Vivian Thangaraj Jeromie Wesley, Mittal Mahima, Verghese Valsan Philip, Kumar C P Girish, Rose Winsley, Sabarinathan R, Pandey Ashok Kumar, Gupta Nivedita, Murhekar Manoj
National Institute of Epidemiology, Chennai, India.
Department of Pediatrics, BRD Medical College, Gorakhpur, India.
Am J Trop Med Hyg. 2017 Nov;97(5):1313-1315. doi: 10.4269/ajtmh.17-0135. Epub 2017 Aug 18.
Seasonal outbreaks of acute encephalitis syndrome (AES) with high mortality occur every year in Gorakhpur region of Uttar Pradesh, India. Earlier studies indicated the role of scrub typhus as the important etiology of AES in the region. AES cases were hospitalized late in the course of their illness. We established surveillance for acute febrile illness (AFI) (fever ≥ 4 days duration) in peripheral health facilities in Gorakhpur district to understand the relative contribution of scrub typhus. Of the 224 patients enrolled during the 3-month period corresponding to the peak of AES cases in the region, about one-fifth had immunoglobulin M (IgM) antibodies against . Dengue and leptospira accounted for 8% and 3% of febrile illness cases. Treating patients with AFI attending the peripheral health facilities with doxycycline could prevent development of AES and thereby reduce deaths due to AES in Gorakhpur region.
印度北方邦戈勒克布尔地区每年都会爆发季节性急性脑炎综合征（AES），死亡率很高。早期研究表明，恙虫病是该地区AES的重要病因。AES患者在病程后期才住院治疗。我们在戈勒克布尔区的基层医疗机构建立了对急性发热性疾病（AFI）（发热持续时间≥4天）的监测，以了解恙虫病的相对影响。在该地区AES病例高峰期对应的3个月期间登记的224例患者中，约五分之一有针对……的免疫球蛋白M（IgM）抗体。登革热和钩端螺旋体分别占发热性疾病病例的8%和3%。用强力霉素治疗在基层医疗机构就诊的AFI患者可以预防AES的发生，从而减少戈勒克布尔地区因AES导致的死亡。
