北京市寨卡病毒病输入疫情处置及经验探讨

目的 描述北京市输入寨卡病毒病的流行病学特征和疫情防控措施,为寨卡病毒病等蚊传疾病防控提供参考依据.方法 对患者进行流行病学调查,采集患者尿液、唾液和血液标本,使用实时荧光PCR方法对标本进行寨卡病毒核酸检测.防控措施包括病例的防蚊隔离、污染物品消毒和防控知识宣教.结果 麻疹样皮疹是这3名患者共有的主要症状,患者同时伴有低热和结膜炎.3例病例均在委内瑞拉首都加拉加斯被蚊虫叮咬后感染发病,并分别于发病后1日、3日和7日从北京入境.患者入境时主动向检疫部门申报,随后被防蚊隔离并人院治疗.实时荧光PCR检测3名患者尿液标本寨卡病毒核酸均为阳性.结论 3例输入寨卡病毒病病例经早期诊断治疗均痊愈出院,防蚊隔离措施和性传播知识的宣教是预防该病在国内的传播、有效防止出现二代病例的有效措施.相关措施将对今后输入寨卡病毒病和其他蚊传疾病的防控有所裨益.     

中国首例输入性裂谷热病例的流行病学调查

目的 描述中国首例输入性裂谷热病例的发病就诊过程、流行病学特征和疫情处理过程,以期对输入性裂谷热病例的管理有所启示.方法 对该患者开展现场流行病学调查.采集患者的血液和唾液标本,应用实时荧光PCR方法对患者标本开展黄热病和裂谷热病毒核酸检测.结果 患者男,45岁,2016年7月14日晚在安哥拉出现发热、头痛等症状,症状持续加重.7月21日22:30患者抵京.抵京后,患者到北京市一传染病专科医院住院治疗,当日经北京市疾病预防控制中心检测患者为裂谷热病毒核酸阳性.经治疗,患者病情好转.9月6日患者治愈出院.结论 该患者为我国首例输入性裂谷热病例.病例在安哥拉工作期间被蚊虫叮咬感染裂谷热.我国与疫情发生国存在持续的人员往来,应加强入境病例排查,做到病例早发现、早隔离,降低出现续发病例的可能性.     

人血清中寨卡病毒微量中和抗体检测方法的建立和应用CSCD

目的 建立人血清寨卡病毒（ZIKV）微量中和抗体检测方法,并用10例经核酸检测和/或病毒分离确诊的寨卡输入病例的急性期和恢复期血清样本进行分析验证.方法 采用分离自输入寨卡病例的寨卡病毒株开展组织培养微量中和抗体测定,在BHK21、VERO和VERO-E6 3种细胞系中选择感染寨卡病毒后能产生典型CPE的细胞系制备病毒储备液,滴定病毒滴度;使用100TCID50的病毒液与连续4倍稀释的经56℃ 30 min灭活的血清于37℃中和2h,然后加入细胞悬液.5％二氧化碳培养箱孵育,逐日观察CPE.结果 BHK21、VERO和VERO-E63种细胞系对寨卡病毒感染的敏感度不同,其中VERO细胞最为敏感,可出现典型的CPE;应用VERO细胞系建立寨卡病毒微量中和抗体检测方法能准确反映寨卡确诊病例急性期和恢复期血清中和抗体水平,并能作为一种特异性诊断方法.结论 寨卡病毒微量中和抗体检测方法不仅可用于人感染寨卡病毒的实验室诊断,还可用于人群血清流行病学调查.     

湖北省首例人感染H5N6禽流感病例流行病学调查

目的 对湖北省首例人感染H5N6禽流感病例的流行病学资料进行分析,探讨病例发现过程、调查处理措施、实验室检测方法,为防控人感染H5N6禽流感疫情提供依据.方法 采用描述性流行病学方法,分析湖北省首例人感染H5N6禽流感病例诊治过程、密切接触者信息,开展现场流行病学调查,并采集病例、密切接触者、活禽市场外环境标本进行实验室检测分析.结果 患者2016年4月9日发病,体温40℃,有活禽市场暴露史.发病早期采集的下呼吸道标本(痰液、气管分泌液)为H5N6禽流感病毒核酸阳性,而上呼吸道标本H5N6禽流感病毒核酸检测均为阴性.患者无外出史和H5N6禽流感病例接触史.患者经两个月的治疗痊愈出院.密切接触者58人均未出现发热和呼吸道感染症状.采集病例经常路过的两家活禽市场和一家土鸡专卖店外环境标本共36份,其中检出H5N6禽流感病毒核酸1 1份,阳性率为30.56％.结论 该病例为湖北省首例人感染H5N6禽流感病例,属本地感染的散发病例,未出现人传人.传播途径可能为:活禽市场通过禽-环境-人的途径传播.在病例诊断中,下呼吸道标本(尤其是痰液、气管分泌液)具有重要意义.另外,尽早应用奥司他韦对病例的成功救治起到了重要的作用.     

