6例人感染新型布尼亚病毒病的临床特征和流行病学调查分析

摘要

目的:分析溧水县2011年确诊的6例人感染新型布尼亚病毒病的临床特征和流行病学特征,为制定预防控制措施提供参考.方法:采用卫生部统一的诊断标准和流行病学个案调查表对病例进行调查.结果:发病率为1.42/10万,死亡率0.24/10万,病死率为16.67%.临床表现主要为发热(6例)、乏力(6例)、食欲减退(6例)、全身酸痛(5例)、腹泻(5例)、恶心(4例);临床实验室检查有血小板计数减少和白细胞计数减少(6例),门冬氨酸氨基转移酶(6例)、磷酸肌酸激酶(6例)、乳酸脱氢酶(6例)、α-羟丁酸脱氢酶(5例)、肌酸激酶同工酶(5例)、胱抑素C(5例)水平升高.病例均来自丘陵村镇,为中老年农民,发病时间集中于4～7月份,部分病例发病前有明确的蜱叮咬史.结论:新型布尼亚病毒感染病例发病初期临床症状不典型,发病有地域特征,高度散发,在丘陵地区生活、生产的居民有较高的感染风险.%Objective: To analyze the clinical and epidemiological characteristics of 6 cases with severe fever with thrombocytopenia syndrome virus( SFTSV ) infection of Lishui County in 2011 , so as to provide reference for making prevention and control measures. Methods: Investigating cases by uniform diagnostic criteria and epidemiological questionnaire of the ministry of health. Results: The incidence rate of disease was 1.42 per 100 thousand, the mortality rate was 0. 24 per 100 thousand. The clinical manifestations including fever ( 6 cases ), fatigue ( 6 cases ), loss of appetite ( 6 cases ), muscular stiffness ( 5 cases ) and diarrhea ( 5 cases ), and nausea ( 4 cases ). Laboratory results including thrombocytopenia and leucopenia ( 6 cases ), elevated AST ( 6 cases ), CPKrn( 6 cases ), LDH ( 6 cases ), a- HBDH ( 5 cases ), CK- MB( 5 cases ) and Cystatin ( 5 cases ). All cases were elderly people from Qiuling Town, and occurred between April to July. There was premorbid history of tick bites in some cases. Conclusions: The clinical symptoms of SFTSV cases were atypical in the early onset. Regional and highly sporadic features were observed. The residents of the hilly area of life, production had a higher risk of infection.