东莞市首起社区登革热暴发疫情流行病学调查

目的:对东莞市首起登革热社区暴发疫情进行调查分析。方法:采用现场流行病学调查方法了解疫情波及范围、病例分布情况及可能传播来源;采用ELISA法进行登革热IgM抗体检测。结果:2010年7月22日～10月26日,东莞市兴塘社区发生了一起登革热社区暴发疫情,共报告病例40例,其中确诊病例24例,可疑病例16例;病例的主要临床特征为发热(92.50%)、头痛(82.50%),血小板及白细胞减少分别占57.50%和52.50%;病例表现为首发病例住家200米范围内的聚集性;首发病例发病前有东南亚国家旅游史。结论:症状不典型输入性病例容易引起本土疫情,人员的高流动性易造成登革热疫情的扩散;控制疫情的关键是开展灭蚊和清除蚊虫孳生地的工作并在短时间内将布雷图指数降至5以下的水平。     

广东阳江市2001和2006年两次登革热流行特征分析

目的分析阳江市2001和2006年两次登革热流行特征，为今后防制工作提供参考。方法收集临床个案和疫点流行病学调查资料；病人采血检测登革病毒IgM抗体，用C6／36细胞分离登革病毒，并用单克隆抗体鉴定型别。结果阳江市2001年8月初至11月初发生登革热流行流行102d，高峰8上旬～10月中旬，确诊136例，发病率为5．31／10万；2006年6月下旬至9月上旬发生疫情，共流行67d，高峰8月中下旬，确诊22例，发病率0，84／10万；病例的消长情况与当地的蚊媒消长情况一致；8～11月份布雷图指数为0．00～111．00；实验诊断150例，临床确诊8例，从13例病人血标本中分离到11株病毒，均为登革病毒Ⅰ型。结论阳江市两次流行的登革热病例病情以轻型居多，发病人群以青壮年为主，人群在流行后经过5～6年普遍易感，流行高峰在8～10月，皆发现白纹伊蚊是当地的传播媒介。     

深圳市福田区2005~2013年登革热疫情及流行风险分析

目的了解深圳市福田区登革热流行现状、分布特征,为防治登革热提供科学依据。方法收集2005~2013年福田区登革热报告病例资料,建立数据库并进行流行病学分析。结果 2005~2013年福田区共报告登革热病例24例,输入性病例13例,占54.17%,本地病例11例,占45.83%,每年输入性病例在7~10月最多,主要源于东南亚。24例病例发病至报告时间中位数为6d,波动范围3~13d。初诊至诊断的时间中位数为2 d,波动范围为0~11d,属于最不稳定的时间段。结论福田区登革热发病率较低,以输入性病例为主,建议加强从东南亚等重点国家入境旅客的检疫查验;影响登革热病例发病至报告的间隔主要为发病至初诊的时间,建议加强社区健康教育宣传,加强临床医生知识培训以及加快推广登革热快速检测技术。     

气温对亚热带季风气候内陆城市登革热传播的影响

目的 以江西省樟树市为例探究气温对登革热传播的影响,为亚热带季风气候内陆城市登革热监测预警提供理论依据。方法 收集樟树市2019年本地感染登革热病例及同时期气温数据,利用核密度分析、标准差椭圆、交叉相关分析等方法分析了登革热时空变化及其与气温因子的关系。结果 樟树市登革热发病具有明显的时空分异特征。从时间上看,2019年8—9月登革热发病数先升高后降低,在8月29日达到峰值,日新增病例为64例。随后新增病例开始减少,9月11日以后无新增病例。从空间上看,人口密集、卫生条件相对较差的老城区（淦阳街道、鹿江街道及福成街道）登革热病例密度最高,而随着与市中心城区距离的增大登革热病例密度逐渐递减,登革热有从中心城区向周边区域辐射的趋势,主要向东北和西南方向扩散。相关分析显示,登革热病例数与最高气温、积温呈正相关关系,并存在明显的滞后效应,以滞后5~10 d,滑动平均7~10 d的相关性最高。登革热病例扩散率与最高气温、最低气温以及积温均呈正相关关系,但未见明显的滞后效应。结论 气温对登革热的传播与扩散有重要影响,及时掌握最高气温、最低气温、积温的变化趋势,尽早采取措施是登革热防控的关键。     

