一起流行性出血热疫苗接种人员发病事件的应急调查  

Emergency investigation of an incident of renal syndrome hemorrhagic fever vaccine

作　　者：曾志笠 金媛 丁晟[1] 谢昀[1] 刘晓青[1] ZENG Zhi-li;JIN Yuan;DING Sheng;XIE Yun;LIU Xiao-qing(Emergency Infectious Disease Control Center,Jiangxi Provincial Center for Disease Control and Prevention,Nanchang,Jiangxi 330029,China)

机构地区：[1]江西省疾病预防控制中心应急传防所,江西南昌330029

出　　处：《现代预防医学》2020年第19期3614-3615,3644,共3页Modern Preventive Medicine

基　　金：江西省杰出青年人才资助计划(707056206014)。

摘　　要：目的分析江西省某县流行性出血热疫苗接种人员发病的原因,为今后类似事件的调查提供经验与借鉴。方法回顾性收集4例疑似病例的流行病学调查资料和疫苗接种资料,应用胶体金法和ELISA法对病例血清标本进行汉坦病毒IgM/IgG抗体检测。结果4例疑似病例均有流行性出血热疫苗接种史。病例1和病例4有发热、"三红"、"三痛"、水肿和尿蛋白阳性等出血热相关的症状,病例1汉坦病毒IgG抗体检测阳性,病例4的IgM和IgG阳性,病例2和病例3无出血热相关的典型症状,汉坦病毒IgM/IgG抗体检测阴性。依据流行性出血热诊断标准综合研判,病例1和病例4被确诊为流行性出血热病例,病例2和病例3排除流行性出血热。结论该起事件共发现2例流行性出血热确诊病例,2例误诊病例。建议加强医疗机构对出血热诊治知识的培训,提高医疗机构出血热的实验室诊断率,提升医疗机构流行性出血热病例的早发现和早诊断能力。Objective Toanalysis the causes of hemorrhagic fever with renal syndrome in a county in Jiangxi Province,and to provide experience andreference for future investigation of such events.Methods Epidemiological investigation data and vaccination data of 4 cases were retrospectively collected.The serum samples of Hantavirus IgM/IgG were detected by colloidal gold method and ELISA method.Results 4 cases of epidemic hemorrhagic fever had a history of epidemic hemorrhagic fever vaccination.Cases 1 and 4 had symptoms associated with hemorrhagic fever such as fever,"three red","three pains",edema,and urine protein positive.Case 1 was positive for Hantavirus IgG antibody,and case 4 was weakly positive for IgM and IgG.Case 2 and Case 3 were not associated with typical symptoms of hemorrhagic fever,and Hantavirus IgM/IgG antibody was negative.According to the comprehensive research judgment of epidemic hemorrhagic fever diagnostic criteria,cases 1 and 4 were confirmed as cases of hemorrhagic fever with renal syndrome,and cases 2 and 3 excluded hemorrhagic fever with renal syndrome.Conclusion A total of 2 confirmed cases of hemorrhagic fever with renal syndrome and 2 misdiagnosis cases were found in the incident.It is recommended to strengthen the training of medical institutions on the knowledge of hemorrhagic fever diagnosis and treatment,improve the laboratory diagnosis rate of hemorrhagic fever in medical institutions,and improve the early detection and early diagnosis ability of epidemic hemorrhagic fever cases in medical institutions.

关 键 词：流行性出血热 肾综合征出血热 流行病学调查 

分 类 号：R512.8[医药卫生—内科学] R181.8[医药卫生—临床医学]