前往登革热流行地区的旅行者中的登革热病毒血清转化
Dengue Virus Seroconversion in Travelers to Dengue-Endemic Areas.
作者信息
Olivero Rosemary M, Hamer Davidson H, MacLeod William B, Benoit Christine M, Sanchez-Vegas Carolina, Jentes Emily S, Chen Lin H, Wilson Mary E, Marano Nina, Yanni Emad A, Ooi Winnie W, Karchmer Adolf W, Kogelman Laura, Barnett Elizabeth D
机构信息
Section of Pediatric Infectious Diseases, Boston Medical Center, Boston, Massachusetts.
Center for Global Health and Development, Boston University School of Public Health (BUSPH), Boston, Massachusetts.
出版信息
Am J Trop Med Hyg. 2016 Nov 2;95(5):1130-1136. doi: 10.4269/ajtmh.16-0159. Epub 2016 Aug 29.
We conducted a prospective study to measure dengue virus (DENV) antibody seroconversion in travelers to dengue-endemic areas. Travelers seen in the Boston Area Travel Medicine Network planning to visit dengue-endemic countries for ≥ 2 weeks were enrolled from 2009 to 2010. Pre- and post-travel blood samples and questionnaires were collected. Post-travel sera were tested for anti-DENV IgG by indirect IgG enzyme-linked immunosorbent assay (ELISA) and anti-DENV IgM by capture IgM ELISA. Participants with positive post-travel anti-DENV IgG or IgM were tested for pre-travel anti-DENV IgG and IgM; they were excluded from the seroconversion calculation if either pre-travel anti-DENV IgG or IgM were positive. Paired sera and questionnaires were collected for 62% (589/955) of enrolled travelers. Most participants were 19-64 years of age, female, and white. The most common purposes of travel were tourism and visiting friends and relatives; most trips were to Asia or Africa. Median length of travel was 21 days. DENV antibody seroconversion by either anti-DENV IgM or IgG ELISA was 2.9-6.8%; lower range percent excluded potential false-positive anti-DENV IgG due to receipt of yellow fever or Japanese encephalitis vaccines at enrollment; upper range percent excluded proven false-positive anti-DENV IgM. Eighteen percent of those with seroconversion reported dengue-like symptoms. Seroconversion was documented for travel to Africa as well as countries and regions known to be highly dengue endemic (India, Brazil, southeast Asia). Given widespread risk of dengue, travel medicine counseling should include information on risk of dengue in endemic areas and advice on preventing insect bites and seeking prompt medical attention for febrile illness.
我们开展了一项前瞻性研究,以测定前往登革热流行地区的旅行者体内登革病毒(DENV)抗体的血清转化情况。2009年至2010年,我们纳入了波士顿地区旅行医学网络中计划前往登革热流行国家至少2周的旅行者。收集了旅行前后的血样和问卷。旅行后的血清通过间接IgG酶联免疫吸附测定(ELISA)检测抗DENV IgG,通过捕获IgM ELISA检测抗DENV IgM。旅行后抗DENV IgG或IgM呈阳性的参与者检测旅行前的抗DENV IgG和IgM;如果旅行前抗DENV IgG或IgM呈阳性,则将他们排除在血清转化计算之外。我们为62%(589/955)的登记旅行者收集了配对血清和问卷。大多数参与者年龄在19至64岁之间,为女性且是白人。最常见的旅行目的是旅游以及探访朋友和亲戚;大多数行程前往亚洲或非洲。旅行的中位时长为21天。通过抗DENV IgM或IgG ELISA检测的DENV抗体血清转化率为2.9%至6.8%;较低范围百分比排除了因入组时接种黄热病或日本脑炎疫苗导致的潜在抗DENV IgG假阳性;较高范围百分比排除了已证实的抗DENV IgM假阳性。18%发生血清转化的人报告有登革热样症状。前往非洲以及已知登革热高度流行的国家和地区(印度、巴西、东南亚)旅行均有血清转化记录。鉴于登革热的广泛风险,旅行医学咨询应包括有关流行地区登革热风险的信息,以及预防蚊虫叮咬和发热疾病时及时就医的建议。