人类腺病毒B组7型致军营聚集性感染的临床特征

Clinical characteristics of clustering infection of human adenovirus-B type 7 in a military camp

目的 探讨2014年1月发生在驻浙、沪某部队新兵营的一起成人腺病毒B组7型聚集性感染疫情的临床特征.方法 对集中发病的70例患者的临床症状、体征、胸部CT、实验室检查进行统计分析,采集咽拭子,荧光定量PCR检测病毒核酸以查找病原.结果 入院的70例患者中,发热70例（100.0％）、咳嗽58例（82.9％）、咳痰51例（72.9％）、咽痛43例（61.4％）.所有患者均表现为咽喉部黏膜充血、咽后壁广泛卵圆形滤泡伴线样充血.扁桃体肿大54例（77.1％）,46例（65.7％）患者可见扁桃体被覆白色分泌物,咽部淋巴滤泡增生58例（82.9％）.51例（72.9％）患者肺部影像学异常,肺纹理增粗模糊、肺间质炎、肺实质浆液性渗出较常见.54份咽拭子标本中,34份（63.0％）分离出B组7型腺病毒株.70例患者全部治愈.结论 腺病毒B组7型临床特征有别于其他型病毒株,传染力强,在特殊群体易致聚集性发病.早发现、早干预,可控制疫情蔓延.

Objective To investigate the clinical characteristics of a clustering infection caused by human adenovirus-B type 7 （HAdV-B7） which occurred in one military camp located at the southeastern coastal region in January 2014.Methods All clinical characteristics of the 70 patients were collected for analysis,including clinical symptoms and signs,chest computer tomography （CT） scans and laboratory results.Throat swabs were collected and real time polymerase chain reaction （RT-PCR） was performed to detect viral nucleotide.Results The prominent symptoms of these patients with HAdV-B7 infection included fever （100.0%,70/70）,cough （82.9%,58/70）,productive cough （72.9%,51/70） and sore throat （61.4%,43/70）.All patients showed posterior pharyngeal wall linear congestion with ovoid follicle.Fifty-four （77.1 %） patients had enlarged tonsils and 46 （65.7 %） patients had tonsils covered by white secretions.Fifty-eight （82.9 %） patients had pharyngeal follicular hyperplasia.Fifty-one （72.9 %） patients had abnormalities on chest radiograph,including lung-marking fuzzy,pulmonary interstitial inflammation and parenchymal serous exudation.Of the 54 throat swabs from patients,34（63.0%） were identified as HAdV-B7.All patients were cured.Conclusions The clinical features of patients with HAdV-B7 infection are different from other viral infection.HAdV-B7 is easy to cause clustering infection in particular populations.Early detection and early intervention are needed to avoid exacerbation and transmission.