| 严睿,何奔,姚凤燕,向泽林,何寒青,谢淑云,冯燕.浙江省平湖市2017年由D8基因型麻疹病毒引起的暴发调查[J].中华流行病学杂志,2018,39(3):333-336 |
| 浙江省平湖市2017年由D8基因型麻疹病毒引起的暴发调查 |
| Investigation of a measles outbreak caused by genotype D8 virus in Pinghu city of Zhejiang province, 2017 |
| 收稿日期:2017-08-22 出版日期:2018-03-21 |
| DOI：10.3760/cma.j.issn.0254-6450.2018.03.016 |
| 中文关键词: 麻疹 D8基因型 暴发 |
| 英文关键词: Measles Genotype D8 virus Outbreak |
| 基金项目:2015年浙江省医药卫生一般研究计划（2015KYB081）；2016年嘉兴市科技计划（2016AY23090） |
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| 中文摘要: |
| 目的 调查浙江省由D8基因型麻疹病毒引起暴发的流行病学特征，为麻疹疫情防控工作提供参考依据。方法 资料来源于中国疾病预防控制信息系统报告的麻疹监测病例，对D8基因型麻疹病例发生地浙江省平湖市开展现场流行病学调查，查阅门诊记录和出入院记录，现场个案调查和疫情处置，采集病例急性期血标本、咽拭子标本。实验室检测包括血清学检测、RNA提取和扩增、麻疹病毒分离和基因型鉴定，采用SPSS 17.0和Excel 2016软件进行数据分析。结果 2017年浙江省平湖市报告一起麻疹暴发疫情，确诊病例10例，>40岁成年人8例。采集病原学标本6例，其中D8基因型5例，1例病原学培养阴性。10例病例之间存在3条传播链同时传播，涉及工厂、医院、家庭内3个场所的传播链。D8和H1a基因型麻疹病例临床表现的差异无统计学意义。及时开展应急接种后，疫情得到有效控制。结论 由D8基因型麻疹病毒引起的暴发疫情，早期病例不易发现，未及时发现和处置首例麻疹病例，形成院内感染传播，成年人麻疹免疫屏障薄弱是本起疫情暴发的原因。应急接种可以阻断传播，说明目前使用的麻疹疫苗对预防D8基因型麻疹病毒感染有效。 |
| 英文摘要: |
| Objective To investigate the epidemiological characteristics of measles outbreak caused by genotype D8 virus in Pinghu city of Zhejiang province, and provide evidence for the control of the outbreak. Methods The measles outbreak data were collected through National Measles Surveillance System. The outpatient records and admission records were checked, field investigation and outbreak response were conducted. Blood samples in acute phase and swab specimens were collected from the patients for laboratory testing, including serology test, RNA extraction and amplification, measles virus isolation and genotype identification. Software SPSS 17.0 and Excel 2016 were used for data analysis. Results A total of 10 confirmed measles cases were reported in Pinghu city, and 8 cases were aged >40 years. Six blood samples were collected, in which 5 were measles D8 virus positive and 1 was negative in measles virus detection. There were epidemiological links among 10 cases which occurred in a factory, a hospital and a family at the same time. There was no statistical difference in symptoms among cases caused by D8 virus and H1a virus. After the emergent measles vaccination, the measles outbreak was effectively controlled. Conclusion Untimely response due to the uneasy detection of measles cases in the early stage, nosocomial infection and weak barrier of measles immunity in adults might be the main reasons for this outbreak. Measles vaccination is effective in the prevention of measles D8 virus infection. It is necessary to strengthen measles genotype monitoring for the tracing of infection source and control of outbreaks. |
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