The first patient with locally acquired dengue fever in Hong Kong

This report is of the first locally acquired case of dengue fever. The diagnosis was made even in the absence of a history of travel outside Hong Kong. The patient was a 21-year-old man, who presented with high fever, leukopenia, thrombocytopenia, and elevated liver enzymes. His haematocrit revealed mild haemoconcentration but the albumin was normal throughout the course of the illness. His blood pressure remained low with no tachycardia or overt shock syndrome. The pyrexia subsided 4 days after admission to hospital and all haematological and biochemical abnormalities eventually normalised. The pathogenesis, diagnostic criteria of dengue haemorrhagic fever and dengue shock syndrome, and control of dengue infection are discussed.     

广州市番禺区2006年登革热疫情分析

目的分析广州市番禺区2006年登革热疫情的流行特征,为预防和控制登革热提供依据。方法对登革热的病例个案进行流行病学调查及疫情资料进行分析,对疫点及非疫点的蚊媒进行监测。结果番禺区2006年共报告登革热病例189例,其中实验室确诊病例166例,临床诊断病例23例。发病高峰出现在8月下旬至9月上旬,全区病例以市桥街为主(占全区病例的79.89%),男性91例(占病例总数48.15%),女性98例(占病例总数51.85%),男女发病比为1:1.08。以工人、家务待业人员以及离退休人员居多,占病例总数的49.21%。常规蚊媒监测,布雷图指数最高为7月,而在疫区8月至10月都有波峰出现。结论广州市番禺区存在登革热流行的基本条件,应加强对蚊虫及疫情的监测,控制登革热的暴发。     

论广州市2012年登革热确诊病例流行病学特征及核酸检测分析

目的了解广州市2012年登革热的流行情况。方法收集广州市2012年登革热确诊病例的流行病学资料和血清标本,用荧光定量PCR检测并确定血清型。结果广州市2012年登革热发病率较2011年上升,发病高峰在9～10月间。输入地以东南亚为主,马来西亚和柬埔寨是主要的输入国家。流行地区以老城区为主,越秀区发病数居首位。4种登革热血清型均有检出,以4型为主。结论广州市登革热疫情形势不容乐观,存在登革热暴发的潜在风险,疫情防控形势较为严峻。     

广州增城市一起输入性登革热暴发的流行病学调查分析

目的分析广州增城市2006年一起输入性登革热暴发的流行病学特征，为制定预防控制措施以及在暴发疫情中进行索源调查提供科学依据。方法采用流行病学调查和回顾性病例搜索，对该起登革热疫情调查分析；采用间接免疫荧光法对病例血清进行登革热抗体检测；用布雷图指数（BI）进行蚊媒密度调查。结果病例刘某为实验室确诊病例，无外出史；索源调查发现的病例黄某及其侄子血清登革热IgM、IgG均阳性，有疫区活动史，发病时间与刘某发病在一个潜伏期内。结论该病例为增城市2006年首例报告登革热确诊的本地感染病例，感染来源为区外输入性；早期被误诊，传染源未被及时发现是导致本次疫情的重要原因；迅速灭蚊和消除伊蚊孳生地是控制疫情的有效措施；多部门参与、组织专业队及时扑救疫情是迅速控制登革热流行的幸兽原因．     

