深圳市1例发热伴血小板减少综合征病例调查与应急处置

目的 综合分析1例发热伴血小板减少综合征(SFTS)病例的流行病学特征和应急处置情况,为制定该病的应急处置措施和防控策略提供依据.方法 对病例、密切接触者和共同暴露者开展流行病学调查和实验室检测.在病例居住和工作场所及可疑暴露地开展寄生蜱和游离蜱等媒介密度监测,并对采集到的蜱虫开展布尼亚病毒(SFTSV)核酸检测.对病...

Investigation and analysis of emergency monitoring results of a severe fever with thrombocytopenia syndrome in Shenzhen

Objective To comprehensively analyze the epidemiological characteristics and emergency treatment of a case of severe fever with thrombocytopenia syndrome (SFTS), analyze the suspected sources of infection, and provide a basis for the development of emergency treatment measures and prevention and control strategies of SFTS. Methods Epidemiological investigation and laboratory tests were carried out among the cases, close contacts and co-exposed persons. The density of parasitic ticks and free ticks was monitored at the living and working places of the cases and the suspected exposure sites, and SFTSV nucleic acid test was performed on the collected ticks. Case search and emergency monitoring was carried out in medical institutions around the living and working places of the cases, and serological monitoring was carried out among healthy people around the living and working places. The flag method was used to monitor tick density in places exposed to suspected cases, and case search and emergency monitoring were carried out in medical institutions and communities. IgM and IgG antibodies were detected by ELISA, nucleic acid was detected by RT-PCR and nucleic acid was sequenced by Sanger sequencing. Results The case had no travel history or contact history with confirmed/suspected cases 14 days before onset of the disease. The blood sample was positive for SFTS bunyavirus nucleic acid by RT-PCR. Parasitic ticks were collected from dogs in residential and workplace, and identified as Rhipicephalus sanguineus. Free-living ticks were not collected by flagging method, and SFTSV was not detected in ticks and dogs. PCR nucleic acid test was performed on the blood sample of the patient, and the result was positive for SFTS bunyavirus nucleic acid test, confirming the case of SFTS. One factory colleague and one healthy person were found to be IgM positive and SFTSV nucleic acid negative. The nucleic acid of the virus was detected as HB2012-197 by Sanger sequencing method, which was approximately homologous to the epidemic strain in Hubei Province. Case searches and emergency surveillance have found no additional cases, and no locally acquired cases or outbreaks have ever been reported in the area where one lives or works. Conclusion The evidence of local infection is insufficient, and the source of infection is likely to be associated with Hubei Province. Follow-up surveillance of cases and vectors should be strengthened to improve the ability of early detection, early investigation and early prevention and control. It took a long time for the case to be diagnosed, suggesting that medical institutions should strengthen training on the disease and improve the ability of early diagnosis of the disease.