一起登革热暴发疫情流行病学特征分析与现场处置

Analysis of the epidemiological characteristics of an outbreak of dengue fever and its treatment

目的对2013年德宏州发生的一起登革热暴发疫情及其处置情况进行分析,为制定有效的登革热防控措施提供依据。方法对2013年德宏州一起登革热疫情的所有登革热病例进行流行病学个案调查,对疑似病例血清标本检测登革病毒NS1抗原,用RT-PCR进行登革热病毒型别鉴定,采用布雷图指数法对蚊媒进行监测。结果全州8-12月份共报告登革热病例247例,其中缅甸输入100例,外省输入2例,本地感染145例。本地感染病例均主要集中在瑞丽市（占94.33%）,男女性别比为1.15︰1,发病年龄最小9月、最大81岁,以20-55岁为主;职业以农民、商业服业者居多（占46.15%）。发热门诊共接诊发热病人43 949人,疑似登革热病人976人血清标本检测,抗原阳性247份,阳性率25.31%。PCR检测82份抗原阳性标本登革病毒核酸均阳性。基因分型显示38份为登革病毒1型（占46.34%）,44份为登革病毒2型（占53.66%）。调查白纹伊蚊全州均有分布,埃及伊蚊主要分布在瑞丽市。结论该起疫情首发病例为输入性病例,以多点爆发,家庭聚集和散发并存为主要特点,病原为登革病毒1型为主,传播媒介为白纹伊蚊和埃及伊蚊。提示应加强输入病例的监测和蚊媒控制。抽取82份抗原阳性标本进行PCR登革病毒核酸检测,结果均阳性。基因分型：

Objective To analyze the epidemiological characteristics of an outbreak of dengue fever in Dehong Prefecture in Yunnan in 2003 and the treatment of that outbreak in order to provide information on effective control of dengue fever. Methods Cases of dengue fever were examined as part of an epidemiological case study.Patients suspected of having dengue fever were tested for dengue virus NS 1,the serotype of the dengue virus was identified with RT-PCR,and vectors of the dengue virus were monitored based on the Breteau Index（BI）. Results From August to December,247 cases of dengue fever were reported.Of those,146 were autochthonous cases while 101 were imported cases of dengue fever imported from Myanmar and 2provinces（2cases）.Autochthonous cases were mainly concentrated in Ruili（accounting for 94.33%）.The sex ratio of patients was 1.5︰1（male︰female）.Most patients were ages 20-50 years;the youngest patient was 0.75 years old and the oldest was 81 years old.In terms of occupation,most patients were farmers or businessmen（accounting for 46.15%）.In total,clinics saw 11,941 patients with a fever or a potential fever.Of serum samples from 892 individuals who were suspected of having dengue fever,247 tested positive for dengue virus NS1（27.69%）.RT-PCR revealed that 82 samples were positive for antigens.Genotyping revealed dengue virus 1in 38samples（46.34%）and dengue virus 2in 44（53.66%）.Aedes albopictus was widely distributed throughout the entire prefecture,and Aedes aegypti was mainly concentrated in Ruili County. Conclusion This epidemic of dengue fever was caused by dengue virus 1and was transmitted by Ae.albopictus and Ae.aegypti.The first case was an imported case and multiple outbreaks occurred with family gatherings and dispersion.These results suggest that imported cases should be monitored and that vector control should be further enhanced.