Ross River Virus Transmission, Infection, and Disease: a Cross-Disciplinary Review

Ross River virus (RRV) is a fascinating, important arbovirus that is endemic and enzootic in Australia and Papua New Guinea and was epidemic in the South Pacific in 1979 and 1980. Infection with RRV may cause disease in humans, typically presenting as peripheral polyarthralgia or arthritis, sometimes with fever and rash. RRV disease notifications in Australia average 5,000 per year. The first well-described outbreak occurred in 1928. During World War II there were more outbreaks, and the name epidemic polyarthritis was applied. During a 1956 outbreak, epidemic polyarthritis was linked serologically to a group A arbovirus (Alphavirus). The virus was subsequently isolated from Aedes vigilax mosquitoes in 1963 and then from epidemic polyarthritis patients. We review the literature on the evolutionary biology of RRV, immune response to infection, pathogenesis, serologic diagnosis, disease manifestations, the extraordinary variety of vertebrate hosts, mosquito vectors, and transmission cycles, antibody prevalence, epidemiology of asymptomatic and symptomatic human infection, infection risks, and public health impact. RRV arthritis is due to joint infection, and treatment is currently based on empirical anti-inflammatory regimens. Further research on pathogenesis may improve understanding of the natural history of this disease and lead to new treatment strategies. The burden of morbidity is considerable, and the virus could spread to other countries. To justify and design preventive programs, we need accurate data on economic costs and better understanding of transmission and behavioral and environmental risks.

罗斯河病毒（Ross River virus, RRV）是一种兼具研究价值与公共卫生重要性的虫媒病毒（arbovirus），在澳大利亚及巴布亚新几内亚呈人类地方性流行与动物间循环流行，1979年与1980年曾在南太平洋地区引发大规模暴发疫情。人类感染RRV后可引发疾病，典型临床表现为外周多关节痛或关节炎，部分患者可伴随发热与皮疹。澳大利亚每年平均报告约5000例罗斯河病毒病病例。首例有详细记录的暴发疫情出现于1928年，第二次世界大战期间暴发频次增多，彼时该病被命名为“流行性多关节炎”。1956年的一次暴发中，研究人员通过血清学检测将流行性多关节炎与A型虫媒病毒（甲病毒属，Alphavirus）关联起来。1963年，研究人员先后从警觉伊蚊（Aedes vigilax）体内分离出该病毒，后续又从流行性多关节炎患者体内分离得到该病毒。本文综述了RRV演化生物学、感染后的免疫应答、致病机制、血清学诊断方法、疾病临床表现、极其多样的脊椎动物宿主、蚊媒传播媒介、传播循环、抗体阳性率、无症状与有症状人类感染的流行病学特征、感染风险以及公共卫生影响等领域的相关研究文献。罗斯河病毒关节炎由关节直接感染引发，当前临床治疗以经验性抗炎方案为基础。进一步开展致病机制相关研究，有助于加深对该病自然病程的认识，并有望催生全新的治疗策略。该病的发病负担相当可观，且该病毒存在向其他国家扩散的风险。为制定并优化预防干预方案，我们需要获取该病经济成本的精准数据，同时进一步明晰其传播途径以及行为与环境相关的感染风险因素。