武汉市首起鹦鹉热家庭聚集性疫情调查
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陈邦华,硕士,副主任医师,主要从事卫生应急和现场流行病学工作

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R181

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Investigation on the first family cluster of Chlamydia psittaci infection in Wuhan
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    摘要:

    目的 对武汉市首起鹦鹉热家庭聚集性疫情开展流行病学调查,为鹦鹉热衣原体感染疫情的防控提供科学依据。方法 采用现场流行病学调查方法收集流行病学资料,采集病例、可疑暴露人员、环境样本开展病原学检测。结果 同一家庭2例病例以发热、头疼、畏寒起病,首发病例先后在5家医疗机构就诊,并在其中2家医疗机构住院。病例肺泡灌洗液宏基因组二代测序检测结果表明为鹦鹉热衣原体感染。采集病家和3户鸽子养殖户环境样本30份、鸽子养殖户家庭成员咽拭子4份,经实时荧光定量聚合酶链式反应检测,环境样本15份阳性,均在病家和邻居养殖户家,其中鸽子粪便涂抹样8份、鸽子饮用残留水样3份、鸽子食用的沙子和玉米各1份、食具外表面涂抹样1份、病家外环境样1份。结论 此次鹦鹉热家庭聚集性疫情是由于暴露于鹦鹉热衣原体污染的外环境所致,规范家禽养殖防止禽间感染传播到人间,同时提高医务人员认识,开展病原学检测以明确诊断,避免重症死亡发生。

    Abstract:

    Objective An epidemiological investigation was carried out on the first family cluster epidemic of psittacosis in Wuhan to provide scientific basis for the prevention and control of Chlamydia psittacosis. Methods Epidemiological data were collected by field epidemiological investigation methods, and pathogenic testing was carried out by collecting cases, suspected exposed persons, and environmental samples. Results The 2 cases in the same family stared with fever, headache and chills. The first case was treated in 5 medical institutions and hospitalized in 2 of them. The results of metagenomic next-generation sequencing in the bronchoalveolar lavage fluid of the case indicated that it was infected with Chlamydia psittaci. Thirty environmental samples from cases and 3 pigeon farmers homes, 4 throat swabs from family members of pigeon farmers were collected, and 15 environmental samples were positive by real-time fluorescence quantitative polymerase chain reaction, all of which were in the cases' home and neighbor farmers' homes, including 8 pigeon feces smearing samples, 3 pigeon drinking residual water samples, 1 sand and corn eaten by pigeons, 1 tableware surface smearing sample, and 1 sample of external environment of the patient's home. Conclusions The family cluster epidemic of psittacosis was caused by exposure to the external environment contaminated by Chlamydia psittacosis. Poultry breeding should be regulated to prevent the spread of poultry infection to the human world. At the same time, the awareness of medical staff should be raised, and pathogenic testing should be carried out to confirm the diagnosis for avoiding the occurrence of severe cases and death.

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  • 收稿日期:2022-05-19
  • 最后修改日期:2022-05-19
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  • 在线发布日期: 2022-07-22
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