浙江省衢州市基孔肯雅热疫情流行病学研究
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摘要
目的分析基孔肯雅热疫情调查结果,为预防控制蚊媒传染病疫情提供依据。方法运用现场流行病学的方法,对2017年9月1日发生在浙江省衢州市衢江区一起输入性基孔肯雅热病例引起本地暴发疫情进行分析,通过病例搜索、病例访谈、流行特征描述、蚊媒密度评估和控制、样本采集和实验室检测等方式,开展疫情处置。结果本调查显示共有4名确诊病例,发病时间为8月20日至9月1日,均出现发热、皮疹和关节痛症状。对11名可疑病例和306名共同暴露者进行检测,结果均阴性,首次蚊媒密度调查布雷图指数高达114,叮咬指数达10只/人·时。结论基孔肯雅热患者在潜伏期可能具有传染性,患者隔离期限应延长。加强蚊媒监测与病例搜索,在疫情早期采取综合防控措施是控制疫情蔓延的关键。
Objective To understand the epidemiological features of chikungunya fever outbreak in Quchou,and to provide the basis for the prevention and control of mosquito-borne infectious disease. Methods We investigated an imported chikungunya fever outbreak occurred on September 1,2017 in Qujing district of Quzhou.The field epidemiological survey was conducted to search and interview cases,describe epidemiological characteristics,assess and control the mosquito density.The serum samples were collected to identify chikungunya virus by RT-PCR. Results Four confirmed cases with chikungunya fever were identified and disease onset time was from August 20 to September 1.They all experienced fever,rash and joint pain.Samples collected from 11 suspects and 306 direct contacts were all virus negative for RT-PCR.The Breteau index of mosquito density in epidemic area was as high as 114 and the Bite index was 10/person·hour during the epidemic period. Conclusions Cases with Chikungunya fever may be contagious during disease latent period,therefore,the duration of quarantined period of case should be extended.Strengthening mosquito monitoring,searching cases and comprehensive intervention are the keys to prevent the spreading of chikungunya fever.
Objective To understand the epidemiological features of chikungunya fever outbreak in Quchou,and to provide the basis for the prevention and control of mosquito-borne infectious disease. Methods We investigated an imported chikungunya fever outbreak occurred on September 1,2017 in Qujing district of Quzhou.The field epidemiological survey was conducted to search and interview cases,describe epidemiological characteristics,assess and control the mosquito density.The serum samples were collected to identify chikungunya virus by RT-PCR. Results Four confirmed cases with chikungunya fever were identified and disease onset time was from August 20 to September 1.They all experienced fever,rash and joint pain.Samples collected from 11 suspects and 306 direct contacts were all virus negative for RT-PCR.The Breteau index of mosquito density in epidemic area was as high as 114 and the Bite index was 10/person·hour during the epidemic period. Conclusions Cases with Chikungunya fever may be contagious during disease latent period,therefore,the duration of quarantined period of case should be extended.Strengthening mosquito monitoring,searching cases and comprehensive intervention are the keys to prevent the spreading of chikungunya fever.
引文
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[18]朱自伟,徐翠平,冯时,等.中国基孔肯雅热监测与防控措施研究进展[J].中国医药科学,2015,5(23):42-45.
[2] Robinson M,Conan A,Duong V,et al.A model for a chikungunya outbreak in a rural Cambodian setting:implications for disease control in uninfected areas[J].PLoS Negl Trop Dis,2014,8(9):e3120.
[3] Coffey LL,Failloux AB,Weaver SC.Chikungunya virus-vector interactions[J].Viruses,2014,6(11):4628-4663.
[4]张海林,施华芳,刘丽华,等.从云南省蝙蝠中分离基孔肯尼雅病毒及血清抗体调查[J].病毒学报,1989,5(1):31-35.
[5] Patil SS,Patil SR,Durgawale PM,et al.A study of the outbreak of Chikungunya fever[J].J Clin Diagn Res,2013,7(6):1059-1062.
[6]段金花,蔡松武,吴德,等.一起基孔肯雅热暴发的蚊媒监控及其病毒检测[J].中国媒介生物学及控制杂志,2012,23(6):492-495.
[7]郑夔,黄吉城,李华,等.全国首例输入性基孔肯雅病的实验室诊断[J].中国卫生检验杂志,2008,18(9):1806-1807.
[8]林炳亮,谢冬英,翟洁卿,等.东莞基孔肯雅热确诊病例的调查分析[J].中山大学学报,2011,32(2):208-211.
[9]中华人民共和国卫生和计划生育委员会.WS/T 590-2018,基孔肯雅热诊断[S].北京:中华人民共和国卫生和计划生育委员会,2018.
[10]中国疾病预防控制中心.基孔肯雅热预防控制技术指南(2012年版)[EB/OL].(2012-11-02)[2018-01-05].http://www.chinacdc.cn/jkzt/crb/qt/jkkyr/jszl-2271/201211/t20121102_71345.html.
[11]郭颂,凌锋,王金娜,等.浙江省不同地理株白纹伊蚊mtDNA-COⅠ基因多态性研究[J].中国人兽共患病学报,2016,32(2):133-136.
[12]杨天赐,傅桂明.浙江省登革热传播媒介白纹伊蚊调查研究[J].中华卫生杀虫药械,2006,12(3):189-191.
[13]中国卫生计生办印发.登革热防治技术指南[EB/OL].(2014-09-29)[2018-01-05].http:www.chinacdc.cn/kgzt/crb/zl/dgr/jszl_2235/201409/t20140929_104958.html.
[14] Ballera JE,Zapanta MJ,de los Reyes VC,et al.Investigation of chikungunya fever outbreak in Laguna,Philippines,2012[J].Western Pac Surveill Response J,2015,6(3):8-11.
[15] van Genderen FT,Krishnadath I,Sno R,et al.First chikungunya outbreak in suriname;clinical and epidemiological features[J].PLoS Negl Trop Dis,2016,10(4):e0004625.
[16]蔡猛森,苏玉城,王婷婷,等.一起输入性基孔肯雅热疫情的调查和处置[J].海峡预防医学杂志.2013,19(6):84-85.
[17] Ang LW,Kam YW,Lin C,et al.Seroprevalence of antibodies against chikungunya virus in Singapore resident adult population[J].PLoS Negl Trop Dis,2017,11(12):e0006163.
[18]朱自伟,徐翠平,冯时,等.中国基孔肯雅热监测与防控措施研究进展[J].中国医药科学,2015,5(23):42-45.