Clinical and epidemiological characteristics of a case of severe fever with thrombocytopenia syndrome in Mentougou district, Beijing in 2021
-
摘要:
目的 描述北京市门头沟区发热伴血小板减少综合征（SFTS）患者感染来源、临床特征和流行病学特征，为制定SFTS防控措施提供科学依据。 方法 采用现场流调、查阅病历等方式获取患者临床、流行病学信息，采集血液标本进行核酸和抗体检测，进行媒介蜱和动物宿主调查。 结果 患者多年未出京，发病前活动范围为居住地周边。 实时荧光定量聚合酶链式反应检测方法显示，患者血清SFTS病毒核酸阳性；血清抗体检测显示，IgM抗体阳性，病毒含量为1.9×104 半数组织培养感染剂量（TCID50）/mL，临床症状以持续发热、进行性血小板减少、白细胞减少为主，服用抗病毒药利巴韦林后好转并逐渐痊愈，整个病程为20 d。 媒介生物调查显示：在患者村落周围环境捕获到的媒介长角血蜱5只，SFTS病毒核酸阴性。 病例家犬血液经检测显示SFTS病毒核酸和抗体均为阴性。 结论 该SFTS病例为北京市门头沟区首次报告，今后应加强病例监测，做好媒介生物监测和健康宣教。 -
关键词:
- 发热伴血小板减少综合征 /
- 临床特征 /
- 本地病例
Abstract:Objective To understand the sources of infection, clinical and epidemiological characteristics of a patient with severe fever with thrombocytopenia syndrome (SFTS) in Mentougou district, Beijing and provide scientific evidence for the development of SFTS prevention and control strategy. Methods An epidemiological investigation was conducted, and the patient's blood sample was collected. Real-time quantitative polymerase chain reaction and enzyme linked immunosorbent assay were used to detect SFTS virus (SFTSV) nucleic acid and antibodies. Additionally, investigations were carried out to identify the vector and host animal involved in the transmission of the virus. Results The investigation results showed that the patient had lived in local area without travel history outside Beijing in recent years. Real time fluorescence quantitative polymerase chain reaction test showed that the serum sample of the patient was SFTSV nucleic positive, and the serum antibody test showed positive result of IgM antibody, and the virus content was 1.9×104 TCID50/mL. The patient exhibited clinical manifestations of fever, progressive thrombocytopenia and leukopenia. Following treatment with the antiviral drug Ribavirin, the patient gradually recovered with the entire illness lasting for a period of 20 days. The blood sample of domestic dog of the patient weas negative for both SFTSV nucleic acid and IgM antibody Five H. longicornis were captured in the surrounding area where the case lived, which were negative for SFTSV nucleic acid. Conclusion This case of SFTS was the first one reported in Mentougou. In the future, it is necessary to improve the surveillance for SFTS, vector surveillance and health education. -
图 1 北京市门头沟区一例本地发热伴血小板减少综合征患者发病时间线
Figure 1. Time line of onset of a case of local Severe fever with thrombocytopenia syndrome in Mentougou district, Beijing
-
[1] 朱娜玲, 唐伟平, 程明基, 等. 发热伴血小板减少综合征布尼亚病毒研究进展[J]. 中国热带医学,2018,18(3):282–288. DOI:10.13604/j.cnki.46−1064/r.2018.03.21.Zhu NL, Tang WP, Cheng MJ, et al. Advances in severe fever with thrombocytopenia syndrome (SFTS) and SFTS virus[J]. China Trop Med, 2018, 18(3): 282–288. DOI: 10.13604/j.cnki.46−1064/r.2018.03.21. [2] Yu XJ, Liang MF, Zhang SY, et al. Fever with thrombocytopenia associated with a novel bunyavirus in China[J]. N Engl J Med, 2011, 364(16): 1523–1532. DOI: 10.1056/NEJMoa1010095. [3] Li J, Han YP, Xing YP, et al. Concurrent measurement of dynamic changes in viral load, serum enzymes, T cell subsets, and cytokines in patients with severe fever with thrombocytopenia syndrome[J]. PLoS One, 2014, 9(3): e91679. DOI: 10.1371/journal.pone.0091679. [4] 陈秋兰, 朱曼桐, 陈宁, 等. 2011-2021年全国发热伴血小板减少综合征流行特征分析[J]. 