中国大陆第三例输入性寨卡病毒病病例调查分析

目的 对中国大陆第三例输入性寨卡病毒病病例进行调查分析,为防控寨卡病毒病提供工作经验和参考依据。方法 对中国大陆第三例输入性寨卡病毒病病例的临床表现、实验室检测、诊疗和流行病学调查进行描述性分析。结果 2016年2月19日,经中国CDC有关专家复核和专家会诊,我国义乌市确诊1例从斐济、萨摩亚旅游归来的输入性寨卡病毒病病例,病例曾在萨摩亚有蚊虫叮咬史。病例2月14日发病,15日出疹,16日出现结膜炎,16日收住入院,17日体温正常,19日皮疹消失,20日结膜炎消失。血液中寨卡病毒核酸检测阳性持续仅3 d,血液核酸检测阴性4 d后尿液仍可检测到核酸阳性。结论 该病例寨卡病毒病症状典型,早期可采集病例血液进行寨卡病毒核酸检测,体温正常后应采集尿液进行寨卡病毒核酸检测。     

江苏省首例输入性寨卡病毒病病例调查

目的分析江苏省首例输入性寨卡病毒病病例的流行病学特征,为寨卡病毒病防控提供依据。方法对南通市通州区一例输入性寨卡病毒病病例开展流行病学调查,采集患者血液、尿液和唾液标本进行核酸检测,采用布雷图指数法对外环境伊蚊进行应急监测。结果患者发病前一直居住于厄瓜多尔,有明确的蚊虫叮咬史。患者于2017年4月28日启程回国,并在当日发病。5月2日检测结果显示患者尿液标本寨卡病毒核酸呈强阳性,5月2日发热症状消失,5月4日皮疹、结膜炎、关节痛症状消失,并于当日对患者的血液和尿液标本再次进行核酸检测,检测结果均为阴性,5月8日治愈出院。以患者家庭为圆心200 m半径范围进行伊蚊应急监测,布雷图指数为3.40,经采取蚊虫消杀和环境整治措施后,布雷图指数降为0,处置后未发生二代病例。结论该起疫情由寨卡病毒引起,应加强临床医生培训、寨卡病毒病知识宣传,防蚊灭蚊是疫情防控的重点。     

中国首例输入性黄热病病例的流行病学调查

目的 描述中国首例输入性黄热病病例的发病就诊过程和流行病学特征,为今后黄热病输入性病例的管理提供依据。方法 通过传染病监测系统及时发现病例并对病例进行流行病学调查,采集病例血液和唾液标本,应用实时荧光PCR方法进行黄热病核酸检测。结果 患者为男性,32岁,2016年3月8日在安哥拉突发寒颤高热,10日凌晨抵京,下午入院治疗,11日北京市CDC实验室检测患者血液标本黄热病毒核酸阳性。患者症状持续加重,肝肾衰竭,肝性脑病,多器官功能衰竭,后于16日死亡。患者在发病前6日内有明确蚊虫叮咬史。结论 该病例为我国首例输入性黄热病确诊病例。对此例病例开展的流行病学调查、实验室检测和疫情处置措施,为今后对输入性黄热病疫情的规范处置提供了科学依据。     

河南省首例输入性寨卡病毒病流行病学调查

描述河南省首例输入性寨卡病毒病的发病就诊过程和流行病学特征,为防控寨卡病毒病提供工作经验和参考依据。对患者进行流行病学调查和临床诊治,同时收集血液、唾液、尿液样本进行寨卡病毒核酸检测。结果显示,该患者为河南省首例输入性寨卡病毒病确诊患者,其在寨卡病毒病疫源地危地马拉感染。该患者体温最高38.5℃,有咽痛,伴有全身麻疹样皮疹,无关节、肌肉痛,无腹痛、腹泻,睑结膜无充血。实验室检测结果显示,血液、唾液、尿液样本病毒核酸阳性并持续一段时间。对此患者的流行病学调查、实验室检测和疫情处置措施进行回顾总结,能够为河南省寨卡病毒防控工作提供经验。     

