Вопросы вирусологии. 2019; 64: 206-214
Нужно быть готовыми к возврату оспы
https://doi.org/10.36233/0507-4088-2019-64-5-206-214Аннотация
В обзоре представлен краткий анализ результатов исследований, выполненных за 40 лет после ликвидации оспы и посвящённых изучению геномной организации и эволюции вируса натуральной оспы, разработке современных методов диагностики, вакцинопрофилактики и химиотерапии оспы и других зоонозных ортопоксвирусных инфекций человека. В связи с тем, что вакцинация против оспы в ряде случаев приводила к тяжёлым побочным реакциям, Всемирная организация здравоохранения рекомендовала после 1980 г. прекратить её во всех странах. В результате этого решения человечество утратило иммунитет не только против оспы, но и против других зоонозных ортопоксвирусных инфекций человека. Участившиеся в последние годы случаи инфицирования людей зоонозными ортопоксвирусами заставляют вернуться к рассмотрению вопроса о возможном возврате оспы в результате естественной эволюции этих вирусов. На основе анализа доступных архивных данных об эпидемиях оспы, истории древних цивилизаций, а также новейших данных об эволюционных взаимосвязях ортопоксвирусов авторами была сформулирована гипотеза о том, что оспа могла в прошлом неоднократно возникать в результате эволюционных изменений зоонозного вируса-прародителя и исчезать вследствие недостаточной численности населения разрозненных древних цивилизаций. Лишь исторически последняя пандемия оспы продолжалась длительное время и была ликвидирована в XX веке при объединении усилий медиков и учёных многих стран под эгидой Всемирной организации здравоохранения. Таким образом, принципиальных запретов на возможность повторного появления в будущем оспы или схожего заболевания человека в процессе естественной эволюции существующих в настоящее время зоонозных ортопоксвирусов нет. Поэтому необходимо разрабатывать и широко внедрять современные методы эффективной и быстрой видоспецифичной диагностики всех видов ортопоксвирусов, патогенных для человека, включая вирус натуральной оспы. Также важно разрабатывать новые безопасные методы профилактики и терапии ортопоксвирусных инфекций человека.
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Problems of Virology. 2019; 64: 206-214
We should be prepared to smallpox re-emergence
https://doi.org/10.36233/0507-4088-2019-64-5-206-214Abstract
The review contains a brief analysis of the results of investigations conducted during 40 years after smallpox eradication and directed to study genomic organization and evolution of variola virus (VARV) and development of modern diagnostics, vaccines and chemotherapies of smallpox and other zoonotic orthopoxviral infections of humans. Taking into account that smallpox vaccination in several cases had adverse side effects, WHO recommended ceasing this vaccination after 1980 in all countries of the world. The result of this decision is that the mankind lost the collective immunity not only to smallpox, but also to other zoonotic orthopoxvirus infections. The ever more frequently recorded human cases of zoonotic orthopoxvirus infections force to renew consideration of the problem of possible smallpox reemergence resulting from natural evolution of these viruses. Analysis of the available archive data on smallpox epidemics, the history of ancient civilizations, and the newest data on the evolutionary relationship of orthopoxviruses has allowed us to hypothesize that VARV could have repeatedly reemerged via evolutionary changes in a zoonotic ancestor virus and then disappeared because of insufficient population size of isolated ancient civilizations. Only the historically last smallpox pandemic continued for a long time and was contained and stopped in the 20th century thanks to the joint efforts of medics and scientists from many countries under the aegis of WHO. Thus, there is no fundamental prohibition on potential reemergence of smallpox or a similar human disease in future in the course of natural evolution of the currently existing zoonotic orthopoxviruses. Correspondingly, it is of the utmost importance to develop and widely adopt state-of-the-art methods for efficient and rapid species-specific diagnosis of all orthopoxvirus species pathogenic for humans, VARV included. It is also most important to develop new safe methods for prevention and therapy of human orthopoxvirus infections.
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