PDF(Pubmed)
Abstract：
Rheumatic heart disease (RHD) and acute rheumatic fever (ARF) disproportionately affect individuals in low-resource settings. ARF is attributed to an immune response to Group A Streptococcus (GAS) following GAS pharyngitis and potentially GAS impetigo in which infection can be initiated by scabies infestation. The burden of ARF and RHD in Aboriginal and Torres Strait Islander people in Australia is among the highest globally. Following recent calls to include dog management programs in ARF and RHD prevention programs, we believe it is timely to assess the evidence for this, particularly since previous recommendations excluded resources to prevent zoonotic canine scabies. While phylogenetic analyses have suggested that the Sarcoptes mite is host specific, they have differed in interpretation of the strength of their findings regarding species cross-over and the need for canine scabies control to prevent human itch. Given that there is also indication from case reports that canine scabies leads to human itch, we propose that further investigation of the potential burden of zoonotic canine scabies and intervention trials of canine scabies prevention on the incidence of impetigo are warranted. Considering the devastating impacts of ARF and RHD, evidence is required to support policy to eliminate all risk factors.
摘要：
风湿性心脏病（RHD）和急性风湿热（ARF）不成比例地影响低资源环境中的个体。ARF归因于GAS咽炎和潜在的GAS脓疱病之后对A组链球菌（GAS）的免疫反应，其中感染可由sc疮感染引发。澳大利亚原住民和托雷斯海峡岛民的ARF和RHD负担是全球最高的。在最近呼吁将狗管理计划纳入ARF和RHD预防计划之后，我们认为评估这方面的证据是及时的，特别是由于以前的建议排除了预防人畜共患病犬sc疮的资源。虽然系统发育分析已经表明，该S螨是宿主特异性的，他们对物种交叉发现的强度以及控制犬sc疮以预防人类瘙痒的必要性的解释有所不同。鉴于从病例报告中也有迹象表明犬sc疮导致人类瘙痒，我们建议有必要进一步调查人畜共患犬sc疮的潜在负担，并进行犬sc疮预防对脓疱病发病率的干预试验。考虑到ARF和RHD的破坏性影响，需要证据来支持消除所有风险因素的政策。
