2023年湖北省某地一起发热伴血小板减少综合征聚集性疫情调查  

Epidemiological investigation of an epidemic of severe fever with thrombocytopenia syndrome in a county in Hubei,2023

作　　者：罗银波 刘力[1] 黄鑫胜 徐俊 刘漫[1] 李粉粉 官旭华[1] 童叶青[1] 吴杨[1] Luo Yinbo;Liu Li;Huang Xinsheng;Xu Jun;Liu Man;Li Fenfen;Guan Xuhua;Tong Yeqing;Wu Yang(Hubei Provincial Center for Disease Control and Prevention,Wuhan 430070,Hubei,China;Huanggang Prefectural Center for Disease Control and Prevention,Huanggang 438000,Hubei,China;Qichun County Center for Disease Control and Prevention,Qichun 435300,Hubei,China)

机构地区：[1]湖北省疾病预防控制中心,湖北武汉430070 [2]黄冈市疾病预防控制中心,湖北黄冈438000 [3]蕲春县疾病预防控制中心,湖北蕲春435300

出　　处：《疾病监测》2024年第8期1085-1089,共5页Disease Surveillance

基　　金：湖北省青年拔尖人才项目(No.202110)。

摘　　要：目的 调查2023年8月湖北省某地一起发热伴血小板减少综合征(SFTS)聚集性疫情的感染来源和传播途径,提出防控建议。方法 制定病例定义,搜索病例,开展病例及相关人员的流行病学调查,描述病例的基本情况、发病就诊经过,分析感染来源和传播途径,开展蜱密度、带病毒率和健康人群血清学监测。结果 本起疫情波及2例病例,死亡1例,续发1例,流行病学调查分析认为首发病例被环境蜱叮咬导致发病的可能性大,续发病例因无防护措施接触患者血液从而导致感染,病例搜索未发现其他关联病例。蜱密度监测结果显示,病例家周边农村外环境中游离蜱的平均密度为16只/(布旗100 m·h);宿主动物中,家犬带蜱指数为9只/宿主,经鉴定均为长角血蜱,均未检出发热伴血小板减少综合征病毒(SFTSV);血清学监测结果显示92名健康人群血清抗体IgM均为阴性,其中28人抗体IgG阳性,抗体阳性率为30.43%。结论 本起疫情为该县首起SFTS家庭聚集性疫情,当地蜱密度和人群抗体阳性率较高,提示SFTSV可能已在当地流行,应进一步加强医疗机构SFTS病例监测和医务人员培训,提高诊断和救治水平;加强重点地区人群健康教育,提高防护意识,降低疾病传播风险。Objective To understand the infection source,transmission routes of an epidemic of severe fever with thrombocytopenia syndrome(SFTS)in a county in Hubei province in August 2023,and put forward prevention and control recommendations.Methods In this study,case definitions were developed for case finding,and then an epidemiological investigation was conducted,the basic characteristics,illness onset and hospital or clinic visits of the cases were described,and the infection source and transmission route were analyzed.Finally,tick density and virus carriage surveillance and serological test for healthy population were carried out.Results Two cases were reported in this epidemic,i.e.1 primary case(death)and 1 secondary case.Epidemiological investigation and analysis results showed that the first case might be bitten by environmental ticks,and the secondary case was infected due to contact with the first case's blood without protection,and case finding found no other associated cases.Tick density surveillance results showed that the mean density of free-living ticks was 16 ticks/(flag 100 m·h)and the density of dog-parasitic ticks was 9/host around the cases’home,and all of the ticks were identified as Haemaphysalis longicornis,which were negative for specific nucleic acids of severe fever with thrombocytopenia syndrome virus(SFTSV).The results of serum antibody testing of 92 healthy persons showed that all of them were IgM negative,and 28 of them were IgG positive,with an IgG positive rate of 30.43%.Conclusion This epidemic was the first family clustering of SFTS cases in the county.Local tick density and population antibody positive rate were high,suggesting SFTSV might being circulated in the local area.Therefore,SFTS surveillance and training in medical institutions should be further strengthened to improve the level of diagnosis and treatment.The health education about self-protection in population in key areas should be improved to reduce the risk for the transmission of the disease.

关 键 词：发热伴血小板减少综合征 家庭聚集性 流行病学调查 蜱 

分 类 号：R211[医药卫生—中医学] R373