中国大陆首例输入性寨卡病毒感染病例临床表现及实验室检测结果分析

目的分析中国大陆首例输入性寨卡病毒感染病例的临床表现及实验室检测结果,为寨卡病毒病的预防控制提供参考依据。方法通过对病例进行流行病学个案调查,收集相关病历资料,并开展相关实验室检测,应用描述性流行病学方法对病例的临床表现及实验室检测结果进行分析。结果病例男性,34岁于2016年2月2日从委内瑞拉出发,途经中国香港、广东省深圳和东莞,于2月5日抵达江西省赣州市赣县,2月6日被收入赣县人民医院感染性疾病科接受隔离治疗,2月14日痊愈出院;病例临床表现为发热、头晕头痛、畏寒、乏力、皮疹、眼眶痛、结膜充血、腹泻等症状;病例白细胞和血小板值正常,单核细胞比率略有升高,凝血酶原时间略有升高,肝肾功能检查白蛋白、尿素氮、尿酸略有下降,左下肺轻度肺气肿改变;病原学检测结果显示,病例尿液标本寨卡病毒核酸存在时间较血清标本长,发病第15 d病例唾液标本未检出核酸阳性。结论本例病例为一典型但症状较轻的输入性寨卡病毒感染病例,对具有流行病学史且同时出现发热或皮疹等症状的归国人员进行排查,采集其血清、尿液等多种标本进行检测,有利于病例的早期发现、诊断和治疗。     

一例输入性寨卡病毒病调查报告

目的对浙江省温州市1例输入性寨卡病毒病进行现场调查,明确诊断,调查感染来源,分析输入性寨卡病毒病监测诊断中存在的问题,为防控工作提供参考。方法通过查阅患者病历和面访开展流行病学个案调查;采集患者发病48 h内的血液、尿液和唾液标本进行寨卡病毒核酸检测;根据温州市的蚊媒状况作传播风险评估并采取控制措施。结果患者于2016年2月21日启程从境外回国途中发病,发病前居住在南美洲苏里南首都帕拉马里博市,当地为寨卡病毒病流行区。患者发病前有暴露史,临床表现为在头面部、颈部、躯干和四肢出现红色弥漫性皮疹。但因无发热,曾一度被诊断为"过敏性皮疹",且两次血清标本核酸检测均为阴性,最后依据尿液和唾液标本核酸检测阳性,同时结合流行病学暴露史确诊为输入性寨卡病毒病。温州市虽有白纹伊蚊,但2月份气温较低,故该病例通过蚊媒传播的风险极低。结论寨卡病毒病可无发热症状,也可有血清标本核酸检测阴性的病例,应谨防漏诊;随着天气转暖,此类输入性病例一旦漏诊,极易经蚊媒传播扩散,因此要进一步完善疫情监测,做好蚊媒监控工作。     

寨卡入国门,我们该如何应对

正近日,国家卫生计生委通报我国大陆发现首例输入性寨卡病毒感染病例。此前,美国1例寨卡病例被确认并非通过蚊虫叮咬传播而是性传播,也就是说,寨卡病毒可以在人际间传播。寨卡已入国门,我们该怎么办?有消灭它的"必杀技"吗?     

专家述评

正《2016年美国佛罗里达州旅行相关寨卡病毒感染患者的尿液、血清和唾液标本中寨卡病毒RNA检测结果的对比分析》一文报道了美国佛罗里达旅行相关寨卡病毒病病例不同类型标本检测结果的比较,在913例患者中,91例符合寨卡病毒病确诊病例或疑似病例标准,发病都与旅游相关。尿液标本来自70例疑似病例,采集日期在发病当     

预防寨卡病毒问答录

正寨卡病毒是否仅通过蚊媒进行传播?目前我国已有输入性病例,在这种情况下,我国有流行的危险吗?寨卡病毒出现在蚊虫数量较多的热带地区,已知该病毒在非洲、美洲、南亚和西太平洋地区流行。但新年伊始,肆虐非洲和美洲的寨卡病毒陆续进入中国境内。自今年2月9日中国内地确诊首例输入性寨卡病毒感染病例以来,截至2月28日,一共确诊了8例,其中江西省1例,广东省3例,浙江省4例。寨卡病毒对中国影响有多大,病毒通过什么途径传     

核酸检测在寨卡病毒病诊断上的应用

目的研究核酸检测技术测定不同样本对我国输入性寨卡病毒(Zika virus)病患者的诊断价值,探讨核酸检测寨卡病毒临床标本的适用性。方法收集医院2016年2月-10月输入性寨卡病毒病患者的血液、唾液和尿液,用于寨卡病毒核酸检测。记录和分析患者临床症状、体征和实验室检验结果。结果血液、唾液和尿液寨卡核酸首次检测阳性率分别为61.5%、76.9%和76.9%;血液、唾液和尿液的核酸总检出阳性率分别为61.5%、84.6%和100%;血液、唾液和尿液核酸阳性持续时间平均分别为2.62、5.69和11.62天,血液没有1例阳性持续时间超过1周,唾液阳性持续时间没有1例超过10天,而尿液有11例核酸阳性超过1周(其中6例超过10天)。随着病程的发展,各样本的检出率也在下降,发病后第3天和第7天采样时,血液、唾液、尿液核酸阳性率分别为25%、100%、100%和7.7%、46.2%、84.6%。少数尿液标本检测阳性有一定滞后现象。结论检测尿液中寨卡病毒核酸具有检出率高、持续时间长的优点,应作为临床诊断寨卡病毒病的主要方法,但在发病早期仍然有必要采集血液、唾液和尿液进行多样本同时检测寨卡病毒核酸。     

