一起出境游旅行团输入性基孔肯雅热疫情调查  

An imported case of Chikungunya fever among members of an outbound touring group:case survey and laboratory test

作　　者：张怡雯 姜晓林[2] 陈德颖 吕涛[3] 张国英[3] 张化江 王茂林 王显军 姜宝法[1] ZHANG Yi-wen;JIANG Xiao-lin;CHEN De-ying(Department of Epidemiology,School of Public Health,Cheeloo College of Medicine Shandong University,Ji'nan,Shandong Province 250012,China;不详)

机构地区：[1]山东大学齐鲁医学院公共卫生学院流行病学系,山东济南250012 [2]山东省疾病预防控制中心 [3]威海市疾病预防控制中心 [4]文登区疾病预防控制中心

出　　处：《中国公共卫生》2021年第5期879-882,共4页Chinese Journal of Public Health

基　　金：国家科技重大专项(2017ZX10104001)。

摘　　要：目的了解某出境旅行团基孔肯雅热(CHIKF)发病和感染情况,评估疫情输入后本地传播的风险。方法对2019年9月18—21日往返于缅甸曼德勒、蒲甘两市旅行团20名成员逐一进行个案调查,采集血清和尿液标本进行病毒核酸和特异性IgM抗体检测。用双层叠帐法和布雷图指数法对核心区进行蚊媒调查。间隔14 d后再次采集成员血清标本进行病毒特异性IgG抗体检测。结果旅行团成员85%(17/20)有蚊虫叮咬史,初次采集得到血清标本20份,尿液标本17份,经检测,基孔肯雅病毒核酸阳性1份。核心区应急蚊媒监测布雷图指数为5.38。再次采集得到血清标本20份,经检测,病毒特异性IgG抗体阳性1份。结论基孔肯雅热继续发生跨境传播到山东省的风险已不可避免,口岸、医院、疾控3方快速联动是防止境外传染病输入造成本地传播的关键。Objective To examine an incidence of Chikungunya fever and Chikungunya virus(CHIKV)infection among members of an outbound touring group and to evaluate local transmission risk of the imported case.Methods Follow-up surveys were carried out among all members(n=20)of a touring group travelling to Mandalay and Bagan of Burma and returning to Shandong province,China during September 18–21,2019.Twenty blood and 17 urine samples were collected among the members for the detection of nucleic acid and specific immunoglobulin M(IgM)antibody of CHIKV.And the regional mosquito vector density of the core epidemic area was estimated with double-stack ledger and the Breteau index method.Fourteen days later,the blood samples of the members were collected again for the detection of serum immunoglobulin G(IgG)antibody.Results The imported case was a 35 years old Chinese man with serum positive for CHIKV nucleic acid detected 3 days after the end of the travelling.Of all the members of the touring group,85%reported the history of mosquito bites.No serum CHIKV nucleic acid positive sample was detected except for the sample from the case.The outdoor Breteau index in the case-relaed core epidemic area was 5.38,which exceeded the transmission threshold and indicated a risk of disease transmission.All the blood samples were negative for serum IgM antibody and only the case′s blood sample was positive for serum IgG antibody.Conclusion There is a risk of imported case-related local transmission of Chikungunya virus in Shandong province and relevant prevention measures should be promoted.

关 键 词：输入性病例 基孔肯雅热(CHIKF) 应急处置 

分 类 号：R184.6[医药卫生—流行病学]