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肯尼亚裂谷热重大疫情调查:2006-2007 年。

An investigation of a major outbreak of Rift Valley fever in Kenya: 2006-2007.

机构信息

Division of Communicable Disease Control, Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya.

出版信息

Am J Trop Med Hyg. 2010 Aug;83(2 Suppl):5-13. doi: 10.4269/ajtmh.2010.09-0288.

Abstract

An outbreak of Rift Valley fever (RVF) occurred in Kenya during November 2006 through March 2007. We characterized the magnitude of the outbreak through disease surveillance and serosurveys, and investigated contributing factors to enhance strategies for forecasting to prevent or minimize the impact of future outbreaks. Of 700 suspected cases, 392 met probable or confirmed case definitions; demographic data were available for 340 (87%), including 90 (26.4%) deaths. Male cases were more likely to die than females, Case Fatality Rate Ratio 1.8 (95% Confidence Interval [CI] 1.3-3.8). Serosurveys suggested an attack rate up to 13% of residents in heavily affected areas. Genetic sequencing showed high homology among viruses from this and earlier RVF outbreaks. Case areas were more likely than non-case areas to have soil types that retain surface moisture. The outbreak had a devastatingly high case-fatality rate for hospitalized patients. However, there were up to 180,000 infected mildly ill or asymptomatic people within highly affected areas. Soil type data may add specificity to climate-based forecasting models for RVF.

摘要

2006 年 11 月至 2007 年 3 月期间,肯尼亚暴发裂谷热疫情。我们通过疾病监测和血清学调查来描述疫情的严重程度,并调查了促成因素,以增强预测策略,从而预防或最大限度减少未来疫情的影响。在 700 例疑似病例中,有 392 例符合可能或确诊病例的定义;有 340 例(87%)可获得人口统计学数据,其中 90 例(26.4%)死亡。男性病例的死亡率高于女性,病死率比为 1.8(95%置信区间 [CI] 1.3-3.8)。血清学调查表明,重灾区的居民发病率高达 13%。基因测序表明,此次和之前裂谷热疫情的病毒具有高度同源性。病例地区比非病例地区更有可能拥有保留地表水分的土壤类型。该疫情中住院患者的病死率极高。然而,在重灾区内,多达 18 万感染患者症状轻微或无症状。土壤类型数据可能会为裂谷热的基于气候的预测模型提供更具体的信息。

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