Zika: the origin and spread of a mosquito-borne virus

ObjectiveTo describe the temporal and geographical distribution of Zika virus infection and associated neurological disorders, from 1947 to 1 February 2016, when Zika became a Public Health Emergency of International Concern (PHEIC).MethodsWe did a literature search using the terms “Zika” and “ZIKV” in PubMed, cross-checked the findings for completeness against other published reviews and added formal notifications to WHO submitted under the International Health Regulations.FindingsFrom the discovery of Zika virus in Uganda in 1947 to the declaration of a PHEIC by the World Health Organization (WHO) on 1 February 2016, a total of 74 countries and territories had reported human Zika virus infections. The timeline in this paper charts the discovery of the virus (1947), its isolation from mosquitos (1948), the first human infection (1952), the initial spread of infection from Asia to a Pacific island (2007), the first known instance of sexual transmission (2008), reports of Guillain-Barré syndrome (2014) and microcephaly (2015) linked to Zika infections and the first appearance of Zika in the Americas (from 2015).ConclusionZika virus infection in humans appears to have changed in character as its geographical range has expanded from equatorial Africa and Asia. The change is from an endemic, mosquito-borne infection causing mild illness to one that can cause large outbreaks linked with neurological sequelae and congenital abnormalities.     

Epidemiologic Features of Animal Bite Cases Occurring in Rabies-Endemic Areas of Korea, 2005 to 2009

ObjectivesHuman rabies is a reemerging infectious disease in Korea. There was no human rabies case for 14 years until the disease had reoccurred in 1999. To prevent occurrence of human rabies, surveillance for animal bite patients in rabies endemic areas in Korea was conducted since 2005 as a part of a human rabies control program. The animal bite cases were analyzed to determine whether patients were treated according to the post-exposure prophylaxis (PEP) guideline of the Korea Centers for Disease Control and Prevention.MethodsInformation of animal bite cases that occurred from 2005 to 2009 in rabies high-risk regions were collected by cooperation with Regional Public Health Centers in 18 cities/districts of rabies endemic areas.ResultsA total of 2458 animal bite cases were reported. Dogs accounted for 86% of animal bites and 67% of the animals were not vaccinated against rabies virus. For PEP, among rabies-vaccinated animals, 92.7% were observed for clinical signs and 1.4% underwent necropsy. Among unvaccinated animals, 72.7% were observed for clinical signs and 4.1% underwent necropsy. The remaining animals were not available for examination. Of the animal bite patients, 32.5% received PEP and 51.6% were treated by first aid or by washing the wound.ConclusionsGiven that no human rabies cases were reported since 2005 and animal rabies was continuously reported in endemic areas of Korea, the human rabies control program implemented in 2005 appears to have a significant role in the prevention and control of human rabies.     

寨卡病毒病若干流行病学问题

寨卡病毒病是由寨卡病毒引起并主要通过蚊媒传播的一种病毒性疾病。2015年在美洲地区发生大规模的传播与流行,因可能与新生儿小头畸形、格林-巴利综合征有关,2016年2月被WHO列为全球紧急公共卫生事件。本文搜集期刊、在线论文及WHO文件进行综述。寨卡病毒病的传染源主要为患者、隐性感染者及非人灵长类动物等;目前该病传染期尚不明确,但通过患者血液、唾液、精液及尿液DNA检测期推断,其传染期至少可达2个月;寨卡病毒主要经虫媒传播,但也可能通过母婴、血液及性传播。目前越来越多的证据支持寨卡病毒感染与小头畸形、格林-巴利综合征,脑膜脑炎以及其他神经和自身免疫综合征之间存在因果关系,但仍需更多的研究予以证实。依靠灭蚊、防蚊可阻断绝大多数的寨卡病毒感染,但仍需采取更多的措施预防寨卡病毒通过母婴、血液及性传播。该病目前仍有一系列的流行病学问题尚待解决,亟需更多的研究以全面地了解其流行病学规律。     

Experiencia de mujeres con infección prenatal por virus Zika que continuaron la gestación en Colombia

ObjectiveTo understand the decision-making process of a group of women to continue gestation following a prenatal Zika virus infection and the diagnosis of microcephaly of their fetuses.MethodQualitative study. Two discussion groups and semi-structured interviews were conducted with 21 women residing in the Department of Huila (Colombia) who presented a prenatal Zika virus infection between 2015 and 2016, their children were born with congenital microcephaly. The data were analyzed following the Grounded Theory approach.ResultsFour categories emerged from the analysis of the data showing a temporal process, from before to taking the decision to continue gestation following prenatal Zika virus infection to its consequences. The process begins with the diagnosis virus infection during the first trimester of gestation, continuing with medical recommendations to interrupt gestation and women's refusal to interrupt gestation, and ending with the birth of children with congenital microcephaly.ConclusionWomen rejected abortion due to ethical conflicts based on religious beliefs and the value of motherhood. It is necessary to design social support policies for women and families affected by this problem in Colombia. Due to the international impact of the epidemic, governments should take appropriate measures to deal with future cases of Zika infections in other countries.     

