Lancet Infect Dis: The epidemiological and clinical α of the emerging insect-borne virus, the emerging insect-borne virus that causes arthritis

Mosquito-borne viruses, also known as insect-borne viruses, have been an important part of infectious diseases for centuries and are often endemic to the equatorial and subtropical regions of the world.
recent outbreaks in the United States have further highlighted the enormous public health burden of these viruses.
In the context of concentrated outbreaks in specific regions, the α virus (Alphavirus), which causes arthritis, is often reported and causes debilitating acute diseases that can continue for many years after infection, and these viruses can be distributed geographically.
November 2020, professor Ali Zaid of Griffith University in Australia published a review paper, Arthritogenic alphaviruses: appelical and clinical perspective on emerging arboviruses, highlighting key features of the α virus known to cause human arthritis disease and outlining current findings on classification, immunogenicity, pathogenesis and experimental methods designed to limit disease performance.
review focuses on the globally identified α viruses that cause arthritis and provides a comprehensive assessment of current and future research directions.
α virus is transmitted by mosquitoes and geographically distributed in areas with appropriate vectors.
, however, it is possible to adapt to new vector species and spread to non-ende local areas where vectors currently exist.
α virus belongs to the α virus family and the α virus genus, and its members are classified as antigen complexes according to serological cross-reactivity and genetic similarity (e.g. Table 1).
table 1: Geographical regions and major vertebrate hosts associated with antigen complexes and member species within the genus α virus, although the distribution of each species is geographically limited by vector hosts and hosts, outbreaks of chikungikunya virus (CHIKV) between 2006 and 2019 properly demonstrate the potential for mass transmission of α viruses (Figure 1).
following the separation in the 1950s, which identified chikV , ONNV (Africa), and MAYV5 (South America), periodic outbreaks have allowed these viruses and their vectors to expand geographically.
from the mid-1950s to 2010, South Africa also recorded sporadic outbreaks.
in the South Pacific, the Ross River virus (RRV) is endetic in Australia (the first outbreak is consistent with the clinical manifestations of RRV reported in 1928).
addition, RRV was the target of outbreaks in the South Pacific islands between 1979 and 1980 and still appears to be spreading on some islands.
Human infection with influenza A virus is rarely associated with death, and its clinical manifestations range from mild fever associated with rash to chronic arthritis α
Figure 1: The spatial distribution of pathogenic α virus outbreaks and the major mosquito-borne epidemiology and genetic diversity of the Ross River Virus (RRV) were first isolated in 1959 from a wild mosquito collected near the Ross River in Australia and are endemic diseases in Australia.
, high temperatures and tides in northwest Australia are between the two countries, which have contributed to the mass breeding of mosquitoes, accelerating the spread of the virus.
RRV has a range of mosquito vectors and vertebrate hosts (possibly humans), which may promote bottleneck effects and prevent large-scale outbreaks.
BFV was first isolated in 1974 from mosquitoes collected in the Balma Forest in northern Victoria, south-east Australia.
BFV disease is one of the most common endeexual mosquito-borne diseases in Australia, with about 1000 cases a year.
the natural host of BFV is unknown, and the BFV separation strain shows a high degree of sequence ismilization, with no evidence of geographical or time differences.
SINV virus is one of the most widely distributed insect-borne viruses, found in northern Europe, the Middle East, Africa, India, Southeast Asia, Australia and the Philippines, mainly in birds and mosquitoes.
sequence of sinV viruses is relatively stable in geographical areas, indicating limited north-south transmission of migratory birds.
MAYV, a virus that causes Mayaro fever, was first isolated from a 24-year-old man in Mayaro County, Trinidad, in 1954.
MayV belongs to the Semliki Forest Virus antigen complex, genotype N, the most recently identified genotype in Peru in 2010.
it is difficult to clinically distinguish between arthritis-caused α viruses for clinical symptoms and signs, and laboratory confirmation is often required, especially in areas where more than one virus may be transmitted (table 2).
the characteristics and nonsexual symptoms of the virus and included CHIKV for comparison.
table 2: Most of the pathogenesis in animal models of characteristic clinical characteristics and nonse specific symptoms, disaggregated by virus and incubation period, is provided by animal models of pathology induced by arthritis α virals, which have identified several pathways that could serve as therapeutic targets for future α viral infections.
In our knowledge, a study conducted by Santos and colleagues in 2019 provided the first comprehensive animal model of MAYV-induced arthritis and myositis, which used Balb/c mice with 15 days of immune activity, rather than the C57BL/6J mice used in most α virus models.
in the pathology of arthritis and myoarthritis, MAYV has also been shown to induce leucin by activating NLRP3 inflammatory bodies, similar to CHIKV and RRV.
α laboratory diagnosis of α virus infection is similar, using reverse transcription polymerase chain reactions to detect viral nucleic acids in the acute phase for confirmation, sometimes in addition to serum conversion or detection of IgM during the recovery period.
, however, patients rarely develop viral haemorrology during acute periods;
treatment and α strategies for treating arthritis and viral infections RRV, BFV, SINV virus, ONNV virus or MAYV virus-induced infections without approved antiviral drugs or vaccines.
treatment is essentially palliative and is designed to avoid the main manifestations of acute infections, especially fever and physical pain.
treatment may include antihistamines and nonsteroidal anti-inflammatory drugs and analgesics for joint symptoms.
, however, there were no controlled studies that assessed or confirmed the effectiveness of these treatments.
the past 15 years, mosquito-borne viruses, such as CHIKV, have spread to previously non-endemic areas, highlighting the important public health impact in the absence of effective vaccines or therapeutic drugs.
before the Zika virus appeared in South America, it was not associated with large-scale outbreaks and substantial consequences of human disease.
outbreak of the infectious bronchitis virus has stimulated research and vaccine development of the virus.
However, there are other arthritis α vires with propagation tendencies; therefore, attention is paid to understanding the pathogenic mechanisms and further clarifying the role of inflammatory pathogens in joint pathology, which contributes to the development of targeted therapy.
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