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6例人感染新型布尼亚病毒病的临床特征和流行病学调查分析
作者:沈爱华1 3  鲍昌俊2  胡建利2  李陆逊3  羊海涛2 
单位:1. 南京医科大学 公共卫生学院,江苏 南京 210029;
2. 江苏省疾病预防控制中心, 江苏 南京 210009;
3. 溧水县疾病预防控制中心,江苏 溧水 211200
关键词:发热伴血小板减少综合征布尼亚病毒 临床特征 流行病学 
分类号:R373.3; R181.8
出版年·卷·期(页码):2012·31·第五期(559-563)
摘要:

目的:分析溧水县2011年确诊的6例人感染新型布尼亚病毒病的临床特征和流行病学特征,为制定预防控制措施提供参考。方法:采用卫生部统一的诊断标准和流行病学个案调查表对病例进行调查。结果:发病率为1.42/10万,死亡率0.24/10万,病死率为16.67%。临床表现主要为发热(6例)、乏力(6例)、食欲减退(6例)、全身酸痛(5例)、腹泻(5例)、恶心(4例);临床实验室检查有血小板计数减少和白细胞计数减少(6例),门冬氨酸氨基转移酶(6例)、磷酸肌酸激酶(6例)、乳酸脱氢酶(6例)、α-羟丁酸脱氢酶(5例)、肌酸激酶同工酶(5例)、胱抑素C(5例)水平升高。病例均来自丘陵村镇,为中老年农民,发病时间集中于4~7月份,部分病例发病前有明确的蜱叮咬史。结论:新型布尼亚病毒感染病例发病初期临床症状不典型,发病有地域特征,高度散发,在丘陵地区生活、生产的居民有较高的感染风险。

Objective: To analyze the clinical and epidemiological characteristics of 6 cases with severe fever with thrombocytopenia syndrome virus(SFTSV) infection of Lishui County in 2011, so as to provide reference for making prevention and control measures. Methods: Investigating cases by uniform diagnostic criteria and epidemiological questionnaire of the ministry of health. Results: The incidence rate of disease was 1.42 per 100 thousand, the mortality rate was 0.24 per 100 thousand. The clinical manifestations including fever (6 cases), fatigue (6 cases), loss of appetite (6 cases), muscular stiffness (5 cases) and diarrhea (5 cases), and nausea (4 cases). Laboratory results including thrombocytopenia and leucopenia (6 cases), elevated AST (6 cases), CPK (6 cases), LDH (6 cases),a-HBDH (5 cases), CK-MB(5 cases) and Cystatin (5 cases). All cases were elderly people from Qiuling Town, and occurred between April to July. There was premorbid history of tick bites in some cases. Conclusions: The clinical symptoms of SFTSV cases were atypical in the early onset. Regional and highly sporadic features were observed. The residents of the hilly area of life, production had a higher risk of infection.

参考文献:

[1] 卫生部.发热伴血小板减少综合征防治指南(2010版).http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohwsyjbgs/s8348/201010/49272.htm.
[2] YU X J,LIANG M F,ZHANG S Y,et al.Fever with thrombocytopenia associated with a novel bunyavirus in China[J].N Engl J Med,2011,364(16):1523-1532.
[3] 张永振,周敦金,熊衍文,等.中国淮阳山地区新蜱传布尼亚病毒引起的出血热[J].中华流行病学杂志,2011,32(3):209-220.
[4] 李德新.发热伴血小板减少综合征布尼亚病毒概述[J].中华实验和临床病毒学杂志,2011,25(2):81-84.
[5] 吕燕宁,窦相峰,王小梅,等.北京地区动物及蜱中新型布尼亚病毒携带状况的初步调查与分析[J].国际病毒学杂志,2011,18(2):33-36.
[6] BAO C J,GUO X L,QI X,et al.A family cluster of infections by a newly recognized bunyavirus in eastern China,2007:further evidence of person-to-person transmission[J].Clin Infect Dis,2011,53(12):1208-1214.
[7] 张文帅,曾晓燕,周明浩,等.江苏省发热伴血小板减少综合征布尼亚病毒血清流行病学调查[J].疾病监测杂志,2011,26(9):676-678.

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