是否依旧有效?李太生介绍称,既往研究显示天花疫苗接种对猴痘约有85%的保护效力。2019年,美国食品药品监督管理局也批准了第三代高减毒天花疫苗应用于成人天花及猴痘的预防。谭文杰也认为,天花病毒和猴痘病毒的相似性可形成交叉免疫,因此对于高感染风险人群或疫情输入地区人群,研判风险后可适时依需进行应急接种,“我国长期进行天花疫苗的应急储备,可随时提供上百万支天花疫苗应急接种。”
中国疫苗行业协会会长封多佳在回应《环球时报》记者问询时表示,尚不确定中国是否会开发猴痘疫苗,但如果需要,从技术角度并无太大难度,“相关技术几十年前就有,现在只会更先进。是否需要研发需要视具体情况而定。”
吉林大学生命科学学院教授姜春来告诉《环球时报》记者,如果有需要,目前中国更有可能是重启针对天花病毒的疫苗,而不是研发出针对猴痘病毒的疫苗,因为专项研发针对猴痘病毒的疫苗耗时较长、不确定性较大,所以选择技术成熟的天花疫苗来预防猴痘较为可行。姜春来表示,目前公众对于猴痘疫情不必过于担心,普通人群减少聚集,戴口罩,勤洗手,避免接触野生动物,不吃生肉,可有效降低感染风险。▲
Fan Wei & nbsp; & nbsp; Zhang Changyue & nbsp; & nbsp; Yin Yeping
Li Taisheng, director of internal medicine in Peking Union Medical College Hospital, told the Global Times on the 30th that monkeypox was a cross-continental epidemic with various potential reasons. In addition to outbreaks in specific populations due to individual characteristics and behavior patterns, and increased infection caused by virus variation, it may also be due to decreased immunity to monkeypox virus after smallpox vaccination was stopped. Li Taisheng said that with the cessation of the global smallpox vaccination program, the number of people who have not been vaccinated against smallpox has gradually expanded over the past 40 years, and the specific immunity of people who have been vaccinated against smallpox has gradually decreased over time. As a result, the population susceptible to monkeypox continues to expand.
At present, no cases of monkeypox have been reported in China, and monkeypox virus has not been detected in wild animals or entry quarantine. Prior to this, Tan Wenjie, a researcher at the Institute for virus Disease Prevention and Control of the Chinese Center for Disease Control and Prevention and chief scientist of the national key research and development project “Mechanism of Interspecies infection and Transmission of Zoonotic virus Diseases”, said in an interview with the media that China has not reported any cases of monkeypox, nor has it reported the discovery of the virus in animal hosts, so the current focus is on external prevention and import.
Tan Wenjie said that after the monkeypox outbreak in the United States in 2003, in order to prevent the entry of the epidemic, the former General Administration of quality Supervision, Inspection and Quarantine issued a notice to strictly quarantine personnel from the epidemic areas and take necessary prevention and control measures for patients with suspected monkeypox. for example, rodents and primates that may spread monkeypox virus from epidemic areas are prohibited from entering the country. Strict quarantine inspection, sanitary supervision and necessary deratization shall be carried out on goods from epidemic areas. Therefore, it is unlikely that monkeypox will be introduced by animals carried by incoming passengers. However, port quarantine personnel should not relax and strictly quarantine personnel, animals, vehicles, containers, goods and parcels from monkeypox epidemic areas.
Li Taisheng believes that with the resumption of global travel and trade, the possibility of finding imported cases in China cannot be ruled out, so it is necessary to strengthen border quarantine and establish a standardized surveillance system. “Monkeypox has a high risk of transmission in close contact and high-risk groups, but the risk of transmission in the general population is low, and the possibility of a global pandemic is extremely low.”
On May 30, the General Administration of Customs announced that recently, many countries around the world have reported monkeypox cases one after another, and the national customs port health and quarantine will continue to do a good job of “common prevention of multiple diseases” to prevent the superimposition of the epidemic. We will strictly implement health and quarantine measures for entry personnel, such as health declaration, strengthen entry carrying, delivery quarantine, and rodent quarantine, strengthen multi-department joint prevention and control, and strictly prevent the risk of epidemic import.
According to a reporter from the Global Times, at present, China has established a variety of genetic detection techniques for early diagnosis of monkeypox, which can quickly realize the screening of monkeypox virus. Tan Wenjie said that, for example, fluorescent quantitative real-time polymerase chain reaction detection technology can make early screening and diagnosis of pox virus within 3 hours, combined with a new generation of sequencing methods, it can not only identify whether the sample is monkeypox virus or other pox virus (such as smallpox virus, cowpox virus, etc.) within 24 hours, but also molecular trace the source and transmission chain of monkeypox virus. In addition, Tan Wenjie also revealed that the Chinese Centers for Disease Control and Prevention has formulated the “Technical Plan for Emergency handling of Monkeypox epidemic,” stocked monkeypox molecular detection reagents, and conducted training for monkeypox nucleic acid PCR testing for disease control professionals in various provinces and cities.
The monkeypox virus nucleic acid detection kit (fluorescent PCR method) developed by China Biotechnology Corporation, which is engaged in the research and development of diagnostic reagents, has recently obtained the qualification of EU CE access. The company official said in an interview with the Global Times that the product will be sold in 27 EU member states and countries and regions that recognize EU CE qualifications. At present, the product has received urgent order inquiries from many countries, and nearly 100000 reagents will be sent to more than 50 countries and regions around the world. At the same time, the product has also launched registration applications in several monkeypox endemic areas.
Shengxiang Biology, another testing kit research and development company, told the Global Times that at present, Spain, the United Arab Emirates, South Africa and other countries have orders for the monkeypox virus nucleic acid detection kit developed by the company, and some countries have definite orders, which are mainly used for emergency reserves.
In the face of monkeypox virus which is very similar to smallpox virus in antigenicity, biology, morphology and structure, are the vaccines we used to deal with smallpox virus still effective? Li Taisheng said that previous studies have shown that smallpox vaccination has about 85% protective effect on monkeypox. In 2019, the US Food and Drug Administration also approved the third generation of highly attenuated smallpox vaccine for adult smallpox and monkeypox prevention. Tan Wenjie also believes that the similarity between smallpox virus and monkeypox virus can form cross-immunity, so for people at high risk of infection or people in areas where the epidemic is imported, emergency vaccination can be carried out in a timely manner after assessing the risk. “China’s long-term emergency reserve of smallpox vaccine can provide millions of emergency vaccinations at any time.”
Feng Duojia, president of the China Vaccine Industry Association, said in response to a reporter from the Global Times that it is not clear whether China will develop a monkeypox vaccine, but if necessary, it will not be too difficult from a technical point of view. “the relevant technology was available decades ago. Now it will only be more advanced. The need for research and development depends on the specific circumstances. “
Jiang Chunlai, a professor at the School of Life Sciences at Jilin University, told the Global Times that if necessary, China is more likely to restart a vaccine against smallpox virus than to develop a vaccine against monkeypox virus. Because it takes a long time and great uncertainty to develop a vaccine against monkeypox virus, it is more feasible to choose a technologically mature smallpox vaccine to prevent monkeypox. Jiang Chunlai said that at present, the public need not worry too much about the monkeypox epidemic, ordinary people gather less, wear masks, wash their hands frequently, avoid contact with wild animals and avoid eating raw meat, which can effectively reduce the risk of infection. ,