571例登革热病例不同年龄组临床特征分析

目的 分析瑞丽市不同年龄组登革热病例临床特征,为当地医疗卫生部门制订有效的登革热诊疗方案提供依据.方法 将2017-2018年瑞丽市人民医院收治住院的571例登革热病例根据年龄分为未成年组(1～18岁)、成年组(>18～60岁)和老年组(>60岁),对3组临床症状和体征、实验室生化指标进行分析.结果 571例登革热患者...     

老挝登革热流行特征研究进展

登革热是由携带登革病毒的白纹伊蚊或埃及伊蚊叮咬人类传播的一种重要虫媒传染病,主要流行在热带亚热带国家或地区。老挝登革热流行较为严重,1979年首次报道登革热病例,并自2008年起,建立了国家登革热数据报告系统,近年来,通过大量的登革热疫情特点、登革热媒介调查、登革病毒血清型监测及其防控措施等研究,基本弄清了老挝登革热流行特征,本文对老挝登革热流行特征研究进展进行综述。     

登革病毒感染模型研究进展

登革病毒属黄病毒属,是一种以蚊虫为主要传播媒介的RNA病毒,可以引起登革热、登革出血热以及登革休克综合征.近年来,登革热流行呈不断上升的趋势,发展成为威胁人类生命健康的重大公共卫生问题.但目前登革热的发病机制仍然不是很清楚,主要是由于感染登革病毒后,只有人类才表现出临床症状,所以急需一种合适的动物模型,来探讨登革病毒及其所致疾病的本质.本文为登革病毒感染模型研究进展的综述.     

登革病毒感染实验室诊断的研究进展

登革病毒（Dengue virus,DV）为黄病毒属成员,是引起登革热（Dengue fever,DF）和登革出血热（Dengue haemorrhagic fever,DHF）／登革休克综合征（Dengue shock syndrome,DSS）的病原体,有4种不同的血清型（1—4型）。主要传播媒介是埃及伊蚊和白蚊伊蚊。流行于热带和亚热带的100多个国家和地区,我国自1978年以来主要在海南、广东、广西、台湾和福建等东南沿海地区发生。世界卫生组织估计全球每年登革热发病人数约5千万到1亿,并导致25至50万登革出血热病例和2．4万人死亡。登革热已成为全球范围内严重的公共卫生问题,建立快速、简便、高效、廉价的登革病毒实验室检测方法是及时进行临床救治和流行病学调查,并最终控制其传播流行的可靠途径。现就目前已应用的登革病毒实验室检测方法作一综述。     

68 例登革热患者的临床诊治特点分析

目的 探讨登革热的临床病程及诊治特点,为登革热的临床诊治提供一定的参考依据。方法 对2013 年8 月~2013 年11 月期间我科收住的68 例登革热患者从临床表现特点、实验室检查、治疗过程及治疗效果、预后等方面进行分析总结。结果 临床主要表现为发热、皮疹、肌肉关节痛、血白细胞下降等。治疗以对症支持的综合治疗为主,预后较好,本组临床治愈67 例,1 例重型登革热表现为持续高热、消化道大出血死亡。结论 对于持续高热伴有皮疹、肌肉关节痛、血白细胞下降等的患者应注意排查诊断登革热,登革病毒抗体阳性有助于确诊本病。治疗以对症支持、预防并发症为主,预后良好。     

三氮唑核苷治疗登革热

登革热是由登革病毒引起、经蚊传播的急性传染病 ,以发热 ,皮疹 ,肌肉骨关节剧烈疼痛 ,淋巴结肿大 ,白细胞减少等为主要表现。治疗采用综合治疗和对症处理。近年有部分报道使用抗病毒药治疗 ,能缩短本病病程。 2 0 0 0年 6月至 10月 ,本院共收治登革热患者 14 4例 ,对其中部分患者使用抗病毒药三氮唑核苷治疗 ,观察病程恢复情况 ,现报道如下。资料与方法一、病例选择及分组全部患者均为该年度流行区内、流行季节本院住院患者。患者具有典型临床症状、体征和化验相应诊断指标 ,全部患者临床分型均为典型登革热 ,无出血型、休克型、脑型。全体…     

