當前的猴痘爆發：從古代歷史中埃及木乃伊的學習？
資料來源：http://www.thelancet.com/microbe / August 23,2022 / https://doi.org/10.1016/S2666-5247(22)00219-1 /
財團法人台灣紅絲帶基金會編譯
根據古病理學，追踪傳染病的歷史和起源有助於預測和更好地治療其現代後代。埃及木乃伊是研究古代世界傳染病流行的理想人群。
在埃及木乃伊中發現的一些最常見的生物是血吸蟲、結核分枝桿菌和天花病毒。
當前的全球猴痘疫情已在 70 多個國家/地區造成 16,000 多例病例，並已被宣佈為國際關注的突發公共衛生事件。猴痘是由一種稱為猴痘病毒的 DNA 病毒引起的，該病毒屬於正痘病毒屬，其中包括天花病毒，可引起天花——因此兩種病毒在遺傳結構、臨床表現和目標疫苗接種方面具有相似性。
在美國疾病控制和預防中心對埃及木乃伊進行的一些分析中，發現了顯示痘病毒的跡象（例如，水皰性皮疹）。然而，研究人員不確定這些病變是否與天花有關。由於這兩種疾病之間的相似性，他們可能一直在關注猴痘而不是天花嗎？這仍然是一個值得回答的問題，因為尚未有分析證實或否認這種似是而非的關聯。
Tiee 和他的同事檢查了 120 年期間收集的 1,000 個博物館標本，揭示了早在 1899 年在五種非洲的非洲松鼠屬物種 (Funisciurus) 中就存在猴痘病毒。他們提出在第一次宣布猴痘的1958 年之前，人類和宿主動物中就存在類似出痘的爆發的病例。他們還強調了猴痘病毒在動物之間傳播的優勢，佔 1980 年代所有猴痘病例的 72-78.1%。他們將這些病例的發生與野生動物聯繫起來；這進一步提出了猴痘病毒的歷史是否可以追溯到遠古時代的問題，當時古埃及人等的主要生存環境是野生動物。
傳染病（例如，霍亂、麻疹、流感和天花）在古埃及人中非常普遍，它們會導致受影響的個體死亡或免疫。因此，鑑於古老的群體生活習慣，猴痘病毒可能存在於古埃及人中，但以無症狀的形式存在，這使得將猴痘與埃及歷史聯繫起來更加複雜。
對數千年前的埃及木乃伊的歷史標本進行分析，將為我們提供有關猴痘病毒歷史和進化的線索和見解。它還將提高我們解釋和預測最近不同基因突變影響的能力。這些見解將幫助我們不僅管理最近的全球猴痘爆發，而且還管理其他現代病毒感染。
我們聲明沒有利益衝突。版權所有 © 2022 作者。由 Elsevier Ltd. 出版。
這是 CC BY-NC-ND 4.0 許可下的開放獲取文章。
作者：Ramadan Abdelmoez Farahat, *Jaffer Shah, Abdelaziz Abdelaal
*jshah6@pride.hofstra.edu
埃及卡夫雷爾謝赫大學醫學院(RAF)；美國紐約州衛生處(JS)；美國麻薩諸塞州波士頓哈佛醫學院，美國馬薩諸塞州波士頓大學，以及埃及坦塔大學醫院 (AA)
Current monkeypox outbreak: lessons from ancient history in Egyptian mummies?
資料來源：http://www.thelancet.com/microbe / August 23,2022 / https://doi.org/10.1016/S2666-5247(22)00219-1 /
財團法人台灣紅絲帶基金會編譯
Tracking the history and origin of an infectious disease can help to predict and better treat its modern descendants, according to paleopathology. Egyptian mummies are an ideal population in which to study the prevalence of infectious diseases in the ancient world.
Some of the most common organisms found in Egyptian mummies were Schistosoma haematobium, Mycobacterium tuberculosis, and variola virus.
The current global monkeypox outbreak has caused more than 16,000 cases in over 70 countries, and has been declared a public health emergency of international concern. Monkeypox is caused by a DNA virus called monkeypox virus, belonging to the Orthopoxvirus genus which includes the variola virus, causing smallpox— hence the similarity between both viruses in terms of genetic structure, clinical presentation, and target vaccinations.
During some analyses conducted by the US Centers for Disease Control and Prevention on Egyptian mummies, signs indicative of a poxvirus were found (eg, vesicular skin eruptions). However, the investigators were uncertain as to whether or not the lesions were related to smallpox. Due to the similarity between both diseases, could they have been looking at monkeypox instead of smallpox? This remains a question worthy of answering, as no analyses have yet confirmed nor denied this plausible link.
Tiee and colleagues examined 1000 museum specimens gathered in a 120-year period, revealing the presence of monkeypox virus in five African Funisciurus species as early as 1899. They proposed the presence of pox-like outbreaks in human and host animals before the first declared monkeypox case in 1958. They also highlighted the predominance of animal-to-human transmission of monkeypox virus, which represented 72–78·1% of all monkeypox cases in the 1980s. They linked the occurrence of these cases to wildlife; this further raises the question of whether the history of monkeypox virus goes back to ancient times, when wildlife was the dominant living environment for people such as the ancient Egyptians.
Infectious diseases (eg, cholera, measles, influenza, and smallpox) were very common among the ancient Egyptians, and they caused either death or immunity in affected individuals. Therefore, given the ancient habits of living in clusters of individuals, monkeypox virus could have been present among ancient Egyptians but in an asymptomatic form, which further complicates linking monkeypox back to Egyptian history.
Analysis of historical specimens of Egyptian mummies thousands of years old will give us hints and insights about the history and evolution of monkeypox virus. It will also improve our ability to interpret and predict the impact of the recent different genetic mutations. These insights will help us manage not only the recent global monkeypox outbreak but also other modern viral infections.
We declare no competing interests. Copyright © 2022 The Author(s). Published by Elsevier Ltd.
This is an Open Access article under the CC BY-NC-ND 4.0 license.
Ramadan Abdelmoez Farahat, *Jaffer Shah, Abdelaziz Abdelaal
jshah6@pride.hofstra.edu