北京市1例人感染H9N2禽流感病例的流行病学调查与分析

目的 分析北京市人感染H7N9禽流感疫情强化监测中发现的1例人感染H9N2禽流感病例流行病学调查情况,为今后科学防控人感染H9N2禽流感疫情提供参考.方法 采用现场流行病学和实验室检测相结合的方法,收集病例流行病学资料,采集并检测病例、暴露环境和密切接触者等标本,分析流行病学特征和可能的感染来源.结果 病例发病第3日和第7日咽拭子标本检测均为H9N2禽流感病毒核酸阳性.病例发病前10天内无禽类接触史,但病例平时活动有暴露于H9N2禽流感病毒污染环境的可能.密切接触者在医学观察期内均未出现流感样症状.结论 该病例为北京市首例成人感染H9N2禽流感确诊病例,同时也是北京市第二例H9N2禽流感确诊病例.医疗机构加强流感样病例监测是及时发现人感染H9N2禽流感病例的重要手段.     

濮阳市首例发热伴血小板减少综合征病例流行病学调查及基因组特征分析

目的报告濮阳市首例发热伴血小板减少综合征病例, 通过流行病学调查和基因测序了解其流行病学特点并分析濮阳市首例新型布尼亚病毒(severe fever with thrombocytopenia syndrome virus, SFTSV)分离株S、M、L片段分子特征。方法采用流行病学调查方法, 分析流行病学特点, 用Vero细胞分离病毒, 提取SFTSV核酸, 实时荧光定量PCR进行检测;构建多重PCR法对病毒核苷酸序列进行特异性扩增, 利用二代测序仪进行全基因组测序, DNAStar、MEGA11等生物信息软件进行同源性分析, 构建系统进化树。结果流行病学调查结果显示, 患者及其密切接触者14 d内均无旅居史, 有野外作业史, 无蜱虫叮咬史;血液样本检测SFTSV核酸阳性;SFTSV基因型为E型, 其S、M、L片段基因均为E型, 与GenBank中已知的SFTSV核苷酸序列进行比对, 核苷酸序列同源性分别为94.8%～99.9%、94.0%～99.8%、95.7%～99.7%。结论该患者确诊为濮阳市首例SFTSV感染引起的发热伴血小板减少综合征, 与河南近年来分离株基因分型差异较大,...     

一起腺病毒引起的急性呼吸道感染暴发疫情分析

目的调查潼南县米心小学流感样病例暴发疫情。进行暴发流行病学和疾病传播模式描述,研究暴发危险因素和控制措施。方法对所有疑似病例开展流行学调查和采集血,咽拭子标本进行实验室检测,同时隔离治疗病例和采取应急接种措施控制疫情蔓延。对收集到的数据进行暴发流行病学描述。结果全校共报告急性呼吸道感染病例44例(8.32%),18例现症患者的鼻咽拭子进行实验室检测,腺病毒核酸检测为阳性,其中2例合并甲型H1N1流感病毒核酸阳性。     

2009年广州市首起本地感染登革热家庭聚集性暴发疫情的调查与处理

目的 探讨登革热家庭聚集性发病的流行病学特点及采取的防控措施,为今后进行有效的预防和控制登革热暴发疫情提供参考。方法 采用现场流行病学调查方法对广州市首起登革热家庭聚集性暴发疫情进行调查和分析;采用ELISA和RT-PCR的方法对标本进行血清学检测和病毒分型。结果 2009年8月广州市越秀区发生的一起登革热家庭聚集性暴发事件中,该家庭4名成员中有3人同时发病,这3例患者登革热抗体IgM均阳性,其中RT-PCR检测阳性者2例,病毒分型均为登革Ⅲ型。并且,在实验室回顾性检测中发现,家庭聚集性疫情出现前有1例输入性登革病例,病毒分型也为登革Ⅲ型,且病毒基因测序结果提示两者之间存在明显关联。结论 根据流行病学调查结果、临床表现和实验室检测结果,可以确定该家庭发生了本地感染的登革热聚集性暴发。感染地是三元里大道景苑街居住地;感染来源可能是输入性疫情引起的,输入性疫情与本地疫情之间的这种流行病学关联在广州市还是首次获得。因此,广州市登革热疫情是由输入性疫情引发的本地疫情的趋势未改变,做好输入性疫情防控是防止疫情扩散的有力措施。     