登革热实验诊断和疫苗的研究进展

登革病毒（dengue virus,DV）属于黄病毒科黄病毒属,是现今最重要的虫媒病毒。它可引起登革热（dengue fever,DF）,登革出血热（dengue hemorrhagic fever,DHF）和登革休克综合征（dengue shock sydrome,DSS）。全球有2．5亿人正受到感染登革病毒的威胁,100多个国家有地方性登革热传播。每年均出现几百万病例,是个较为严重的公共卫生问题。本文论述了登革热的流行病学概况、分子生物学特征以及实验室诊断和免疫保护方面的国内外研究进展。     

中缅边境地区孟定镇首次暴发登革热病例临床特征分析

目的 对中缅边境地区云南省耿马县孟定镇首次暴发登革热的住院病例流行病学特征和临床特征进行分析,为登革热临床诊治提供参考。方法 收集云南省耿马县孟定镇2015年收治住院的174例登革热暴发疫情病例的个案资料,对登革热住院病例的流行病学特征、临床症状、实验室结果、治疗转归等情况进行回顾性分析。结果 174例登革热住院病例均来自耿马县孟定镇,分别收治于孟定镇中心卫生院和孟康中医院,发病时间集中在2015年7—11月。其中男性99例（占56.90%）,女性75例（占43.10%）;年龄分布以18～35岁为主（72例,占41.38%）,民族分布以汉族为主（147例,占84.48%）,职业分布以农民为主（120例,占68.97%）。主要临床症状为发热（162例,占93.10%）、肌肉酸痛（123例,占70.69%）、畏寒（110例,占63.22%）、乏力（86例,占49.43%）和头痛（84例,占48.28%）。实验室检查出现白细胞计数降低89例（占51.15%）、血小板计数降低121例（占69.54%）、谷丙转氨酶升高23例（占13.22%）、谷草转氨酶升高70例（占40.23%）、乳酸脱氢酶升...     

中缅边境地区登革热患者临床特征分析

目的分析中缅边境地区云南耿马县登革热(DF)患者的临床特征,为当地DF诊疗方案的制定提供依据。方法收集2019年耿马县住院的DF患者急性期血清,采用BHK细胞培养法分离登革病毒(DENV),采用实时荧光定量PCR法鉴定DENV血清型;收集DF患者临床资料,采用Excel 2017和SPSS 20.0分析DF流行病学基本特征、临床症状、体征及实验室生化指标等。结果检测140例DF患者的DENV血清型,其中33例为DENV-1型,43例DENV-2型,64例DENV-3型。3种DENV血清型感染患者临床症状均主要表现为发热、肌肉酸痛、畏寒、乏力。DENV-1型感染者主要出现红细胞减少(69.70%)、低密度脂蛋白降低(72.73%)、乳酸脱氢酶升高(51.52%)(P0.05),DENV-2型感染者为血钾降低(44.19%)(P0.05),DENV-3型感染者以皮疹发生率降低(50.00%)和高密度脂蛋白降低(97.67%)为主(均P0.05)。结论中缅边境地区耿马县DF患者感染DENV型多样性高,临床特征较为复杂,建议当地相关卫生部门进一步加强对临床医师的培训,提高DF诊治能力,减少重症DF或死亡病例的发生。     

云南西双版纳州勐腊县一起登革热暴发疫情调查分析

目的分析云南省西双版纳州勐腊县2013年1起登革热暴发疫情的流行病学特征,为登革热控制提供依据。方法对所有登革热病例进行流行病学个案调查,疑似病例血清标本采用登革病毒NS1抗原法进行检测,用RT-PCR进行登革热病毒型别鉴定,采用布雷图指数法进行蚊媒密度监测。结果本次疫情流行历时35d,共发现病例44例,其中本地感染病例34例,输入性病例10例(景洪市7例、缅甸2例、老挝1例);病例主要集中在勐腊县城区,共28例,占63.64%(28/44);男女性别比为1.44:1,发病年龄最小4岁、最大75岁,以20~49岁年龄组为主,共33例,占75.00%;职业以农民、商业服务和家政及待业居多;共检出3个登革血清型(Ⅰ型、Ⅱ型和Ⅲ型),其中老挝输入病例为登革病毒Ⅱ型,缅甸输入病例为登革病毒Ⅰ型,其余为登革病毒Ⅲ型。结论该起疫情属于以登革病毒Ⅲ型为主,传播媒介白纹伊蚊和埃及伊蚊并存的暴发疫情。提示今后应进一步加强登革热输入病例的监测和蚊媒控制工作。     