中华流行病学杂志,2022,43(6):852–859. DOI:10.3760/cma.j.cn112338−20220325−00228.Chen QL, Zhu MT, Chen N, et al. Epidemiological characteristics of severe fever with thtrombocytopenia syndrome in China, 2011–2021[J]. Chin J Epidemiol, 2022, 43(6): 852–859. DOI: 10.3760/cma.j.cn112338−20220325−00228. [5] Wang SW, Li JD, Niu GY, et al. SFTS virus in ticks in an endemic area of China[J]. Am J Trop Med Hyg, 2015, 92(4): 684–689. DOI: 10.4269/ajtmh.14−0008. [6] Miao D, Liu MJ, Wang YX, et al. Epidemiology and ecology of severe fever with thrombocytopenia syndrome in China, 2010–2018[J]. Clin Infect Dis, 2021, 73(11): e3851–e3858. DOI: 10.1093/cid/ciaa1561. [7] 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. DOI:10.3760/cma.j.issn.1673−4092.2011.02.001.Lü YN, Dou XF, Wang XM, et al. Preliminary investigation on the carriage status of the novel bunyavirus among animals and ticks in Beijing area[J]. Int J Virol, 2011, 18(2): 33–36. DOI: 10.3760/cma.j.issn.1673−4092.2011.02.001. [8] 窦相峰, 吕燕宁, 王全意, 等. 北京市发热伴血小板减少综合征监测和病原检测分析[J]. 疾病监测,2011,26(12):928–930,945. DOI:10.3784/j.issn.1003−9961.2011.12.003.Dou XF, Lü YN, Wang QY, et al. Surveillance of syndrome of fever with thrombocytopenia and etiological detection in Beijing[J]. Dis Surveill, 2011, 26(12): 928–930,945. DOI: 10.3784/j.issn.1003−9961.2011.12.003. [9] Liu W, Lu QB, Cui N, et al. Case-fatality ratio and effectiveness of ribavirin therapy among hospitalized patients in china who had severe fever with thrombocytopenia syndrome[J]. Clin Infect Dis, 2013, 57(9): 1292–1299. DOI: 10.1093/cid/cit530. [10] Shimojima M, Fukushi S, Tani H, et al. Combination effects of ribavirin and interferons on severe fever with thrombocytopenia syndrome virus infection[J]. Virol J, 2015, 12(1): 181. DOI: 10.1186/s12985−015−0412−3. [11] 雷新军, 孔金屏, 熊进峰, 等. 发热伴血小板减少综合征的流行病学特征及其与蜱密度消长的关系[J]. 上海预防医学,2022,34(7):646–649. DOI: 10.19428/j.cnki.sjpm.2022.21771.Lei XJ, Kong JP, Xiong JF, et al. Epidemiological characteristics of severe fever with thrombocytopenia syndrome and association with tick density[J]. Shanghai J Prev Med, 2022, 34(7): 646–649. DOI: 10.19428/j.cnki.sjpm.2022.21771. [12] 李建民, 曹务春, 张习坦, 等. 北京林区蜱类及鼠类调查[J]. 中国媒介生物学及控制杂志,2002,13(3):165–168. DOI:10.3969/j.issn.1003−4692.2002.03.001.Li JM, Cao WC, Zhang XT, et al. Investigation on ticks and mice in forest areas of Beijing, China[J]. Chin J Vect Biol Control, 2002, 13(3): 165–168. DOI: 10.3969/j.issn.1003−4692.2002.03.001. [13] Tran XC, Yun Y, Van An L, et al. Endemic severe fever with thrombocytopenia syndrome, Vietnam[J]. Emerg Infect Dis, 2019, 25(5): 1029–1031. DOI: 10.3201/eid2505.181463. -
下载:
点击查看大图
图(2)
计量
- 文章访问数: 115
- HTML全文浏览量: 61
- PDF下载量: 35
- 被引次数: 0
