一起登革热和一起基孔肯雅热暴发疫情的对比分析

A comparing analysis between dengue fever outbreak and chikungunya fever outbreak

目的了解登革热和基孔肯雅热这两种伊蚊传播疾病的流行病学特征和临床特征异同点,为预防控制这两种疾病提供依据。方法采用问卷调查和查阅患者就诊资料的方法,搜集东莞市2010年发生的一起登革热和一起基孔肯雅热社区暴发疫情的流行病学特征和临床特征资料并进行对比分析。结果两起疫情共同点为:输入性疫情;发生在夏秋季节;具有一定的家庭聚集性;发生疫情的社区蚊媒密度高;采取以杀灭成蚊和清除伊蚊孳生地为主的综合性防控措施可有效控制疫情;登革热和基孔肯雅热临床表现类似,以发热、疼痛为主。两起疫情的不同点:与登革热暴发疫情相比,基孔肯雅热暴发疫情强度更大、扩散范围更广、家庭聚集性更强,但疫情持续时间短;在临床表现方面,基孔肯雅热患者关节痛、皮疹、肌肉痛的发生率高于登革热患者,而登革热患者头痛、白细胞减少、血小板减少的发生率高于基孔肯雅热患者。结论登革热和基孔肯雅热的流行病学和临床特征类似。但与登革热相比,基孔肯雅热传播能力更强;病人更常见关节痛、皮疹,而白细胞、血小板则多正常。

Objective To understand the differences and similarities of epidemiology and clinical manifestations between dengue fever outbreak and chikungunya fever outbreak and to provide evidence for preventing and controling the two aedes-borne infectious diseases.Methods Epidemiological and clinical data of a community-based dengue outbreak and a chikungunya outbreak occurred in Dongguan in 2010 were collected by questionaire investigation and looking up medical records of patients and a comparing analysis between two outbreaks was conducted.Results There were similarities between two outbreaks as following： imported,occurring in summer and autumn,showing familial clustering,high density of vector mosquito in epidemic focus,comprehensive control measures based on reducing the density of aedes mosquitoes showing effective in controlling both of the epidemics,similar clinical manifestation with fever and ache occurring in most cases.The differences between dengue outbreak and chikungunya outbreak were： higher attack rate,spreading wider and more significant familial aggregation observed in chikungunya outbreak than in dengue outbreak.But duration of chikungunva outbreak was shorter than that of dengue.As for clinical manifestations,the occurring rate of arthralgia,erythra and myalgia of chikungunya fever patients were significantly higher than those of dengue patients,while the occurring rates of headache,decreasing white blood cell counting and decreasing blood platelet counting of dengue patients were significantly higher than those of chikungunya patients.Conclusions Dengue fever and chikungunya fever have similar epidemiological and clinical characteristics.Compared with dengue fever,chikungunya patients,while most of them had normal white blood cell and platelet counting,fever seemed to have stronger ability to spread,arthralgia and erythra were more common in chikungunya