3 dengue fever cases,infected during a group tour to the Philippines

We report three dengue fever cases, infected during a group tour to the Philippines. A 58-year old male experienced sudden onset of high fever 5 days after returning to Japan, followed by rash and thrombocytopenia. The other 2 cases experienced similar symptoms. Clinically suspected from the travel history, incubation time and the state of dengue fever epidemic in the Philippines, dengue virus infection was confirmed by the laboratory tests. The incidence and geographical distribution of dengue virus infection have greatly increased in recent years. There have been reports of Japanese travelers who visited dengue endemic countries, infected and developed symptoms after returning home. Dengue virus infection should be included in the differential diagnosis of the patients who develop high fever and rash after returning from tropical areas.     

登革病毒相关检测技术研究进展

登革病毒主要通过伊蚊传播,流行于(亚)热带,会导致登革热、登革出血热、登革休克综合征.因此,发展快速准确、简便价廉的登革病毒检测技术势在必行.目前主要包括有病毒分离、血清学检测、RT-PCR及其衍生技术和其他核酸扩增技术.该文将对上述检测技术作一综述.     

Dengue Hemorrhagic Fever: A State-of-the-Art Review Focused in Pulmonary Involvement

Dengue fever is an arboviral disease transmitted to humans through the bites of infected female Aedes mosquitoes. Dengue virus is a member of the Flaviviridae family, and human infection can be caused by any of the four antigenically distinct serotypes (DENV 1–4). The infection has become recognized as the most important and prevalent arboviral disease in humans, endemic in almost 100 countries worldwide. Nearly 3 billion people live in areas with transmission risk. Autochthonous transmission of the virus in previously disease-free areas, increased incidence in endemic areas, and epidemic resurgence in controlled regions could increase the risk of contracting more severe forms of the disease, such as dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). Symptomatic dengue virus infection can present with a wide range of clinical manifestations, from mild fever to life-threatening DSS. Thoracic complications may manifest as pleural effusion, pneumonitis, non-cardiogenic pulmonary edema, and hemorrhage/hemoptysis. No vaccine is currently available and no specific treatment for dengue fever exists, but prevention and prompt management of complications in patients with DHF can help reduce mortality. This review describes the main clinical, pathological, and imaging findings of thoracic involvement in DHF.     

福建省莆田市2007年登革热暴发的流行病学调查分析

目的调查分析2007年福建省莆田市登革热暴发的流行病学特征、影响因素,并对病原体的可能来源进行追踪。方法利用流行病学调查和疫情报告数据以及病毒分离株的序列信息,分析、阐明暴发的流行学特点及影响因素;从感染者体内分离病毒并进行病毒序列测定,分析本次暴发可能的病毒来源。结果本次暴发为登革II型病毒引起的登革热暴发流行。共报告确诊病例103例,波及5个乡镇,发病主要集中在9月8日-10月8日,多数病例发生在1-2个村(街道),发病具有时间和空间的聚集性特征,病例临床表现均为典型登革热特征,无临床严重或死亡病例。从病毒分离株的序列分析表明,导致暴发的病毒来源可能为东南亚。外界病毒传入、高白纹伊蚊密度和临床漏诊可能是导致该起登革热暴发流行的主要原因。结论本次暴发流行为一起由输入性病例引起,在当地扩散造成的登革II型病毒暴发,病毒的来源可能是东南亚一带。     

Dengue fever in international travelers.

Dengue virus infection is becoming increasingly recognized as one of the world's major emerging infectious diseases. Although only a few systematic studies have been conducted to assess the incidence and clinical course of dengue fever in travelers, it is now possible to estimate risk factors for travelers to areas of endemicity. Dengue virus and its vector, Aedes mosquitoes, benefit from human habitation and travel-related aspects of human behavior. Thus, travelers serve an important double role as potential victims of the disease and as vehicles for further spread of dengue.     

