摘要
目的通过对河南某医院报告的5例发热伴血小板减少综合征(SFTS)病例开展现场流行病学调查,为有效、快速调查此次聚集性疫情传染源及传播途径,正确引导和回应社会关切提供依据。方法对病例和密切接触者进行流行病学调查和RT-PCR核酸检测。收集该病例所在村健康居民血清,进行血清抗体水平检测。对可疑暴露地开展寄生蜱和游离蜱等媒介密度监测,并对采集到的蜱开展布尼亚病毒(SFTSV)核酸检测。结果本次聚集性疫情续发率22.73%;首发病例不排除蜱叮咬而感染,5例续发病例接触阳性体液后感染发病的可能性大;病例所在村居民SFTSV血清IgG抗体阳性率17.14%;应急监测159人,SFTSV核酸阳性率3.14%。对病例居住和工作场所采集寄生蜱4只,经鉴定为长角血蜱。结论本起SFTS聚集性疫情可能由体液接触引起,建议加强医防协同工作,提高早发现、早诊断能力;医疗机构加强院内感染控制和宣教工作,避免直接接触病人或遗体体液。
Objective To carry out an field epidemiological investigation on 5 cases of severe fever with thrombocytopenia syndrome(SFTS)reported in a hospital in Henan province so as to investigate the source of infection and transmission route of this cluster effectively and quickly,guide and respond to social concerns correctly.Methods Epidemiological investigation and RT-PCR were performed on the cases and close contacts.Sera of healthy residents in the village where the cases was located were collected for detection of serological antibody levels.The density of parasitic and free ticks and other vectors were monitored at suspected exposure sites,and the collected ticks were tested for SFTSV nucleic acid.Results The secondary incidence rate of the cluster was 22.73%.Tick bite infection was not excluded in the first case,and the possibility of infection after contact with positive body fluids was high in the 5 secondary cases.The positive rate of SFTSV IgG antibody was 17.14%in the villagers.Of the 159 cases conducting the urgent test,the positive rate of SFTSV nucleic acid was 3.14%.Four parasitic ticks were collected from the residence and working places,and identified as Haemaphysalis longicornis.Conclusions This clustered incidence of SFTS may be caused by humoral contact.It is suggested to strengthen the coordination of disease prevention and treatment,and improve the ability of early detection and diagnosis.Medical institutions should strengthen nosocomial infection control and education to avoid direct contact with bodily fluids of patients or dead bodies.
作者
张丽
胡艳
张继
黄河秋
陈俊东
ZHANG Li;HU Yan;ZHANG Ji;HUANG Heqiu;CHEN Jundong(Xinyang Center for Disease Control and Prevention,Xinyang,Henan 464000,China)
出处
《现代疾病预防控制》
2023年第6期471-473,477,共4页
MODERN DISEASE CONTROL AND PREVENTION
