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目的 探讨登革热家庭聚集性发病的流行病学特点及采取的防控措施,为今后进行有效的预防和控制登革热暴发疫情提供参考。方法 采用现场流行病学调查方法对广州市首起登革热家庭聚集性暴发疫情进行调查和分析;采用ELISA和RT-PCR的方法对标本进行血清学检测和病毒分型。结果 2009年8月广州市越秀区发生的一起登革热家庭聚集性暴发事件中,该家庭4名成员中有3人同时发病,这3例患者登革热抗体IgM均阳性,其中RT-PCR检测阳性者2例,病毒分型均为登革Ⅲ型。并且,在实验室回顾性检测中发现,家庭聚集性疫情出现前有1例输入性登革病例,病毒分型也为登革Ⅲ型,且病毒基因测序结果提示两者之间存在明显关联。结论 根据流行病学调查结果、临床表现和实验室检测结果,可以确定该家庭发生了本地感染的登革热聚集性暴发。感染地是三元里大道景苑街居住地;感染来源可能是输入性疫情引起的,输入性疫情与本地疫情之间的这种流行病学关联在广州市还是首次获得。因此,广州市登革热疫情是由输入性疫情引发的本地疫情的趋势未改变,做好输入性疫情防控是防止疫情扩散的有力措施。
Objective To investigate the epidemiological characteristics of dengue fever family aggregation and its prevention and control measures in order to provide reference for the effective prevention and control of the outbreak of dengue fever in the future. Methods Epidemiological survey method was used to investigate and analyze the first outbreak of dengue familial outbreak in Guangzhou. Serological detection and virus typing were performed by ELISA and RT-PCR. Results In August 2009, there was an incidence of dengue familial cluster outbreak in Yuexiu District of Guangzhou City. There were 3 out of 4 members of the family with onset of IgM in all 3 patients. The positive rate of IgM in dengue fever was 3 Cases, the virus typing Dengue type Ⅲ. Moreover, retrospective testing in the laboratory found that there was 1 case of imported dengue before the outbreak of familial aggression, and the virus type was dengue type III, and the results of virus gene sequencing suggested that there was a clear correlation between the two. Conclusions Based on epidemiological findings, clinical manifestations, and laboratory tests, dengue aggregative outbreaks of the locality-associated infection in this family can be determined. The source of the infection is the place of residence of Jingyuan Street in Sanyuanli Avenue; the origin of the infection may be caused by the imported epidemic, and the epidemiological link between the imported epidemic and the local epidemic is still the first such acquisition in Guangzhou. Therefore, the epidemic situation of dengue in Guangzhou is unchanged from the epidemic situation caused by the imported epidemic. To prevent and control the imported epidemic is a powerful measure to prevent the spread of the epidemic.