2005年汕头市登革热定点监测结果分析

目的 通过定点监测为汕头市登革热流行趋势的预测、预警和制定防治对策、措施提供科学依据。方法收集监测点的登革热疫情、人群抗体水平和媒介伊蚊等监测资料，用EPI2002软件统计分析。结果2005年汕头市无登革热疫情，抗登革热病毒IgG、IgM阳性率低，伊蚊幼虫孳生密度高峰在6、8、9、10月份，低谷在4、7、11月份，孳生情况随着月平均降水量、平均气温变化而变化；孳生场所以农村、暂时性容器为主。结论汕头市有登革热流行的自然、社会环境条件，人群普遍对登革热易感，8～10月是发动爱国卫生运动，清除伊蚊孳生地，预防、控制登革热流行的适当时机。     

广州2010年首例本地感染登革热病例调查与分析

2010年4月广州传染病监测系统报告1例登革热疑似病例,经流行病学调查、血清学检测和病原学分离培养等实验室检测,最终确定该病例为2010年广州市首例本地感染登革热病例,亦是广州市历年来发病及报告时间最早的本地感染登革热病例,感染来源不明,这对广州市登革热疫情的发生具有重要的流行病学意义。本次疫情经积极的调查和处理,无二代或继发病例发生,疫情防控措施及时有效。     

汕头市2006年登革热的流行情况及防制对策

目的分析2006年汕头市登革热流行特征和防治措施,探索适宜的防制对策。方法对2006年汕头市登革热监测、实验室结果及疫情调查处理进行综合分析。结果汕头市2006年报告登革热177例,发病率为18.72/10万。疫情波及1区个8个镇（街道）,病例集中在9-10月份,流行期为53d。临床表现以轻型登革热为主。在7份急性期病人的血标本中分离出3株登革Ⅰ型病毒。病例以多点散发流行为主。疫点媒介密度高,传染源未及时发现是造成传播扩散的主要因素;设立定点医院,开展地毯式病例搜索和清理伊蚊孳生地是疫情得到较快控制的主要措施。结论2006年汕头市登革热疫情是由登革Ⅰ型病毒引起的,病例临床症状轻。以疫情多发区为中心,以周边区为重点,采取加强传染源控制管理和清除蚊媒孳生地及疫点紧急灭蚊等综合措施,是较快扑灭疫情的有效防制对策。     

辽宁省锦州市首例输入性登革热病例的调查、快速检测方法与防控探讨

目的通过调查总结输入性登革热的防治经验,并建立Taqman MGB实时荧光PCR技术快速检测登革热病毒,更好地指导今后登革热防制工作。方法流行病学调查,利用Taqman MGB技术,根据登革病毒3’端非编码区一段序列,设计登革1~4型荧光PCR通用引物和探针,以DF病毒株作为标准,以乙脑毒株作阴性对照,建立荧光PCR检测DF的快速方法。同时给予1份ELISA法检测阳性的临床血清标本进行荧光PCR扩增。结果采用PCR引物对登革1~4型病毒进行扩增,与设计相符;而乙型脑炎病毒均无非特异性扩增条带,对引物的相关性实验结果表明引物之间不会因相互干扰而出现假阳性结果,1份疑似患者血标本RT-PCR扩增阳性率为83.3%(25/30),其核酸序列与登革1型病毒柬埔寨株以及中国1997、1999年流行株GD14/97、GD05/99同源性分别为97%。结论在今后的登革热防控工作中,我们应用RT-PCR检测方法时间短、灵敏性高、有较高的特异性,以此作为为DF的临床早期诊断方法;其次重点加强出国和归国人员的管理,开展登革热防治知识的宣传教育,建立和其他部门的登革热联防体制,加强基层医务人员登革热防治知识培训,提高基层医务人员登革热诊治水平,来达到控制登革热的目标。     

Epidemiological and clinical features of dengue versus other acute febrile illnesses amongst patients seen at government polyclinics

