上海市首例黄热病病例的确认及其现场流行病学调查分析

发布时间：2018-03-16 09:47

本文选题：黄热病　切入点：病例报告　出处：《中华疾病控制杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的查明上海首例输入性黄热病病例的发病情况、感染来源和传播途径,为我国黄热病防控决策提供科学依据。方法通过个人访谈开展流行病学调查;采集血液、尿液及唾液,通过实时荧光聚合酶链式反应(polymerase chain reaction,PCR)法开展黄热病毒核酸检测;采用双层叠帐法开展蚊媒密度应急监测。结果病例3月5日在安哥拉突发高热,7日凌晨抵沪,8日住院治疗,有明确蚊虫叮咬史,无黄热病疫苗接种史;病后4 d的血液黄热病毒核酸阳性,病后9 d、26 d的尿液均为阳性,病后9 d、26 d、33 d的唾液标本均为阴性。病例周边成蚊密度为0.5只/(人·h),就医所在的金山区3月份蚊媒密度为0.83只/(人·h)。防蚊隔离治疗后,病例于4月8日痊愈出院;27名密切接触者均未出现相关症状。结论病例感染来源于安哥拉,其发病时间(3月5日)早于我国首例病例(3月6日发病),未发生二代病例,对病例开展防蚊隔离治疗和蚊媒应急监测处置有效防止黄热病扩散传播。
[Abstract]:Objective to investigate the incidence, source and transmission of the first imported yellow fever case in Shanghai, so as to provide a scientific basis for the decision of prevention and control of yellow fever in China. Methods Epidemiological investigation was carried out through personal interviews, and blood, urine and saliva were collected. The detection of yellow fever virus nucleic acid was carried out by real-time fluorescent polymerase chain reaction PCR, and the emergency surveillance of mosquito vector density was carried out by double-layer accounting method. Results the case occurred in Angola on March 5th, arrived in Shanghai early on 7th, and was hospitalized on 8th. There was a clear history of mosquito bite and no history of yellow fever vaccination. The blood yellow fever virus nucleic acid was positive 4 days after the disease, and the urine of 9 days and 26 days after the disease were all positive. The saliva samples were negative at 9 days, 26 days and 33 days after the disease. The density of adult mosquitoes around the case was 0.5 / (human 路hmh, the mosquito vector density in Jinshan District, where the doctor was treated, in March) was 0.83. In April 8th, all the 27 close contacts had no related symptoms. Conclusion the infection originated in Angola and the onset time (March 5th) was earlier than that of the first case (March 6th) in China, and there was no second generation case. Antimosquito isolation treatment and mosquito vector emergency surveillance were carried out to prevent the spread of yellow fever.
【作者单位】：上海市金山区疾病预防控制中心传染病防制科;上海市疾病预防控制中心急性传染病防治科;
【分类号】：R181.3;R512.8

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