一例输入性寨卡病毒病调查报告

Investigation report on an imported Zika virus case

目的对浙江省温州市1例输入性寨卡病毒病进行现场调查,明确诊断,调查感染来源,分析输入性寨卡病毒病监测诊断中存在的问题,为防控工作提供参考。方法通过查阅患者病历和面访开展流行病学个案调查;采集患者发病48 h内的血液、尿液和唾液标本进行寨卡病毒核酸检测;根据温州市的蚊媒状况作传播风险评估并采取控制措施。结果患者于2016年2月21日启程从境外回国途中发病,发病前居住在南美洲苏里南首都帕拉马里博市,当地为寨卡病毒病流行区。患者发病前有暴露史,临床表现为在头面部、颈部、躯干和四肢出现红色弥漫性皮疹。但因无发热,曾一度被诊断为"过敏性皮疹",且两次血清标本核酸检测均为阴性,最后依据尿液和唾液标本核酸检测阳性,同时结合流行病学暴露史确诊为输入性寨卡病毒病。温州市虽有白纹伊蚊,但2月份气温较低,故该病例通过蚊媒传播的风险极低。结论寨卡病毒病可无发热症状,也可有血清标本核酸检测阴性的病例,应谨防漏诊;随着天气转暖,此类输入性病例一旦漏诊,极易经蚊媒传播扩散,因此要进一步完善疫情监测,做好蚊媒监控工作。

Objective To investigate an imported case of Zika virus disease in Wenzhou City, to explore the source ofinfection, to analyse the problems during smweillance and diagnosis, and to provide evidence for prevention and control ofZika virus disease. Methods By field investigation, medical records of the patient were collected and a face - to - faceinterview was conducted; blood, urine and saliva samples within 48 h were collected for RNA detection; assess the risk ofdisease spreading by mosquito smweillance and take control measures. Results The onset of the disease was on the patient way home from aboard on February 21st ,2016. Before then, She lived in Paramaribo, the capital of Suriname in SouthAmerica, which is an epidemic area of Zika virus. The patient had exposure history,with red, diffuse rash on her head, face,neck and limbs, and once was diagnosed as allergic eruption because of no fever. The two blood samples were both testednegative yet We detected urine and saliva samples showed positive. With the evidence above, the patient was finallydiagnosed as an imported Zika virus case. The spreading risk of this case was low due to the low temperature. Conclusionthere may be cases without fever or with blood sample tested RNA negative. As the weather gets warmer, missed diagnosisshould be aware of, or the risk of spreading through mosquitos would increase. Therefore, in order to further improvementshould lie in mosquito control and disease smweillance.