目的 调查浙江省舟山市枸杞岛一起家庭聚集性发热伴血小板减少综合征(SFTS)疫情流行病学特征,为其预防控制提供依据。方法 2015年7月对舟山市枸杞岛SFTS患者及其密切接触者和周围环境进行流行病学调查及媒介蜱监测,采集患者血清进行发热伴血小板减少综合征布尼亚病毒(SFTSV)核酸检测、序列测定和同源性分析。结果 舟山市枸杞岛一对老年夫妇先后出现发热、腹泻、血小板减少等临床症状,经核酸检测确诊为SFTS,1例有蜱叮咬史;密切接触者和媒介蜱的SFTSV检测均为阴性。其中分离自1例患者的病毒核苷酸序列与我国岱山病毒株(ZJ2013-06)以及我国宁波病毒株(Rodent01/NB/CHN/2014)和日本病毒株(SPL097A/Japan)的同源性为98.8%~99.9%,而与岱山主要流行株、淮阳山及河南省流行株的同源性为94.0%~96.0%。结论 首次证实舟山市枸杞岛存在SFTS流行,病例与蜱叮咬传播有关,疫情是否因候鸟迁徙扩散SFTSV有待进一步研究。
Objective To investigate the epidemiological characteristic of a family clustering occurrence of severe fever with thrombocytopenia syndrome(SFTS) in Gouqi Island, Zhejiang province, to evaluate the risk of further transmission and provide scientific evidence for SFTS outbreak prevention. Methods Field investigation was conducted in July, 2015 to collect the epidemiological information of the two patients from Gouqi Island, as well as their relative household and the surrounding environment. Serum nucleic acid test, gene sequencing and homology analysis were carried out in laboratory. Results An old couple had fever and diarrhea in succession, and thrombocyte was progressive declining, and were diagnosed as confirmed SFTS by viral nucleic acid detection. The husband was bitten by a tick ten days before onset. Virus nucleic acid detection results of the related household and the vector ticks around the surroundings were negative. The serum of the wife was collected for culture, and high nucleotide homology was found at 98.8%-99.9% with the strains from Daishan(ZJ2013-06), Ningbo, and Japan, while only 94.0%-96.0% with the main strain of Daishan, Huaiyangshan, and Henan. Conclusion It was the first time to confirm the prevalence of SFTS in Gouqi Island. The transmission was related to the bites from ticks. The migratory birds may be related to the spread of SFTSV, which needs more studies to validate.
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