一宗输血性恶性疟个案的流行病学调查与分析

Epidemiological investigation and analysis of a transfusion Plasmodium falciparum case

目的查明深圳市首例输血性恶性疟病例的感染原因。方法查阅患者的病历档案,收集流行病学资料;镜检法和快速诊断试验(RDT)检测患者和献血员血样中疟原虫及其分泌的特异性抗原。结果患者发病10 d前因手术接受输血,临床症状主要为发热、咳嗽伴肌肉酸痛;血常规提示:红细胞计数、血小板计数及血红蛋白浓度下降;血涂片镜检查见恶性疟原虫小滋养体。患者为深圳本地居民,近1年无疟疾疫区外出史;提供血液的1名献血员曾在非洲喀麦隆疟疾流行区工作10个月,其献血留存血样RDT检测恶性疟原虫阳性。结论根据临床表现、疟原虫检查结果,结合流行病学分析判断为经输血传播的恶性疟个案。

Objective To identify the cause of the first case of transfusion Plasmodium falciparum malaria in Shenzhen.Methods The patient＇s medical record was reviewed, and the epidemiological data was collected to analyze the cause ofinfection. Blood samples from the patient and her blood donors were examined for Plasmodium and its specific antigens bymicroscopic examination and malaria rapid diagnostic test（RDT）. Results The patient received a blood transfusion 10 daysbefore onset, and her clinical symptoms included fever, cough and muscle ache. Blood routine showed decrease in red bloodcell count, platelet count and hemoglobin concentration, and small trophozoites of Plasmodium falciparum were visualized inher blood smear. The patient was a local resident in Shenzhen without history of traveling to malaria endemic areas in recentyear. One of her blood donors had worked in Cameroon, the malaria epidemic area, for 10 months, and his blood sample wastested positive for P. falciparum by RDT. Conclusion According to the clinical manifestations, laboratory findings andepidemiological analysis, the patient was confirmed to be a transfusion Plasmodium falciparum malaria case.