塞拉利昂儿童感染埃博拉病毒的临床特点及预后分析

Clinical features and prognosis of children with Ebola virus disease in Sierra Leone

目的探讨儿童感染埃博拉病毒的临床特点及预后。方法回顾性分析2014年10月-2015年1月我院医疗队在塞拉利昂弗里敦Jui医院收治的埃博拉（Ebola virus disease,EVD）患儿的临床表现及预后。结果 653例疑似EVD患者中,75例儿童被实验室确诊感染埃博拉,平均年龄8.9±5.6岁（11个月~18岁）。男性患儿29例（38.7%）,女性患儿46例（61.3%）。49例有随访,41例资料详细。与家人密切接触为主要感染途径,占45.3%。潜伏期平均10.5 d,出现症状到住院时间为3.5 d,出现症状到死亡平均时间为7 d。常见临床症状为发热32例（80.5%）,乏力31例（75.6%）,腹痛30例（73.2%）,肌肉疼痛30例（73.2%）,恶心、呕吐29例（70.7%）。随访49例死亡15例,病死率为30.6%。结论儿童EVD患者与家人密切接触为主要感染途径,临床特征无明显特异性。女性患儿的发病率高于男性患儿,死亡率无明显差异。

Objective To investigate the clinical characteristics and prognosis of children infected with Ebola virus. MethodsClinical features and prognosis of children with suspected or confirmed Ebola virus disease（EVD） in Jui hospital Free Town, Sierra Leone from October 2014 to January 2015 were retrospectively analyzed. Results Of the 653 patients who presented with EVD symptoms, 75 children had laboratory-confirmed EVD with mean age of 8.9±5.6 years（range from 11 months to 18 years）. There were 29 males（38.7%） and 46 females（61.3%）. Forty-nine patients were followed up, with 41 cases of detailed data. Close contact with family member was the main route of Ebola transmission, accounting for 45.3%. The mean incubation period was 10.5 d, the symptom onset to hospitalization time was 3.5 d, and the average time of symptom onset to death was 7 d. The most common symptoms were fever in 32 cases（80.5%）, followed by fatigue in 31 cases（75.6%）, diarrhea in 30 cases（73.2%）, muscle pain in 30 cases（73.2%）, nausea and vomiting in 29 cases（70.7%）. Fifteen children died in 49 followed up cases with the mortality rate of 30.6%. Conclusion Close contact with family member is a main route of Ebola transmission for children. It has no obvious specific clinical features. The incidence rate of female is higher than that of male, however, there is no significant difference between male and female in mortality rate.