山西省1例新发内脏利什曼病病例调查

Survey on a New Case of Visceral Leishmaniasis in Shanxi Province

2011年9月,山西省长治市疾病预防控制中心通过传染病网络直报系统报告1例幼儿内脏利什曼病新发病例。围绕该病例展开了相关的临床个案和现场流行病学调查。患儿,2岁,山西省长治市黄碾镇人。临床检查示患儿肝脾肿大,血常规检查示全血细胞呈持续性降低,骨髓病理涂片发现利杜体,rK39免疫诊断试条检测示强阳性,确诊为内脏利什曼病。患儿经葡萄糖酸锑钠治疗1个疗程(总剂量为150～200 mg/kg,分6 d注射,1次/d)后,症状明显好转。现场调查该病例所在地区无内脏利什曼病既往病例。居民家中犬和家养动物的数量较多。采用rK39免疫诊断试条对周围人群(17人)及部分家养动物(3只犬、1头羊和1只猫)血样进行检测,结果均为阴性。推测该地区存在内脏利什曼病潜在流行风险。

A new case of visceral leishmaniasis （kala-azar） was reported by Changzhi CDC of Shanxi Province in September 2011. The case was investigated clinically and epidemiologically. The patient was a two-year-old boy who lived in Huangnian Town of Changzhi County in Shanxi Province. Clinical examination showed hepatosplenomegaly, consistent decrease of blood ceils and Leishman-Donovan body in the bone marrow smear. The rK39 immune diagnosis test showed strongly positive. The case was diagnosed as kala-azar. After one course treatment of sodium stibogluconate, the patient＇s condition improved markedly. There were no cases of kala-azar in this region historically. Blood samples of 17 individuals and 5 domestic animals including 3 dogs were all negative in the rK39 immunodiagnostic test. It is speculated that the potential risk of kala-azar transmission exists in this region.