Classical dengue fever is characterized by the clinical features of fever, headache, severe myalgia and occasionally rash, which can also be caused by a number of other viral and bacterial infections. Five hundred and fifty eight patients who fulfilled the criteria of clinical diagnosis of acute dengue from 4 government outpatient polyclinics were recruited in this prospective field study. Of the 558 patients, 190 patients were categorized as acute dengue fever, 86 as recent dengue and 282 as non-dengue febrile illnesses based on the results of a number of laboratory tests. Epidemiological features of febrile patients showed that the mean age of patients in the dengue fever group was significantly younger in comparison with patients in the non-dengue group. There was no significant difference between the two groups with respect to gender but there was significant ethnic difference with foreign workers representing a higher proportion in the dengue fever group. Patients with acute dengue fever were more likely to have patient-reported rash and a history of dengue in family or neighbourhood but less likely to have respiratory symptoms, sore-throat and jaundice in comparison to patients with non-dengue febrile illnesses. As with patients with dengue fever, patients in the recent dengue group were more likely to have history of patient-reported rash and a history of dengue contact and less likely to have respiratory symptoms in comparison to patients with non-dengue febrile illnesses. In contrast to patients with dengue fever, patients in the recent dengue group were more likely to have abdominal pain and jaundice in comparison to non-dengue febrile patients. The finding strongly suggests that a proportion of patients in the recent dengue group may actually represent a subset of patients with acute dengue fever at the late stage of illness.     

广州市1例境外误诊登革热的新型冠状病毒肺炎病例调查

对1例境外误诊为登革热的新型冠状病毒肺炎（coronavirus disease 2019,COVID-19）进行流行病学调查,探讨被误诊的可能关键环节,为制定登革热流行期的新型冠状病毒肺炎防控策略提供依据。运用描述性流行病学方法对COVID-19病例及其密切接触者和可疑感染来源进行调查和分析,采用RT-PCR方法进行新型冠状病毒核酸检测、免疫层析法进行登革热病毒抗原、抗体检测。结果该COVID-19病例于病前14 d有武汉和柬埔寨居住史,2020年1月23日发病,在柬埔寨“某集团医院”门诊就诊1月30日检测登革热抗原NS1结果为可疑阳性,登革热抗体IgM、IgG结果均为阴性,该医院诊断为“可疑登革热”。1月31日凌晨,病例入境广州在某酒店隔离观察。经酒店驻点医务人员为病例采血送海珠区疾病预防控制中心以免疫层析法（胶体金）排查登革热,结果登革病毒NS1抗原阴性,IgM、IgG抗体均为阴性,排除“登革热”。1月31日医院采集咽拭子标本检测,结果新型冠状病毒核酸阳性,以“新型冠状病毒肺炎疑似病例”网络直报,2月1日广州市疾病预防控制中心复核新型冠状病毒核酸阳性,以“新型冠状病毒肺炎确诊病例”进行订正。COVID-19早期症状与登革热相似。在登革热流行期,做好登革热与COVID-19早期鉴别诊断非常重要,早诊早治,是预防疫情扩散的关键。     

Role of primary care providers in dengue prevention and control in the community

Dengue fever is a major public health threat in Malaysia, especially in the highly urbanized states of Selangor and the Federal Territory of Kuala Lumpur. It is believed that many seek treatment at the primary care clinics and are not admitted. This study aims at establishing the fact that primary care practitioners, as the first point of patient contacts, play a crucial role in advising patients suspected of having dengue to take early preventive measures to break the chain of dengue transmission. A total of 236 patients admitted to two government hospitals for suspected dengue fever were interviewed using a structured questionnaire over a one week period in December 2008. It was found that 83.9% of the patients had sought treatment at a Primary Care (PC) facility before admission to the hospital, with 68.7% of them seeking treatment on two or more occasions. The mean time period for seeking treatment at primary care clinic was one and a half (1.4) days of fever, compared to almost five (4.9) days for admission. The majority of patients (96-98%) reported that primary care practitioners had not given them any advice on preventive measures to be taken even though 51.9% of the patients had been told they could be having dengue fever. This study showed the need for primary care providers to be more involved in the control and prevention of dengue in the community, as these patients were seen very early in their illness compared to when they were admitted.     

