1Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia.
2Addis Ababa Emergency Burn & Trauma Hospital, Addis Ababa, Ethiopia.
Am J Trop Med Hyg. 2021 Jun 28;105(2):511-516. doi: 10.4269/ajtmh.20-1246.
In October 2016, we received reports of five deaths among prisoners with leg swelling of unknown etiology in southwestern Ethiopia. A descriptive cross-sectional study was conducted to investigate the outbreak. A suspected case was defined as a prisoner with leg swelling of unknown etiology noted between May 15, 2016 and November 29, 2016. A total of 118 suspected cases were identified with unilateral or bilateral leg swelling without an identifiable cause from a total of 2,790 prisoners. Eight of the suspected cases were thoroughly examined, and seven of these suspected cases had clinical findings consistent with scurvy. Three of the clinical cases had undetectable vitamin C levels in the serum. The attack rate for the prison was 4.2% (118/2,790), and 11 deaths were identified, making the case fatality rate 9.3% (11/118). Clinical cases of scurvy had symptoms of fatigue, myalgia, arthralgia, and signs of follicular hyperkeratosis, petechiae, peripheral edema, and oral lesions. All clinical cases had severe anemia with hemoglobin < 6.0 g/dL. The diet provided by the prison excluded fruits and vegetables. Scurvy was determined to be the cause of the outbreak, and vitamin C supplementation was promptly initiated. All symptomatic prisoners improved, and no further cases were identified in a 4-week follow-up period of active surveillance.
2016 年 10 月，我们收到报告称，在埃塞俄比亚西南部，有 5 名囚犯出现不明病因的腿部肿胀后死亡。我们开展了一项描述性横断面研究，以调查此次疫情。疑似病例定义为 2016 年 5 月 15 日至 11 月 29 日期间出现不明病因腿部肿胀的囚犯。从总共 2790 名囚犯中发现了 118 例单侧或双侧腿部肿胀且无明确病因的疑似病例。对 8 例疑似病例进行了全面检查，其中 7 例疑似病例的临床检查结果符合坏血病。3 例临床病例的血清维生素 C 水平无法检测到。该监狱的发病率为 4.2%（118/2790），有 11 例死亡，病死率为 9.3%（11/118）。坏血病的临床病例有疲劳、肌肉疼痛、关节痛和滤泡性角化过度、瘀点、外周水肿和口腔病变的症状。所有临床病例均有严重贫血，血红蛋白<6.0 g/dL。监狱提供的饮食中不含水果和蔬菜。确定坏血病是疫情的原因，并及时开始补充维生素 C。所有有症状的囚犯都得到了改善，在 4 周的主动监测随访期间未再发现新病例。
