Hanna J N, Ritchie S A, Phillips D A, Serafin I L, Hills S L, van den Hurk A F, Pyke A T, McBride W J, Amadio M G, Spark R L
Tropical Public Health Unit, Queensland Health, Cairns, QLD.
Med J Aust. 2001 Feb 19;174(4):178-82. doi: 10.5694/j.1326-5377.2001.tb143213.x.
To describe an epidemic of dengue type 3 that occurred in far north Queensland in 1997-1999 and its influence on the further development of dengue prevention and control strategies.
Epidemiological and laboratory investigation of cases, entomological surveys and phylogenetic analysis of dengue virus isolates.
Numbers and characteristics of confirmed cases; Breteau Index (BI; number of containers breeding Aedes aegypti per 100 premises); effect of control measures on mosquito populations; genetic homology of epidemic virus with other dengue virus isolates.
The epidemic lasted 70 weeks and comprised 498 confirmed cases in three towns (Cairns, Port Douglas and Mossman); 101 patients (20%) were admitted to hospital. Median interval between symptom onset and notification was seven days (range, 0-53 days), and cumulative duration of viraemia of public health significance was 2,072 days. BIs in affected areas were high, particularly in Mossman (45) and Port Douglas (31). Control measures significantly reduced mosquito populations (assessed as number of ovitraps containing Ae. aegypti eggs and mean number of eggs per trap [P< 0.05 for both]). However, transmission persisted in several foci, in part due to undetected waterfilled containers breeding Ae. aegypti. The epidemic virus belonged to serotype 3; phylogenetic analysis suggested it was imported from Thailand.
The epidemic had greater morbidity than other recent Queensland epidemics of dengue and was harder to control, necessitating substantial revision of the Dengue Fever Management Plan for North Queensland. The epidemic's severity supports the hypothesis that dengue viruses from South East Asia are more virulent than others.
描述1997 - 1999年发生在昆士兰远北地区的登革热3型疫情及其对登革热预防控制策略进一步发展的影响。
对病例进行流行病学和实验室调查、昆虫学调查以及对登革热病毒分离株进行系统发育分析。
确诊病例的数量和特征；布雷图指数（BI；每100处房产中埃及伊蚊滋生容器的数量）；控制措施对蚊虫种群的影响；流行病毒与其他登革热病毒分离株的基因同源性。
疫情持续70周，三个城镇（凯恩斯、道格拉斯港和莫斯曼）有498例确诊病例；101名患者（20%）住院治疗。症状出现至报告的中位间隔时间为7天（范围0 - 53天），具有公共卫生意义的病毒血症累计持续时间为2072天。受影响地区的布雷图指数很高，特别是在莫斯曼（45）和道格拉斯港（31）。控制措施显著减少了蚊虫种群（以含有埃及伊蚊卵的诱蚊产卵器数量和每个诱蚊产卵器的平均卵数评估[两者P均<0.05]）。然而，传播在几个疫点持续存在，部分原因是未检测到滋生埃及伊蚊的积水容器。流行病毒属于3型；系统发育分析表明它是从泰国传入的。
此次疫情的发病率高于昆士兰近期其他登革热疫情，且更难控制，因此有必要对北昆士兰登革热管理计划进行大幅修订。疫情的严重程度支持了东南亚登革热病毒比其他病毒更具毒性的假说。
