中缅边境地区一起登革热暴发疫情调查分析

Analysis and investigation of one outbreak of dengue fever in the border areas of Yunnan, PR China with Myanmar

目的分析2019年中缅边境地区孟连县一起登革热暴发疫情特点,为制定当地登革热防控措施提供依据。方法对2019年一起登革热暴发疫情的所有登革热病例进行流行病学个案调查,分析流行因素;采集疑似病例血清标本,采用快速免疫色谱测试卡检测登革病毒NS1抗原,RT-PCR鉴定登革病毒血清型;采用布雷图指数法及其双层叠帐捕蚊法检测蚊媒密度,综合评价防控效果。结果本次疫情是境外疫情引起的本地疫情暴发,共报告登革热病例45例,其中本地病例15例,缅甸输入病例25例,景洪输入病例5例。发病年龄以20~59岁青壮年居多(占95.6%),男女比例1.5:1,职业均为农民。白纹伊蚊平均成蚊密度36只/人·h,未捕获埃及伊蚊。病例以轻型为主,均有发热、畏寒、头痛、全身乏力、肌肉关节痛及血小板减少等临床特征。登革病毒血清型均为DENV-1。结论本次登革疫情病原的血清型为DENV-1型,主要传播媒介为白纹伊蚊,与云南省以埃及伊蚊为主要流行区有所不同,结果提示当地相关部门须重点关注境外疫情对当地疫情防控的影响,建议加强双边传染病联防联控合作,提高境外防控机构防控能力。

Objective To analyze the characteristics of one dengue fever outbreak in the border areas of Menglian, Yunnan, PR China with Myanmar in 2019,providing local evidences for dengue control measurements. Methods An epidemiological case study of all dengue cases in a dengue outbreak in 2019 was conducted to analyze the epidemiological factors, Serum samples of suspected cases were collected, Dengue virus NS1 antigen was detected by rapid immunochromatographic test card, and Dengue virus serotype was identified by RT-PCR,Breteau index method and double-layer net method were used to detect mosquito density and comprehensively evaluate the prevention and control effect. Results This outbreak is a local outbreak caused by a foreign outbreak, A total of 45 cases of dengue fever have been reported, including 15 local cases, 25 imported cases from Myanmar and 5 imported cases from Jinghong city of Yunnan province. The age of onset was mostly in young adults aged 20-59 years(95.6%),the ratio of male to female was 1.5:1,and all of them were farmers average population density of Aedes albopictus was very high with 36 individuals per human per hour, but no Ae. aegypti;all case clinic symptom were light with fever, chills, headaches, general fatigue, muscle and joint pain, and low platelet;all cases were infected by DENV-1. Conclusion The serotype of this dengue epidemic was DENV-1,mainly transmitted by Aedes albopictus,which was different from that by Aedes aegypti in Yunnan Province, above results hinted that local relative departments should pay more attention to the dengue epidemic influence from the border areas of Myanmar, and improve their abilities of dengue prevention and control by strengthening the both sides joint prevention and control of infectious diseases.