昆明市登革热输入性病例的调查及C/PreM基因序列分析

目的 调查云南省昆明市登革热输入性病例分布状况及病原分子特征.方法 收集登革热病例资料,采集本病急性期病人血清标本,用ELISA法检测登革病毒(DENV) IgM抗体,RT-PCR法检测DENV核酸,核酸阳性者进行DENV-C/PreM区的基因核苷酸序列测定和分析,采用MEGA5软件的邻接法构建进化树.结果 2010-2013年在昆明市第三人民医院住院病人中采集到登革热临床诊断病例血清标本13份,经检测DENV-IgM抗体均为阳性,DENV核酸阳性2份.根据流行病学史、临床表现和实验室检测结果,这13例病人均被诊断为登革热.获得了两株病毒(YNH8和YNH12)的C/PreM区基因核苷酸序列,进化分析表明YNH8和YNH12株均为登革Ⅰ型病毒.其中YNH8株与南亚地区印度流行株进化关系最为接近,而YNH12株与泰国、缅甸、柬埔寨和越南等东南亚国家流行株具有较近亲缘关系.结论 昆明市登革热患者均为输入性病例.流行病学史和分子流行病学研究证实,YNH8和YNH12病例与印度和缅甸流行株具有较近亲缘关系.     

深圳口岸6例输入性疟疾的调查分析

目的分析深圳口岸输入性疟疾病例的相关资料和追踪调查,为输入性疟疾防控工作提供依据。方法对经深圳口岸入境疑似疟疾者进行流行病学个案调查和实验室检查。结果通过现场体温监测、医学巡查、流行病学个案调查和实验室检测,从某劳务派遣入境团体人群中流行病学确诊6例输入性疟疾病例,并对确诊的病例进行了跟踪。结论深圳口岸面临输入性疟疾的威胁,需对来自疟疾流行区的人群加强检疫,以防止疟疾传入。     

Detection of Zika virus in saliva

BackgroundDuring the largest Zika virus (ZIKV) outbreak ever reported that occurred from October 2013 to March 2014 in French Polynesia, we observed that several patients presenting the symptoms of acute phase Zika fever were tested negative in blood by ZIKV real-time PCR (RT-PCR).ObjectivesAs we have previously detected ZIKV RNA in the saliva of a young child, we investigated the use of saliva as an alternative sample for routine ZIKV RNA detection.Study designOver a 6 month period, 1,067 samples collected from 855 patients presenting symptoms of Zika fever (saliva only, blood only or both samples) were tested using a specific ZIKV RT-PCR. A medical questionnaire was available for most of the patients.ResultsZIKV was more frequently detected in saliva compared to blood. For the 182 patients with both samples collected, tests were positive for 35 (19.2%) in saliva while negative in blood and tests were positive for 16 (8.8%) in blood while negative in saliva; the difference in mean days after symptoms onset and the percentage of the main symptoms of Zika fever for patients only positive in saliva or in blood was not significant.ConclusionThe use of saliva sample increased the rate of molecular detection of ZIKV at the acute phase of the disease but did not enlarge the window of detection of ZIKV RNA. Saliva was of particular interest when blood was difficult to collect (children and neonates especially).     

中国首次输入性黄热病疫情处置及相关问题探讨

目的 描述中国首次输入性黄热病疫情处置过程及防控效果,并深入探讨防控的经验和教训,以期对今后黄热病疫情处置有所启示.方法 依据国家卫计委《黄热病预防控制技术指南》(2008年),同时参考登革热和寨卡病毒病相关规定对病例实施隔离、开展蚊媒应急监测、划定共同暴露者和密切接触者并对其实施为期6日的健康监测.结果 此次疫情是我国首次输入性黄热病人间疫情.对输入性黄热病病例实施防蚊隔离和血液-体液隔离,对13例共同暴露者和11例密切接触者健康监测6日,均未出现黄热病相关症状.北京市蚊媒应急监测未发现蚊虫,对病例可能污染的环境使用含氯制剂进行消毒,公布疫情后及时对公众开展媒体信息发布,并对公众开展防控措施宣传.结论 此次疫情是我国首次输入黄热病疫情,疫情处置措施得当,未出现疫情扩散和公众恐慌.采取的措施将对今后我国输入性黄热病疫情的规范处置有所帮助.     

Is saliva as reliable as urine for detection of cytomegalovirus DNA for neonatal screening of congenital CMV infection?

