北京市203例猴痘确诊病例的临床和流行病学特征分析

Clinical and epidemiological characteristics of 203 confirmed mpox cases in Beijing

目的描述北京市猴痘确诊病例的临床及流行病学特征,为后续疫情防控提供参考。方法选取北京市2023年5月31日至9月6日医疗机构报告的主动就诊及密接排查发现的203例猴痘确诊病例,开展流行病学调查,分析其三间分布、发病就诊情况及临床特征。结果203例猴痘确诊病例年龄范围17~56岁,男性占99.51%(202/203),以无业/待业人员为主(50例,24.63%),自由职业者有14例(6.90%),学生6例(2.96%)。男男性行为者(men who have sex with men,MSM)人群183例(90.15%)。具有明确暴露时间的有86例,潜伏期均值为8.85 d。病例发现方式以主动就诊为主,占95.07%(193/203)。有症状的有201例,主要症状为皮疹(97.54%)、发热(67.98%)及淋巴结肿大(33.00%);出疹部位涉及全身多个不同部位,无明显时间顺序。有明确的就诊记录病例198例,发病到首次就诊时间间隔为0~38 d,中位数为4 d,首诊检出率为52.53%(104/198);HIV感染者占44.33%。结论北京市猴痘疫情主要在MSM人群中流行,通过男男性接触方式传播,平均潜伏期8.85 d。症状以发热、皮疹为主,多为轻症患者,首诊诊断率较低。性伴多不固定,导致疫情风险人群判定较难,疫情防控存在一定难度。

Objective To describe the clinical and epidemiological characteristics of mpox cases reported in Beijing,so as to provide reference for the prevention and control of mpox epidemics.Methods A total of 203 confirmed mpox cases were selected from the cases reported by active reporting by medical institutions and screening of close contacts in Beijing from May 31 to September 6,2023.Epidemiological investigation was carried out to analyze the disease distribution,disease onset and hospital visits as well as the clinical characteristics of the cases.Results For the 203 confirmed mpox cases,the age ranged from 17 to 56 years old while male patients accounted 99.51%(202/203).The patients were mainly unemployees/job-waiting persons(50,24.63%).Fourteen cases were self-employees(6.90%)and 6 were school students(2.96%).There were 183 cases(90.15%)in men who have sex with men(MSM).There were 86 cases with definite exposure time,and the average incubation period was 8.85 d.The main detection method of the cases was voluntary treatment,accounting for 95.07%(193/203).Two hundred and one cases had symptoms,mainly rash(97.54%),fever(67.98%)and lymph node enlargement(33.00%).The skin lesion involved multiple sites of whole body,and there was no obvious order of rash occurrence.There were 198 patients with definite medical records,and the interval from onset to first visit to hospital was 0-38 d,with median value of 4 d and an average of 4.71 d.The detection rate in the first visit was 52.53%(104/198)and HIV infected patients accounted for 44.33%.Conclusions The mpox cases occurred mainly in MSM and transmitted by man-man sexual contact with an average incubation period of 8.85 d.The main symptoms were fever and rash and most patients were mild case.The rate of diagnosis at the first visit was low.Frequently change of sexual partners and several partners at the same time lead to difficulties in defining risk population and in the prevention and control of epidemics.