Department of Pathology, Prince of Songkla University, Songkhla, Thailand.
Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Transfusion. 2019 Aug;59(8):2612-2621. doi: 10.1111/trf.15401. Epub 2019 Jun 22.
The impact of the spread of chikungunya virus (CHIKV) by autochthonous transmission and blood transfusion in nonendemic areas via travelers returning from CHIKV-affected locations is a concern.
We analyzed the risks of potential CHIKV importation and transfusion transmission from Thailand to Europe via travelers visiting southern Thailand from 2008 through 2015, using the web-based European Up-front Risk Assessment Tool.
The risk of CHIKV importation by European travelers returning from Thailand from 2008 through 2015 varied depending on the year of travel, tourist destination, duration of stay, and time since last possible exposure. Specifically, the risks of acquiring CHIKV among travelers visiting Songkhla and Krabi for 1, 5, or 10-30 days during the highest epidemic activity in 2009 were estimated to be 74.40, 371.99, and 706.77 (Songkhla) and 1.82, 9.08, and 17.25 (Krabi) per 100,000 travelers, respectively. In contrast, such risks were estimated to be fewer than 0.099 per 100,000 travelers in nonepidemic years. The 2009 yearly average rates of expected incidence among 4,059,988 European travelers who stayed for 1 or 10-30 days in all six outbreak activity destinations were calculated to be, respectively, 4.01 × 10 or 1.20 × 10 cases per day, corresponding to the estimated rates of viremia and transfusion-transmitted CHIKV via traveling blood donations of 3.21 × 10 and 0.61, and 9.62 × 10 and 3.34, respectively. Additionally, it is probable that 18 (0.0004%) Europeans acquired CHIKV in Thailand, representing a maximum attack rate of 0.0023%.
The extent of the expected risks and attack rates of CHIKV infection might reflect the travel preferences for popular destinations rather than the true risks of CHIKV transmission in travelers' home nonendemic countries. Nevertheless, preventive and blood-safety intervention measures may be applied to returning travelers at risk for infection to reduce CHIKV transfusion threats in their home countries.
基孔肯雅热病毒（CHIKV）通过在非流行地区的本地传播和输血传播，以及旅行者从受 CHIKV 影响的地区返回，对旅行者造成了影响。
我们使用基于网络的欧洲预先风险评估工具，分析了 2008 年至 2015 年间从泰国到欧洲的旅行者潜在 CHIKV 输入和输血传播的风险。
2008 年至 2015 年间，从泰国返回的欧洲旅行者感染 CHIKV 的风险因旅行年份、旅游目的地、停留时间和最后一次可能暴露的时间而异。具体而言，在 2009 年疫情高峰期，前往宋卡和甲米旅行 1、5 或 10-30 天的旅行者感染 CHIKV 的风险估计分别为每 10 万人 74.40、371.99 和 706.77（宋卡）和 1.82、9.08 和 17.25（甲米）。相比之下，在非流行年份，这种风险估计不到每 10 万人 0.099 人。2009 年，在所有六个疫情活动地区停留 1 天或 10-30 天的 4059988 名欧洲旅行者中，预计每年的平均发病率分别为每天 4.01×10 或 1.20×10 例，这与通过旅行献血传播的 CHIKV 的估计病毒血症和输血传播率分别为 3.21×10 和 0.61，以及 9.62×10 和 3.34 相对应。此外，有 18 名（0.0004%）欧洲人在泰国感染了基孔肯雅热病毒，这意味着最高攻击率为 0.0023%。
预期的 CHIKV 感染风险和发病率程度可能反映了旅行者对热门目的地的旅行偏好，而不是旅行者本国非流行地区 CHIKV 传播的真实风险。然而，可以对感染风险较高的返回旅行者采取预防和血液安全干预措施，以减少其在本国的 CHIKV 输血威胁。
