2009年广州市首起本地感染登革热家庭聚集性暴发疫情的调查与处理

Investigation and Management of the First Case of Family Cluster Outbreak of Dengue Fever in 2009 in Guangzhou

目的 探讨登革热家庭聚集性发病的流行病学特点及采取的防控措施,为今后进行有效的预防和控制登革热暴发疫情提供参考。方法 采用现场流行病学调查方法对广州市首起登革热家庭聚集性暴发疫情进行调查和分析;采用ELISA和RT-PCR的方法对标本进行血清学检测和病毒分型。结果 2009年8月广州市越秀区发生的一起登革热家庭聚集性暴发事件中,该家庭4名成员中有3人同时发病,这3例患者登革热抗体IgM均阳性,其中RT-PCR检测阳性者2例,病毒分型均为登革Ⅲ型。并且,在实验室回顾性检测中发现,家庭聚集性疫情出现前有1例输入性登革病例,病毒分型也为登革Ⅲ型,且病毒基因测序结果提示两者之间存在明显关联。结论 根据流行病学调查结果、临床表现和实验室检测结果,可以确定该家庭发生了本地感染的登革热聚集性暴发。感染地是三元里大道景苑街居住地;感染来源可能是输入性疫情引起的,输入性疫情与本地疫情之间的这种流行病学关联在广州市还是首次获得。因此,广州市登革热疫情是由输入性疫情引发的本地疫情的趋势未改变,做好输入性疫情防控是防止疫情扩散的有力措施。

Objective To analyze the epidemic characteristics of the first case of family cluster outbreak of dengue fever in Guangzhou,and to provide reference for the control of dengue fever outbreak in the community.Methods Epidemiological method was used to investigate the family cluster outbreak of dengue fever in Guangzhou.Serum samples were analyzed ELISA and RT-PCR.Results A case of dengue fever outbreak（August,2009）was identified in Yuexiu District of Guangzhou.3 out of 4 family members were infected.Serological analysis revealed that 3 family members were seropositive for IgM.Two samples were positive and showed that the virus was type Ⅲ by the RT-PCR.One imported case of dengue fever was noted before this outbreak,and the virus was identified as type Ⅲ.Further analysis indicated that there was an association between these 2 cases of dengue fever.Conclusions According to the clinical features,laboratory detection and the epidemiological investigation,the dengue fever outbreak was occurred within a family living in the Yuexiu District of Guangzhou.The source of infection was Jingyuan habitation in Sanyuan Avenue.This may be a case of imported infection.