中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2015年
4期
364-367
,共4页
顾时平%吴雪%周斌%凌锋%张宏%黄艺%胡雪根%郑昆颖%叶炜
顧時平%吳雪%週斌%凌鋒%張宏%黃藝%鬍雪根%鄭昆穎%葉煒
고시평%오설%주빈%릉봉%장굉%황예%호설근%정곤영%협위
发热伴血小板减少综合征%聚集性%接触传播
髮熱伴血小闆減少綜閤徵%聚集性%接觸傳播
발열반혈소판감소종합정%취집성%접촉전파
Severe fever with thrombocytopenia syndrome%Cluster%Transmission through contact
目的 调查2014年5月浙江省西北山区一起发热伴血小板减少综合征(SFTS)暴发疫情的发生原因、传播方式和危险因素.方法 制订病例定义并开展病例主动搜索,现场调查采用统一调查表,利用回顾性队列研究分析危险因素.采集首发病例污染的血迹涂抹标本和续发病例血液标本,采用RT-PCR检测新型布尼亚病毒核酸,同时开展人群和动物血清流行病学调查及生物媒介监测.结果 该起疫情共发生13(男性6,女性7)例.首发病例于4月23日急性起病,5月1日死亡,5月10-16日参与丧事的8名亲属、3名邻居及1名同村村民陆续发病,发病高峰为5月13日,潜伏期为9～15d.该13例均急性起病,临床表现为发热(100％)、畏寒(92％)、乏力(92％)、全身酸痛(92％)、纳差(92％)、头痛(77％)、恶心(69％)等.首发病例病前在居住地采野茶持续1月余,曾有蜱叮咬史.5月1日首例死亡后,续发病例中9人直接接触过死者血液,回顾性队列研究证实直接接触血液是危险因素(RR=43.36,95％CI:13.66 ～ 137.63,P=0.000).结论 该起为家庭内人传人SFTS聚集性疫情,直接接触血液是疫情暴发的主要危险因素,但不排除通过气溶胶传播的可能性.
目的 調查2014年5月浙江省西北山區一起髮熱伴血小闆減少綜閤徵(SFTS)暴髮疫情的髮生原因、傳播方式和危險因素.方法 製訂病例定義併開展病例主動搜索,現場調查採用統一調查錶,利用迴顧性隊列研究分析危險因素.採集首髮病例汙染的血跡塗抹標本和續髮病例血液標本,採用RT-PCR檢測新型佈尼亞病毒覈痠,同時開展人群和動物血清流行病學調查及生物媒介鑑測.結果 該起疫情共髮生13(男性6,女性7)例.首髮病例于4月23日急性起病,5月1日死亡,5月10-16日參與喪事的8名親屬、3名鄰居及1名同村村民陸續髮病,髮病高峰為5月13日,潛伏期為9～15d.該13例均急性起病,臨床錶現為髮熱(100％)、畏寒(92％)、乏力(92％)、全身痠痛(92％)、納差(92％)、頭痛(77％)、噁心(69％)等.首髮病例病前在居住地採野茶持續1月餘,曾有蜱叮咬史.5月1日首例死亡後,續髮病例中9人直接接觸過死者血液,迴顧性隊列研究證實直接接觸血液是危險因素(RR=43.36,95％CI:13.66 ～ 137.63,P=0.000).結論 該起為傢庭內人傳人SFTS聚集性疫情,直接接觸血液是疫情暴髮的主要危險因素,但不排除通過氣溶膠傳播的可能性.
목적 조사2014년5월절강성서북산구일기발열반혈소판감소종합정(SFTS)폭발역정적발생원인、전파방식화위험인소.방법 제정병례정의병개전병례주동수색,현장조사채용통일조사표,이용회고성대렬연구분석위험인소.채집수발병례오염적혈적도말표본화속발병례혈액표본,채용RT-PCR검측신형포니아병독핵산,동시개전인군화동물혈청류행병학조사급생물매개감측.결과 해기역정공발생13(남성6,녀성7)례.수발병례우4월23일급성기병,5월1일사망,5월10-16일삼여상사적8명친속、3명린거급1명동촌촌민륙속발병,발병고봉위5월13일,잠복기위9～15d.해13례균급성기병,림상표현위발열(100％)、외한(92％)、핍력(92％)、전신산통(92％)、납차(92％)、두통(77％)、악심(69％)등.수발병례병전재거주지채야다지속1월여,증유비정교사.5월1일수례사망후,속발병례중9인직접접촉과사자혈액,회고성대렬연구증실직접접촉혈액시위험인소(RR=43.36,95％CI:13.66 ～ 137.63,P=0.000).결론 해기위가정내인전인SFTS취집성역정,직접접촉혈액시역정폭발적주요위험인소,단불배제통과기용효전파적가능성.
Objective To investigate the source,transmission route and risk factors of an outbreak of severe fever with thrombocytopenia syndrome (SFTS).Methods Case definition was made and suspected cases were searched.A standardized questionnaire was used to collect information on demographic features (age,gender,occupation,residential address),history of exposure,clinical signs and symptoms etc.Blood samples were collected from 12 suspected cases while index patient's blood samples were collected from walls of the residence.All samples were detected for SFTS vires using RT-PCR.Sero-prevalence rates of SFTS virus IgG were also conducted among healthy people,host and vectors.Results A total of 13 cases including 6 male and 7 female were identified during this outbreak in May 2014.Index patient developed illness onset on April 23 and died on May 1.Secondary patients would include 8 family members,3 neighborhoods,1 individual who lived in the same village,developing illness onset between May 10 and 16,with a peak on May 13.The incubation period was 9-15 days.Clinical signs and symptoms appeared as fever (100％),chill (92％),anergy (92％),body aches (92％),anorexia (92％),headache (77％),nausea (69％) etc.Neutropenia and thrombocytopenia also appeared.History of the index patient showed that she collected tea leaves in her hometown 1 month before the illness onset.After index patient died on May 1,9 secondary patients had directly contacted the blood of the deceased.Data from the retrospective cohort study showed that 'direct contact with blood' was an important risk factor (RR=43.36,95％ CI:13.66-137.63,P=0.000).Conclusion Majority of the secondary patients of these clusters contracted the SFTS virus infection through exposure to the blood of the index patient.However,aerosol transmission could not be ruled out,suggesting that precaution should be taken for doctors,nurses and family members when looking after the patients with SFTS virus infection.