一起气溶胶暴露引起人感染H5N6禽流感病毒的流行病学调查

目的 分析1例由气溶胶暴露引起人感染H5N6禽流感病毒病例的发生和传播途径，为人禽流感防控提供依据。方法 对病例开展流行病学调查，明确病例暴露史及感染途径，追踪病例病情进展与转归。对病例、密切接触者、病家环境、禽类交易市场环境标本进行核酸检测。结果 病例无活禽、禽类交易市场暴露史，发病前1 d具有禽类临时存放密闭狭小环境气溶胶暴露史。病例下呼吸道提取物及病家冰箱剩余冷冻鸡块表面涂抹标本检出H5N6禽流感核酸阳性。结论 病例感染来源为批发市场购买的活禽，禽类临时存放密闭狭小环境气溶胶暴露可能为其感染途径。应在广州市范围推进"集中屠宰、冷链配送、生鲜上市"，加强健康宣教，树立消费生鲜禽肉的观念。     

长沙市1例人感染H3N8禽流感病例的流行病学调查和病原学分析

目的 了解人感染H3N8禽流感病例的流行病学特征和临床特征及其病原的分子生物学特征，为人感染H3N8禽流感防控提供科学依据。方法 采用流行病学调查方法对长沙市2022年5月1例人感染H3N8禽流感病例的可疑暴露史、感染途径、发病及就诊经过，以及密切接触者、可疑暴露者等涉疫重点人员进行现场调查，并进行描述性分析；采用核酸检测和基因测序技术，进行病原学检测和基因特征分析。结果 病例发病前6 d有活禽交易市场暴露史，在活禽交易市场、活禽来源批发市场均检测出禽流感H3、N8亚型阳性。深度基因测序显示，病毒对哺乳动物发生适应性突变，对烷胺类药物敏感性降低，未检测到神经氨酸酶抑制剂类药物和聚合酶抑制剂类药物相关的耐药性突变。结论 病例暴露于被H3N8禽流感病毒污染的活禽交易市场环境而感染，未发现人际间传播。     

Detection of Zika Virus in Urine

We describe the kinetics of Zika virus (ZIKV) detection in serum and urine samples of 6 patients. Urine samples were positive for ZIKV >10 days after onset of disease, which was a notably longer period than for serum samples. This finding supports the conclusion that urine samples are useful for diagnosis of ZIKV infections.     

U.S. pregnant women’s knowledge and attitudes about behavioral strategies and vaccines to prevent Zika acquisition

IntroductionZika virus infection during pregnancy can cause significant infant morbidity. Little is known about pregnant women’s attitudes regarding behavioral strategies and hypothetical vaccination to prevent Zika infections and sequelae.MethodsPregnant women across the United States (N = 362) completed an online questionnaire regarding attitudes about Zika, including six behavioral prevention strategies (i.e., abstaining from sex, using condoms, not traveling to an area with Zika, their partner not traveling into an area with Zika, using mosquito repellant, wearing long pants and sleeves) and vaccination.ResultsMost women (91%) were married/living with the baby’s father, 65% were non-Hispanic White, and 71% had been pregnant. Seventy-four percent were worried about Zika, while 30% thought they were knowledgeable about Zika. The mean knowledge score was 5.0 out of 8 (SD = 2.09), and the mean behavioral strategies score was 4.9 out of 12 (SD = 3.7) with a range of 0 (none would be hard to do) to 12 (all would be hard to do). In a multivariable model, having had a sexually transmitted infection, living/traveling in an area with Zika, and worrying about Zika were significantly related to reporting behavioral strategies as hard to do. Seventy-two percent would be willing to be vaccinated. In the multivariable model, living/traveling in an area with Zika, believing they knew a lot about Zika, worrying about Zika, and considering Zika vaccine development as important were significantly associated with willingness to get vaccinated.ConclusionsPregnant women were worried about Zika, yet had gaps in their factual knowledge. Most women reported they would get vaccinated if a vaccine was available. Pregnant women who reported themselves as vulnerable (being worried, having lived in or traveled to a Zika area) were more likely to view behavioral strategies as hard to do and to accept vaccination.