西尼罗病毒血清学检测技术研究进展

西尼罗热(West Nile Fever, WNF)是由西尼罗病毒(West Nile Virus, WNV)感染引起经蚊虫叮咬传播的一种人兽共患性疾病。WNV在世界上广泛分布,主要分布在欧洲、中东和北美等地。人对WNV普遍易感,WNF临床症状主要包括高热、全身乏力、头痛、肌肉酸痛等,并发神经性疾病致死、致残率高,早期实验室诊断WNV 感染对于患者治疗和防止疫情暴发或扩散具有重要价值。实验室检测WNV技术主要包括血清学试验、病毒分离技术和分子生物学检测技术;其中,血清学检测仍是目前使用最广泛的方法,包括中和试验、酶免疫法、免疫荧光试验、血细胞凝集抑制试验和补体结合试验等。本文就上述常用的WNV 血清学检测技术进行综述。     

Secondary dengue virus type 4 infections in Vietnam

This study was designated to describe clinical and biological features of patients with a suspected diagnosis of dengue fever/dengue hemorrhagic fever during an outbreak in Central Vietnam. One hundred and twenty-five consecutive patients hospitalized at Khanh Hoa and Binh Thuan Provincial hospitals between November 2001 and January 2002 with a diagnosis of suspected dengue infection were included in the present study.Viruses were isolated in C6/36 and VERO E6 cell cultures or detected by RT-PCR. A hemagglutination-inhibition test (HI) was done on each paired sera using dengue antigens type 1-4, Japanese encephalitis (JE) virus antigen, Chickungunya virus antigen and Sindbis virus antigen. Anti-dengue and anti-JE virus IgM were measured by a capture enzyme-linked immunosorbent assay (MAC-ELISA). Anti-dengue and anti-JE virus IgG were measured by an ELISA test. Dengue viruses were isolated in cell culture and/or detected by RT-PCR in 20.8% of blood samples. DEN-4 and DEN-2 serotypes were found in 18.4% and 2.4% of the patients, respectively. A total of 86.4% of individuals had a diagnosis of acute dengue fever by using the HI test and/or dengue virus-specific IgM capture-ELISA and/or virus isolation and/or RT-PCR. The prevalence of primary and secondary acute dengue infection was 4% and 78.4%, respectively. Anti-dengue IgG ELISA test was positive in 88.8% of the patients. In 5 cases (4%), Japanese encephalitis virus infection was positive by serology but the cell culture was negative. No Chickungunya virus or Sindbis virus infection was detected by the HI test. In patients with acute dengue virus infection, the most common presenting symptom was headache, followed by conjunctivitis, petechial rash, muscle and joint pain, nausea and abdominal pain. Four percent of hospitalized patients were classified as dengue hemorrhagic fever. The clinical presentation and blood cell counts were similar between patients hospitalized with acute dengue fever and patients with other febrile illnesses.     

Changing clinical and biological manifestations of dengue during the dengue-2 epidemic in French Polynesia in 1996/97 – description and analysis in a prospective study

In August 1996 dengue-2 virus was detected in French Polynesia for the first time since 1976. A prospective study was conducted from November 1996 to April 1997. Each time one of 7 physicians suspected dengue, the patient was enrolled and epidemiological, clinical and biological data were recorded. Dengue diagnosis was confirmed by virus isolation and IgM detection. The aims of this study were to find clinical and biological predictive factors constituting a specific profile of dengue (DF) and dengue haemorrhagic fever (DHF/DSS) and to assess the possibility of diagnosing dengue at primary health care level using clinical criteria and basic laboratory parameters. Of 298 clinically suspect cases, 196 (66%) were confirmed as dengue. The association of macular rash, pruritis, low platelet count and leukopenia was statistically predictive of dengue but not clinically, since these four signs occur in many other viral infections. As the prevalence of clinical and biological manifestations varied over time in our study, a specific profile useful for dengue diagnosis cannot be defined. With six cases of DHF, the morbidity of this dengue-2 outbreak was very low despite the sequential infection scheme DEN-3/DEN-2. The clinical expression of dengue could depend on a specific virus strain circulating in a specific population in a particular place, with varying virulence over time.