湖北省首起输入性登革热引起本地暴发流行的特征及处置效果分析  

Epidemic characteristics and treatment effect of the first dengue fever outbreak in Hubei Province

作　　者：戴本南[1] 王芬[1] 潘洁[1] 韩春生[1] 黄科 DAI Bennan;WANG Fen;PAN Jie;HAN Chunsheng;HUANG Ke(Huanggang Center for Disease Control and Prevention,Huanggang,Hubei 438000,China)

机构地区：[1]湖北省黄冈市疾病预防控制中心,湖北黄冈438000

出　　处：《公共卫生与预防医学》2020年第4期62-65,共4页Journal of Public Health and Preventive Medicine

基　　金：湖北省卫健委联合基金项目(WJ2018H264)。

摘　　要：目的分析2019年8月黄冈市黄州区发生的湖北省首起输入登革热病例引起本地感染暴发疫情流行特征,评价疫情处置效果,为今后防控登革热提供参考。方法依据病例定义回顾性搜索病例,检测患者血清IgM、IgG、NS1抗原和登革病毒核酸,应用双层叠帐法监测成蚊密度,应用布雷图指数法监测蚊幼密度。结果此起疫情自6月21日首例(输入)病例发病至9月11日末例病例发病,累计发现病例50例,流行高峰为8月20日至9月1日,无重症和死亡病例,主要临床表现依次为发热(94.00%)、乏力(78.00%)、头痛(48.00%)、肌肉关节痛(37.00%)、皮疹/出血点(26.00%)。病例分布于1个街道(禹王街道)内相邻的2个村(韦家凉亭村49例、樊家湾村1例)。病例男女性别比为0.85∶1,发病年龄以50岁及以上人群为主,占89.10%。职业分布以农民和家务及待业为主,各占26.10%,其次为工人13.00%。疫情家庭聚集性较为明显。有8例病例检测登革病毒核酸为阳性,基因分型为Ⅰ型登革病毒。应急响应启动后,黄州区各乡镇(街道)的村居环境均得到明显改善,BI均降至5以下。结论这是一起输入性登革热病例引起的本地暴发疫情,医务人员诊断识别能力不足、环境卫生差、蚊密度高是导致该起登革热疫情暴发的主要原因,防控重点是传染源的早期发现和规范管理,蚊媒孳生环境的制理和快速杀灭成蚊。Objective To analyze the epidemic characteristics of the first local outbreak of dengue fever in Huangzhou District,Huanggang City,Hubei Province in August 2019,to evaluate the treatment effect of the epidemic situation,and to provide reference for the prevention and control of dengue fever in the future.Methods Retrospective investigation was carried out according to the case definition.The serum IgM,IgG,NS1 antigen,and dengue virus nucleic acid of the patients were detected.The density of mosquito larvae was monitored by Breteau index and the density of adults was monitored by a double mosquito net method.Results A total of 50 cases were detected from the first case on June 21 to the last case on September 11.No severe cases or deaths occurred.The main clinical manifestations were fever(94.00%),weakness(78.00%),headache(48.00%),muscle and joint pain(37.00%),and skin rashes(26.00%).The epidemic peak was from August 20 to September 1.The cases were distributed in two villages adjacent to one street(Yuwang Street)(49 cases in Weijialiangting Village and 1 case in Fanjiawan Village).Among the patients,23 were male and 27 were female.The male to female ratio was 0.85∶1.The age of onset was mainly 50 years and above,accounting for 89.1%.The occupational distribution was dominated by farmers and housework and unemployed,each accounting for 26.10%,followed by workers at 13.00%.The epidemic family aggregation was obvious.Eight cases were positive for dengue virus nucleic acid and the genotype was DENV-1.From the discovery of the outbreak to the end of the emergency response,the living environment of villagers of all towns(streets)in Huangzhou District had been significantly improved,and BI of key streets dropped below 5.Conclusion This was a local outbreak caused by an imported case.Insufficient medical personnel for the diagnosis and identification,poor environmental sanitation,and high mosquito density were the main reasons for the outbreak of dengue fever.The focus of prevention and control is the early detection a

关 键 词：登革热 暴发疫情 本地病例处置 治疗 

分 类 号：R183[医药卫生—流行病学]