2023年云南省首例猴痘确诊病例的流行病学调查与处置

Epidemiological investigation and emergency response of the first confirmed case of mpox in Yunnan province,2023

目的 描述2023年云南省首例猴痘确诊病例的发病过程、流行病学特征和疫情处置过程,为猴痘疫情防控提供参考依据。方法 对疑似病例及相关人员开展现场流行病学调查。采集病例咽拭子、丘疹表面擦拭子、疱疹液等样本,应用实时荧光定量聚合酶链式反应对标本进行猴痘病毒核酸检测、基因测序等。结果 病例于2023年6月16日在云南省外发生多次高风险暴露行为,6月22日出现生殖器部位瘙痒伴皮疹,乏力、肌痛。其咽拭子、肛拭子、尿道口分泌物、疱疹液均检出猴痘病毒核酸阳性,基因测序结果显示,病例感染的猴痘病毒属西非系B.1.3分支。病例的6名密切接触者中,1人检出猴痘病毒核酸阳性,为有同性性行为者。采集患者床单、被套,卫生间毛巾等6份环境标本,其中1份卧室床单标本为阳性。结论 综合流行病学调查和实验室结果,该猴痘确诊病例系国内本土感染引起,需密切关注猴痘疫情的发展趋势,加强健康教育,同时加强监测和预警系统的建设,做好猴痘疫情监测和防控准备工作。

Objective To describe the illness course,epidemiological characteristics and response process of the first confirmed case of mpox in Yunnan province in 2023,and provide evidence for the prevention and control of mpox.Methods An epidemiological investigation of the first case of mpox was conducted.Throat swabs,papular surface swabs,herpes fluid and other samples were collected from the case and close contacts for the detection of mpox virus by real-time fluorescence quantitative polymerase chain reaction and sequence analysis.Results The case had high-risk behavior exposure outside Yunnan on June 16,2023.On 22 June,the case showed genital itching with rash,fatigue,and muscle soreness.The case's throat swab,anal swab,urethral discharge and herpes fluid were all positive for the nucleic acid of mpox virus.The genetic sequencing results showed that the mpox virus isolated from the case belonged to the B.1.3 branch of the West African strain.In the 6 close contacts of the case,1 was positive for nucleic acid of mpox virus,who once had homosexual intercourse.Six environmental samples,including case's bed sheets,duvet covers,and bathroom towels,were collected,in which one bedroom bed sheet was positive.Conclusion Based on the comprehensive epidemiological investigation and laboratory results,the confirmed case of mpox was caused by domestic infection.It is necessary to monitor the trend of the mpox epidemic,strengthen health education.Meanwhile,the establishment of surveillance and early warning system should be strengthened for the better prevention and control of mpox.