深圳市首例输入性黑热病病例流行病学调查分析

Epidemiological investigation and analysis of the first imported case of kala⁃azar in Shenzhen

目的对深圳市首例输入性黑热病病例进行流行病学调查及溯源分析,探讨其感染来源,为黑热病的预防控制提供科学依据。方法2023年3月15日,深圳市报告1例黑热病病例,收集该病例的临床应用资料和流行病学调查,并进行溯源分析。结果病例,男,75岁,2023年3月6日前来深圳,出现不适。根据该病例无规则发热、畏寒及全血细胞减少等临床表现,骨髓涂片可见利杜体骨髓象且病原体靶向测序结果提示与杜氏利什曼原虫高度同源等实验室检测结果,及其河南安阳林州市太行山疫区的居住史(2022年9月7日-10月27日),且该疫区黑热病病犬的阳性筛查率为22.22%,判定该病例为林州市输入的黑热病确诊病例。结论结合深圳本次报告黑热病病例的居住环境、居住地疫情情况等因素判断,排除该病例在深圳感染的可能,推测其在河南安阳林州市感染风险较高。

Objective To investigate the origin of the first imported case of kala⁃azar in Shenzhen,and provide scientific basis for the prevention and control of kala⁃azar.Methods On March 15,2023,a case of kala⁃azar was reported in Shenzhen.Clinical data and epidemiological investigations were collected and analyzed for this case based on the relevant literature content.Results The patient,male,75 years old,had arrived in Shenzhen on March 6,2023 and presented with discomfort.According to the clinical manifestations of irregular fever,chills,and decreased peripheral blood cells in this case,the bone marrow smear showed Leishman⁃Donovan bodies,and the pathogen⁃targeted sequencing results indicated a high degree of homology with Leishmania donovani.Laboratory test results also include the patient's history of residence in the Taihang Mountains epidemic area in Linzhou city,Anyang,Henan(September 7⁃October 27,2022).Additionally,the positive screening rate for kala⁃azar in dogs in this epidemic area was 22.22%.Based on these findings,this case was a confirmed case of kala⁃azar imported into Linzhou city.Conclusion Combined with the living environment and epidemic situation of the reported cases in Shenzhen,the possibility of infection in Shenzhen was excluded,and it was speculated that the risk of infection in Linzhou city,Anyang,Henan was presumed to be higher.