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[一例从印度新德里输入至土耳其安卡拉的基孔肯雅热病例:土耳其首例输入病例及文献综述]

[An imported Chikungunya fever case from New Delhi, India to Ankara, Turkey: the first imported case of Turkey and review of the literature].

作者信息

Yağcı Çağlayık Dilek, Uyar Yavuz, Korukluoğlu Gülay, Ertek Mustafa, Unal Serhat

机构信息

Refik Saydam National Public Health Agency, Virology Reference and Research Laboratory, Ankara, Turkey.

出版信息

Mikrobiyol Bul. 2012 Jan;46(1):122-8.

Abstract

Chikungunya virus (CHIKV) is an arthropod-borne alphavirus that causes an acute febrile illness, chikungunya fever. CHIKV virus is geographically distributed in Africa, India, and South-East Asia. Chikungunya fever outbreaks have been reported from India since 2006. The incubation period is 3-7 days, and the disease is characterized by sudden onset of high fever and severe arthralgia. Other symptoms can be rash, headache, fatigue, nausea-vomiting, and myalgias. Here, we report the first Chikungunya case imported from India, New-Delhi to Ankara, Turkey. In December 2010, a 55-year-old female Turkish government employee living in urban area of New Delhi for the last 3 years had sudden onset fever up to 38.4°C for 2 days. Itching rash and arthralgia also developed. Symptomatic treatment was given to patient in New Delhi. She returned to Turkey and was admitted to Hacettepe University Medical Faculty, Department of Internal Medicine, Infectious Diseases Unit, since arthralgia has continued on the 26th day of her complaints. Hepatomegaly and tenosynovitis were detected in her physical examination. Serum sample sent to Refik Saydam National Public Health Agency, Virology Reference and Research Laboratory, yielded negative results for specific IgM and IgG antibodies against Hantavirus and Dengue virus types 1-4; however, the results were positive for CHIKV specific IgM and IgG antibodies by commercial immunofluorescence method (Euroimmun, Germany). CHIKV RNA which was searched by in-house real-time RT-PCR was negative. The second serum sample obtained three weeks later also found positive for CHIKV specific IgM and IgG antibodies. This was the first laboratory confirmed imported Chikungunya case in Turkey. There are predictions regarding the presence of Aedes species mosquitos that can transmit this virus in Turkey. This case report will be an alarming signal for the clinicians in our country to consider Chikungunya fever in the differential diagnosis of patients presenting with fever, arthralgia and rash.

摘要

基孔肯雅病毒(CHIKV)是一种节肢动物传播的甲病毒,可引起急性发热性疾病——基孔肯雅热。CHIKV病毒在地理上分布于非洲、印度和东南亚。自2006年以来,印度已报告多起基孔肯雅热疫情。潜伏期为3至7天,该疾病的特征是突然高烧和严重关节痛。其他症状可能包括皮疹、头痛、疲劳、恶心呕吐和肌痛。在此,我们报告了首例从印度新德里输入土耳其安卡拉的基孔肯雅病例。2010年12月,一名55岁的土耳其女性政府雇员,在新德里市区生活了3年,突然发烧至38.4°C,持续了2天。还出现了瘙痒性皮疹和关节痛。该患者在新德里接受了对症治疗。她返回土耳其后,因关节痛在其发病第26天被收治于哈杰泰佩大学医学院内科传染病科。体格检查发现肝肿大和腱鞘炎。送往雷菲克·赛达姆国家公共卫生机构病毒学参考与研究实验室的血清样本,针对汉坦病毒和1 - 4型登革病毒的特异性IgM和IgG抗体检测结果为阴性;然而,采用商业免疫荧光法(德国欧蒙公司)检测,CHIKV特异性IgM和IgG抗体结果呈阳性。通过内部实时逆转录聚合酶链反应检测的CHIKV RNA为阴性。三周后获得的第二份血清样本CHIKV特异性IgM和IgG抗体检测也呈阳性。这是土耳其首例经实验室确诊的输入性基孔肯雅病例。有预测称土耳其存在可传播该病毒的伊蚊种类。本病例报告将为我国临床医生在鉴别诊断发热、关节痛和皮疹患者时考虑基孔肯雅热发出警示信号。

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