杭州市上城区35例猴痘流行病学特征分析与讨论  

Analysis and discussion on the epidemiological characteristics of 35 cases of monkeypox in Shangchengdistrict of Hangzhou city

作　　者：杨茜 倪志敏 方芳 YANG Qian;NI Zhi-min;FANG Fang(Hangzhou Shangcheng District Center for Disease Control and Prevention,Hangzhou,Zhejiang 310000,China;不详)

机构地区：[1]杭州市上城区疾病预防控制中心,浙江杭州310000 [2]苏州市相城区疾病预防控制中心,江苏苏州215100

出　　处：《现代预防医学》2024年第11期2084-2087,2093,共5页Modern Preventive Medicine

摘　　要：目的了解杭州市上城区猴痘病例的临床特点和流行特征,为猴痘疫情防控工作提供参考依据。方法收集2023年7—12月间杭州市上城区医疗机构发现的35例猴痘病例的基本人口学信息、临床表现、流行病学信息以及实验室检测结果等资料,分析病例的临床特点与流行特征。结果35例猴痘病例均为男男性接触者,中位年龄28岁(20~37岁),均无天花疫苗接种史,均通过主动就诊方式发现,其中25例(71.43%)承认在发病前21 d内有男男性行为,末次暴露时间至发病时间间隔为1~14 d,M(Q1,Q3)为6(5,9)d。临床症状以发热、皮疹、腹股沟淋巴结痛、肌肉酸痛为主;24例(68.57%)出现发热,35例均出现皮疹,其中9例(25.71%)皮疹伴疼痛,皮疹部位以生殖器或肛周为主,占比65.71%(23/35)。11例(31.43%)猴痘病例合并人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染,性传播疾病患病比例为48.57%(17/35)。所有病例均采集咽拭子和疱液拭子进行核酸检测,其中咽拭子阳性检出率为62.86%(22/35),CT值中位数为31,疱液拭子阳性检出率为100%(35/35),CT值中位数为22。结论猴痘临床特征以皮疹为主,临床医生对猴痘病例皮疹的识别是早期发现病例的关键。皮疹疱液标本猴痘核酸检测阳性率较高,高危人群出现皮疹症状后,应及时进行核酸检测,以实现早期诊断及治疗。Objective To understand the clinical features and epidemiological characteristics of monkeypox cases in Shangcheng district,Hangzhou city,providing reference basis for monkeypox epidemic prevention and control work.Methods Data on 35 monkeypox cases detected by medical institutions in Shangcheng district,Hangzhou city from July to December 2023 were collected,including demographic information,clinical manifestations,epidemiological information,laboratory test results,and the clinical features and epidemiological characteristics of the cases were analyzed.Results All 35 monkeypox cases were male sexual contacts,with a median age of 28 years(range:20 to 37 years).None had a history of smallpox vaccination,and all of them were identified through active medical consultation.Among them,25 cases(71.43%)admitted to having had male homosexual contact within 21 days before onset,with an interval from last exposure to onset ranging from 1 to 14 days,median(Q1,Q3)of 6(5,9)days.Clinical symptoms mainly included fever,rash,inguinal lymph node pain,and muscle soreness;24 cases(68.57%)presented with fever,all 35 cases had a rash,of which 9 cases(25.71%)had painful rashes,predominantly in the genital or anal region,accounting for 65.71%(23/35).Eleven cases(31.43%)of monkeypox cases were co-infected with Human Immunodeficiency Virus(HIV),with a 48.57%(17/35)prevalence of sexually transmitted diseases.Throat swabs and vesicle swabs were collected from all cases for nucleic acid testing,with a positive detection rate of 62.86%(22/35)in throat swabs,median CT value of 31,and 100%(35/35)in vesicle swabs,median CT value of 22.Conclusion The main clinical feature of monkeypox is rash,and the early recognition of skin rash by clinical doctors is key to early detection of cases.The high positive rate of monkeypox nucleic acid detection in vesicle specimens indicates the need for timely nucleic acid testing in high-risk individuals presenting with rash symptoms for early diagnosis and treatment.

关 键 词：猴痘 流行特征 男男性接触者 核酸检测 疫情防控 

分 类 号：R511[医药卫生—内科学] R181.3[医药卫生—临床医学]