贵州省首例C群流行性脑脊髓膜炎的发现及处理

Detecting and Conducting of the First Case of Group C Meningooccus in Guizhou Province

目的分析贵州省首例C群流行性脑脊髓膜炎(流脑)的发现及处理情况。方法访视病例发病前后的相关知情人,查阅临床病历,对病例及其密切接触者进行医学观察。采集病例脑脊液、血液以及病例密切接触者的咽拭子标本,采用乳胶凝集试验、荧光定量聚合酶链反应(PCR)、酶联免疫吸附试验对病例标本进行检测。结果2007年在遵义县发现贵州省首例C群流脑。病例的脑脊液、血清标本检测结果为C群脑膜奈瑟菌(Neisseria men-ingitidis,Nm),病例脑脊液标本经中国疾病预防控制中心传染病预防控制所国家重点实验室用PCR复核,证实为C群Nm。在其密切接触者中未分离到相关菌株。该病例于2006年6月接种过A群脑膜炎球菌多糖疫苗,无外出史。结论采取了包括主动搜索、主动监测、预防服药和健康教育等多项措施,未造成流行。此例C群流脑的出现,对贵州省流脑的预防控制提出了新的挑战。

Objective To analyze the detection and conduction on the first case of group C meningococcus in Guizhou province. Methods Information on epidemiology and clinical manifestation of the case was eollected from interviewing the keyman and referring to related medical records. Medical check-up was undergone among the close contacts of the cases. Cerebral spinal fluid of the case was collected and tested by Neisseria meningitis culture,latex agglutination and PCR Throat swab of the close contacts of the cases were collected and tested by Neisseria meningitis culture. Serum of the case including acute and convalescent pha- ses were also collected and tested by ELISA assays to detect C-special antibody. Result It is first time for Guizhou Provincial Laboratory for Epidemic Cerebrospinal Meningitis to detect C Neisseria meningitis by both latex agglutination and ELISA from cerebral spinal fluid and serum of the case at Tiechang township of Zunyi County sent by Guizhou Province, C. Neisseria meningitis was detected by PCR from Cerebral spinal fluid of the case sent by Guizhou province to the key laboratory of Chinese Center for Disease Control and Prevention. C. Neisseria meningitis was not detected by Neisseria meningitis culture from throat swab of the close contacts of the cases. After that,No C. Neisseria meningitis case was found in Guizhou province again,separately,the case had a A Neisseria meningitis vaccine history in 2006, but no travelling history. Conclusion The immunization coverage investigation,actively searching for ECM cases,taking preventative medicine and health education were conducted in Tiechang township of Zunyi county to control ECM,no additional ECM case was found. The detection of C. Neisseria meningitis in Zunyi county was a new challenge in controlling ECM in Guizhou.