江苏省淮安市首例猴痘确诊病例流行病学调查分析
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许磊,硕士,主管医师,主要从事传染病防控工作

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R186

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Epidemiological investigation of the first confirmed case of mpox in Huai’an, Jiangsu Province
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    摘要:

    目的 描述江苏省淮安市首例猴痘确诊病例发现处置过程、流行病学特征,为本地区重点传染病防控工作提供参考。方法 对2023年6月21日确诊的首例猴痘病例的现场流行病学调查资料,以及实验室标本核酸检测、基因测序结果进行回顾性分析,并对可能的感染来源进行探讨。结果 首例猴痘确诊病例为艾滋病患者、男同性行为者,发病前21天内无境外、市外旅居史,但与多名市外人员存在交集,流行病学轨迹复杂。猴痘病毒核酸阳性(伯杰试剂:Ct值21.8,卓诚试剂:Ct值21.2)。经基因测序,首例确诊病例分型为IIb分支C.1.1谱系。在对首例确诊病例感染来源调查过程中,新发现一例无症状感染者。综合流行病学调查和实验室结果,认为首例确诊病例是本土感染引起,但感染来源不明确,与无症状感染者虽然存在流行病学关联,但是相互感染的直接证据不充分,不排除区域间仍存在隐匿传播链;无症状感染者的感染来源推测可能是首例病例或与其发生高危性行为并造成肛门出血的不明身份人员。结论 该猴痘确诊病例系本土感染引起,应提高医疗机构病例诊断报告意识,对重点暴露人群,特别是男同性行为人群的宣传教育,以防止出现本土规模性疫情。

    Abstract:

    Objective To investigate the discovery and disposal process and epidemiological characteristics of the first confirmed case of mpox (formerly named monkeypox) in Huai’an, Jiangsu Province, and to provide reference for the prevention and control of key infectious diseases in this region. Methods The on-site epidemiological investigation data of the first confirmed case of mpox on June 21, 2023, as well as the results of nucleic acid detection and gene sequencing of laboratory specimens were analyzed retrospectively. Possible sources of infection were explored. Results The first confirmed case of mpox was an AIDS patient, men who had sex with men (MSM), who had no history of travel abroad or outside the city within 21 days before the onset of the disease, but had interacted with some people outside the city, and the epidemiological trajectory was complex. The detection of mpox virus nucleic acid was positive (BioGerm reagent: Ct value 21.8, ZhuoCheng reagent: Ct value 21.2). According to genetic sequencing, the first confirmed case was classified as C.1.1 lineage of clade IIb. During the investigation on the source of infection of the first confirmed case, one new asymptomatic infected person was found. Based on the epidemiological investigation and laboratory results, the first confirmed case was believed to be caused by local infection, however, the source of infection was unclear. Although there was an epidemiological association with asymptomatic infected people, the direct evidence of mutual infection was insufficient, and it could not be ruled out that there was still a hidden transmission chain between regions. The source of infection of the asymptomatic infected person was presumed to be the first confirmed case or an unidentified person with whom he had high-risk sex and caused anal bleeding. Conclusion The first confirmed case is caused by local infection. Awareness of case diagnosis and reporting in medical institutions should be improved, and publicity and education should be provided to key exposed populations, especially those men who have sex with men, to prevent the occurrence of large-scale local epidemic.

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  • 收稿日期:2024-12-03
  • 最后修改日期:2024-12-03
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  • 在线发布日期: 2025-01-15
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