BACKGROUND: There are no studies on the detection of cytomegalovirus (CMV) DNA by molecular methods in the saliva of newborn infants in large scale screening programs. OBJECTIVES: To evaluate the usefulness of saliva as a sample for the neonatal screening of congenital CMV infection as compared to urine when processed by a PCR. STUDY DESIGN: Saliva and urine samples were obtained during the first week of life. Both samples were attempted to be obtained from the first 2816 neonates. Subsequently, only saliva was obtained from other 1623 infants. Urine and saliva were processed by DNA-PCR. Confirmation of positive results was done by PCR and virus isolation by 3 weeks after birth. RESULTS: A urine sample was not obtainable from 893/2816 (31.7%) infants. Both saliva and urine samples were obtained from the remaining 1923 infants. Of these, 28 (1.45%) were CMV-infected. There was 99.7% agreement between the results with both samples. CMV excretion was similar when PCR was applied to urine (1.3%) or to saliva (1.2%) samples. Among the subsequent 1623 infants for whom only a saliva sample was planned for screening, 16 (0.98%) were CMV-infected. CONCLUSIONS: Saliva samples are as useful as urine for the identification of CMV-DNA in large use for screening programs.     

我国首例输入性裂谷热病例病毒全基因组测序分析

目的 对我国首例输入性裂谷热病例病毒进行全基因组测定,分析其进化来源及潜在变异.方法 提取样本核酸,非特异性反转录扩增病毒基因组RNA,使用Ion Torrent二代测序仪进行病毒全基因组测定.对获得的基因组数据进行序列拼接、比对、进化树构建和关键位点分析.结果 通过测定获得了病毒全基因组11 979nt,该测定病毒属E基因分支,序列与先前南非分离株Kakamas相似度最高(＞98％).病毒Gn蛋白C端信号肽区存在1个氨基酸突变.结论 本研究分析测定的裂谷热病毒全基因组与目前非洲流行株高度相似,病毒基因特征未出现明显变异.     

Zika virus infections imported to Italy: Clinical,immunological and virological findings,and public health implications

We report the first two cases of laboratory confirmed Zika virus (ZIKV) infections imported into Italy from French Polynesia. Both patients presented with low grade fever, malaise, conjunctivitis, myalgia, arthralgia, ankle oedema, and axillary and inguinal lymphadenopathy. One patient showed leukopenia with relative monocytosis and thrombocytopenia.The diagnosis was based on ZIKV seroconversion in both cases and on ZIKV RNA detection in one patient from acute serum sample. Sera from both patients exhibited cross-reactivity with dengue virus antigens. Our immunological analysis demonstrated that recovery from ZIKV infection is associated with restoration of normal numbers of immune cells in the periphery as well as with normal function of antigen-presenting cells. ZIKV is an emerging arbovirus, which has recently spread extensively in tourist destinations on several West Pacific islands. Returning viremic travelers may ignite autochthonous infections in countries like Italy, which are infested by Aedes albopictus, a suitable vector for ZIKV. The role of clinicians is crucial and includes early diagnosis and timely notification of public health authorities in order to quickly implement adequate focal vector control measurements.     

Investigation surrounding a fatal case of yellow fever in C?te d'Ivoire in 1999]

C?te d'Ivoire is an endemic country for yellow fever, but no case was officially notified in recent years. In July 1999, however, one fatal case was reported. A German citizen was infected in the national park of Comoe, in the north eastern area of the country. In order to evaluate the extent of amaril virus circulation and the risk for local people, a virological, entomological and epidemiological investigation was carried out by the ministry of health, the OCCGE, the C?te d'Ivoire Pasteur Institute (IPCI) and the World Health Organisation in the area where the fatal case had been staying. 18 suspected and 24 confirmed mosquito catchers were identified by interview and a blood specimen was collected from each of them. In addition, 159 batches of mosquitoes from which 94 batches of potential vectors were collected; among the suspected cases, 22% were immunised against yellow fever. Serological and virological analyses were made at IPCI and the Paris Pasteur Institute by ELISA technique and isolation on cells cultures and newborn mice. All the suspicious sera and 87.5% of the catchers were positive for IgG anti-amaril virus. One catcher's serum was positive for IgM anti-amaril virus. 11 suspected sera were positive for IgG anti-dengue virus with 1 positive for IgM. 1 strain of amaril virus and 3 strains of Zika virus were isolated from mosquitoes at IPCI and confirmed by CRORA in Dakar. These results indicated that there is a yellow fever and dengue virus are prevalent among the human and vector populations in the study area. Preventive measures must be adopted to protect human beings at risk for amaril infection.