2019 年玻利维亚啮齿动物中的查帕雷出血热与病毒检测
Chapare Hemorrhagic Fever and Virus Detection in Rodents in Bolivia in 2019.
机构信息
From Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra (R.L.M., C.E.A.A., C.A.A., M.C.Z., A.D.A., N.M.L., A.-M.M., F.L.M.A., J.R.G., S.S.M.), and Unidad de Epidemiología (C.R., G.A.D.L.V., A.M.R., J.T.M.G.), Unidad de Gestión de Riesgos en Salud Ambiental, Emergencias y Desastres (A.J.C.P.), and Instituto Nacional de Laboratorios de Salud "Dr. Néstor Morales Villazón" (R.S.B.), Ministerio de Salud, the Pan American Health Organization (A.A.), Hospital Obrero No. 1, Caja Nacional de Salud (A.S.), Hospital Militar Central, Hospital Municipal Boliviano Holandés (K.M.T.C.), and Hospital de Clínicas (A.V.-C.), La Paz - all in Bolivia; the Centers for Disease Control and Prevention, Atlanta (M.E.M.-B., C.M.C., S.W., B.R.A., M.J.C., B.-R.E., C.G., J.C.G., A.J., J.D.K., A.L., J.H.M., S.T.N., K.P., T. Sealy, T. Shoemaker, C.F.S., A.T., J.S.T., J.M.M.); Instituto Nacional de Enfermedades Virales Humanas "Dr. Julio I. Maiztegui," Pergamino, Argentina (J.B., J.G.); the Pan American Health Organization, Washington, D.C. (J.M.-R.); and Universidade Federal do Rio Grande do Norte, Natal, Brazil (K.L.).
出版信息
N Engl J Med. 2022 Jun 16;386(24):2283-2294. doi: 10.1056/NEJMoa2110339.
BACKGROUND
In June 2019, the Bolivian Ministry of Health reported a cluster of cases of hemorrhagic fever that started in the municipality of Caranavi and expanded to La Paz. The cause of these cases was unknown.
METHODS
We obtained samples for next-generation sequencing and virus isolation. Human and rodent specimens were tested by means of virus-specific real-time quantitative reverse-transcriptase-polymerase-chain-reaction assays, next-generation sequencing, and virus isolation.
RESULTS
Nine cases of hemorrhagic fever were identified; four of the patients with this illness died. The etiologic agent was identified as , or Chapare virus (CHAPV), which causes Chapare hemorrhagic fever (CHHF). Probable nosocomial transmission among health care workers was identified. Some patients with CHHF had neurologic manifestations, and those who survived had a prolonged recovery period. CHAPV RNA was detected in a variety of human body fluids (including blood; urine; nasopharyngeal, oropharyngeal, and bronchoalveolar-lavage fluid; conjunctiva; and semen) and in specimens obtained from captured small-eared pygmy rice rats (). In survivors of CHHF, viral RNA was detected up to 170 days after symptom onset; CHAPV was isolated from a semen sample obtained 86 days after symptom onset.
CONCLUSIONS
was identified as the etiologic agent of CHHF. Both spillover from a zoonotic reservoir and possible person-to-person transmission were identified. This virus was detected in a rodent species, . (Funded by the Bolivian Ministry of Health and others.).
背景
2019 年 6 月，玻利维亚卫生部报告了一起出血热病例群集，该病例群集始于卡拉瓦尼市，并蔓延至拉巴斯。这些病例的病因尚不清楚。
方法
我们获得了用于下一代测序和病毒分离的样本。通过病毒特异性实时定量逆转录聚合酶链反应检测、下一代测序和病毒分离检测人类和啮齿动物标本。
结果
共发现 9 例出血热病例，其中 4 例患者死亡。病原体被鉴定为 ，或查帕病毒（CHAPV），引起查帕出血热（CHHF）。确定了卫生保健工作者之间存在可能的医院内传播。一些 CHHF 患者有神经系统表现，幸存者恢复时间较长。在各种人体体液（包括血液；尿液；鼻咽、口咽和支气管肺泡灌洗液；结膜；和精液）以及从捕获的小耳小家鼠（）中检测到 CHAPV RNA。在 CHHF 的幸存者中，病毒 RNA 可在症状出现后 170 天检测到；CHAPV 是从症状出现后 86 天的精液样本中分离出来的。
结论
被鉴定为 CHHF 的病原体。鉴定出了从动物宿主溢出和可能的人际传播。这种病毒在一种啮齿动物物种，中被检测到。（由玻利维亚卫生部和其他机构资助）。
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