喜马拉雅山麓急性发热性疾病的暴发调查:解开发热之谜

Outbreak investigation of acute febrile illness from the Himalayan foothills: Solving the puzzle of fever.

作者信息

Satapathy Prakasini, Goel Kapil, Sharma Vikrant, Sarkar Subhabrata, Kang Mannat, Dhingra Shefali, Bora Ishani, Kaur Kanwalpreet, Arora Neeraj, Aggarwal Arun, Ratho Radha Kanta

机构信息

Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Community Medicine & SPH, PGIMER, Chandigarh, India.

出版信息

Front Pharmacol. 2023 Oct 26;14:1159377. doi: 10.3389/fphar.2023.1159377. eCollection 2023.

Abstract

In September 2022, Panchkula Civil Hospital reported an outbreak of acute febrile illness (AFI) in Pinjore, located in the Himalayan foothills, Haryana, North India. There was an upsurge of fever cases. Blood samples were taken from suspected patients ( = 58) with AFI and subjected to serology of dengue, chikungunya, Japanese encephalitis, and scrub typhus. The samples were also screened for West Nile & Zika virus RNA using real-time PCR. Viral strains were characterized by sequencing. Of the 58 cases of AFI, Dengue could be identified in 45 (77.58%) followed by JE and Chikungunya in 2 cases each (3.44%), respectively. Among Dengue positive cases, 44 had monoinfection (97.77%) and 1 patient had dengue and JE. None were positive for Zika, West Nile, Scrub typhus, and with the testing protocol. Four patients developed dengue with warning signs, such as abdominal pain in one patient and recurrent vomiting in the remaining three. The dengue serotype could be determined in 17 samples and revealed serotype 2. Molecular evolution analysis based on the complete envelope gene revealed that all DENV-2 strains ( = 13) circulated in the outbreak area belonged to the DENV-2 cosmopoliton genotype. In the early stages of infection, relying only on clinical manifestations is ineffective, so both molecular and serological assays along with clinical diagnosis are noteworthy for determining the aetiology of AFI.

摘要

2022年9月,旁遮普古拉市民医院报告称,位于印度北部哈里亚纳邦喜马拉雅山麓的平乔尔爆发了急性发热性疾病(AFI)。发热病例激增。从58名疑似AFI患者身上采集了血样,并对其进行了登革热、基孔肯雅热、日本脑炎和恙虫病的血清学检测。还使用实时聚合酶链反应对样本进行了西尼罗河病毒和寨卡病毒RNA筛查。通过测序对病毒株进行了鉴定。在58例AFI病例中,45例(77.58%)被确诊为登革热,其次是2例日本脑炎和基孔肯雅热(各占3.44%)。在登革热阳性病例中,44例为单一感染(97.77%),1例患者同时感染了登革热和日本脑炎。寨卡病毒、西尼罗河病毒、恙虫病检测均为阴性,符合检测方案。4名患者出现了登革热的警示症状,1名患者出现腹痛,其余3名患者反复呕吐。在17份样本中确定了登革热血清型,结果显示为2型。基于完整包膜基因的分子进化分析表明,在疫情爆发地区传播的所有登革热病毒2型毒株(共13株)均属于登革热病毒2型世界基因型。在感染的早期阶段,仅依靠临床表现是无效的,因此分子检测、血清学检测以及临床诊断对于确定AFI的病因都值得关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9baf/10637397/1bfa667cece4/fphar-14-1159377-g001.jpg

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