A case report: intracranial haemorrhage in a patient with probable dengue fever

We present a rare case of a patient diagnosed with probable dengue fever sustaining an intracranial haemorrhage after a trivial motor vehicle accident. From the literature reviewed, it was noted that there have been no reports of dengue fever presenting with an intracranial haemorrhage, and the association is more common in patients diagnosed with dengue hemorrhagic fever and/or dengue shock syndrome.     

登革热数学模型及其应用研究（I）——兼评Newton的登革热传播模型

80年代海南省曾两次发生大规模的登革热暴发流行。为了深入研究登革热的流行规律和评价不同防治措施的效应,我们在分析登革热疾病生态学、制定传播流程图和重新给出蚊虫出生率、死亡率定义的基础上,建立了一个登革热的确定性微分方程模型。并以海南省两个登革热流行的现场资料检验了模型的可靠性,结果显示观察值与预测值之间有很好的吻合。表明模型很好地反映了登革热的流行规律及各流行病学因子之间的定量关系。同时,将我们的模型与Newton的登革热模型作了深入、详细的分析比较。     

广州市2010-2012年登革热临床诊断报告现况分析

目的分析广州市2010-2012年登革热病例诊断报告情况,探讨登革热病人发病后到疫情报告的影响因素,为进一步加强疾病监测,避免登革热疫情扩散蔓延提供参考。方法对广州市2O10-2012年网络直报病例、部分现场调查病例的发病后就诊、诊断、报告等时间间隔特点进行分析,探讨登革热病人从发病至报告中各环节时间问隔的影响因素。结果 311例网络直报病例中,发病至诊断的时间为发病至报告的主要时间段(中位数7 d),原始报告为确诊病例(临床诊断病例及实验室诊断病例)的发病至诊断时间较原始报告为疑似病例的发病至诊断时间长(中位数相差1 d),其差异有统计学意义(P0.05)。259例现场调查病例中,影响登革热病例从发病至报告的时间最主要的是发病至诊断的时间(中位数8 d)。结论广州市登革热疫情报告及时性的主要影响因素为病例诊断的及时性,各相关单位应提高及早发现病例、及早报告,及早处理的能力。     

Dengue encephalitis: why we need to identify this entity in a dengue-prone region

Classical dengue fever is commonly seen in children and young adults. It commonly presents with fever, severe headache, body ache and retro-orbital pain. Unlike other arboviral infections, dengue virus does not usually cause neurological manifestations. We report a 13-year-old boy with dengue encephalitis. Dengue encephalitis should be considered in the differential diagnosis of acute viral encephalitis especially in countries like India where dengue has assumed epidemic proportions. These undiagnosed cases are at risk of developing complications of dengue haemorrhagic fever.     

Serum transaminase level changes in dengue fever and its correlation with disease severity

It was observed that liver enzymes are elevated in dengue fever. In this study our aims were to determine the changes in serum transaminases in dengue fever, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) and to find out the relation of transaminase level changes with the disease severity. This cross sectional, prospective hospital based observational study was carried out in the department of Gastrointestinal Hepatobiliary and Pancreatic diseases and Internal Medicine department of BIRDEM Hospital, Dhaka. Patients are classified into 3 groups depending on clinical & laboratory findings: Group 1 dengue fever (DF), Group 2 dengue hemorrhagic fever & Group 3 dengue shock syndrome. A total of 240 cases were taken in this study who fulfilled the selection criteria. Out of whom 125 male and 115 female patients. DF was 157(65.4%) & DHF was 83(34.6%). Aminotransferases [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] were significantly raised in DHF cases compared to those of classical dengue fever (AST 84.5±42.4 in DF vs. 507±106.8 IU/L in DHF and ALT 59.9±31.3 in DF vs. 234±30.6 IU/L in DHF). The rise of AST is far greater than ALT in both DF and DHF. Dengue fever is usually associated with mild to moderate elevations of aminotransferase levels. The increase in aminotransferases, mainly AST has been associated with disease severity and serves as an early indicator of dengue infection.