Epidemiology and Research Office, Puerto Rico Department of Health, San Juan, Puerto Rico.
Am J Trop Med Hyg. 2013 May;88(5):997-1002. doi: 10.4269/ajtmh.12-0575. Epub 2013 Mar 11.
In June of 2007, West Nile virus (WNV) was detected in sentinel chickens and blood donors in Puerto Rico, where dengue virus (DENV) is hyperendemic. Enhanced human surveillance for acute febrile illness (AFI) began in eastern Puerto Rico on July 1, 2007. Healthcare providers submitted specimens from AFI cases for WNV and DENV virology and serology testing. Over 6 months, 385 specimens were received from 282 cases; 115 (41%) specimens were DENV laboratory-positive, 86 (31%) specimens were laboratory-indeterminate, and 32 (11%) specimens were laboratory-negative for WNV and DENV. One WNV infection was detected by anti-WNV immunoglobulin M (IgM) antibody and confirmed by a plaque reduction neutralization test. DENV and WNV infections could not be differentiated in 27 cases (10%). During a period of active WNV transmission, enhanced human surveillance identified one case of symptomatic WNV infection. Improved diagnostic methods are needed to allow differentiation of WNV and DENV in dengue-endemic regions.
2007 年 6 月,在波多黎各(登革热病毒高度流行的地方)的哨兵鸡和献血者中检测到西尼罗河病毒(WNV)。2007 年 7 月 1 日,在波多黎各东部开始对急性发热性疾病(AFI)进行强化人类监测。医疗保健提供者从 AFI 病例中提交了用于 WNV 和 DENV 病毒学和血清学检测的标本。在 6 个月的时间里,从 282 例病例中收到了 385 份标本;115 份(41%)标本为 DENV 实验室阳性,86 份(31%)标本为实验室不确定,32 份(11%)标本为WNV 和 DENV 实验室阴性。一份 WNV 感染通过抗 WNV 免疫球蛋白 M(IgM)抗体检测到,并通过蚀斑减少中和试验得到确认。在 27 例(10%)中无法区分 DENV 和 WNV 感染。在 WNV 传播活跃期间,强化人类监测发现了一例有症状的 WNV 感染。在登革热流行地区,需要改进诊断方法以区分 WNV 和 DENV。