Watts D M, Callahan J, Rossi C, Oberste M S, Roehrig J T, Wooster M T, Smith J F, Cropp C B, Gentrau E M, Karabatsos N, Gübler D, Hayes C G
U.S. Naval Medical Research Institute Detachment, NAMRID/Unit 3800, Lima, Peru.
Am J Trop Med Hyg. 1998 Jan;58(1):35-40. doi: 10.4269/ajtmh.1998.58.35.
A survey was conducted from October 1, 1993 to June 30, 1995 to determine the arboviral etiologies of febrile illnesses in the city of Iquitos in the Amazon River Basin of Peru. The study subjects were patients who were enrolled at medical care clinics or in their homes by Peruvian Ministry of Health (MOH) workers as part of the passive and active disease surveillance program of the MOH. The clinical criterion for enrollment was the diagnosis of a suspected viral-associated, acute, undifferentiated febrile illness of < or = 5 days duration. A total of 598 patients were enrolled in the study. Demographic information, medical history, clinical data, and blood samples were obtained from each patient. The more common clinical features were fever, headache, myalgia, arthralgia, retro-ocular pain, and chills. Sera were tested for virus by the newborn mouse and cell culture assays. Viral isolates were identified initially by immunofluorescence using polyclonal antibody. An ELISA using viral-specific monoclonal antibodies and nucleotide sequence analysis were used to determine the specific variety of the viruses. In addition, thin and thick blood smears were observed for malaria parasites. Venezuelan equine encephalitis (VEE) virus subtype I, variety ID virus was isolated from 10 cases, including three cases in October, November, and December 1993, five cases in January and February 1994, and two cases in June 1995. The ELISA for IgM and IgG antibody indicated that VEE virus was the cause of an additional four confirmed and four presumptive cases, including five from January through March 1994 and three in August 1994. Sixteen cases were positive for malaria. The 18 cases of VEE occurred among military recruits (n = 7), agriculture workers (n = 3), students (n = 3), and general laborers (n = 5). These data indicated that an enzootic strain of VEE virus was the cause of at least 3% (18 of 598) of the cases of febrile illnesses studied in the city of Iquitos in the Amazon Basin region of Peru.
1993年10月1日至1995年6月30日期间进行了一项调查，以确定秘鲁亚马逊河流域伊基托斯市发热性疾病的虫媒病毒病因。研究对象是秘鲁卫生部（MOH）工作人员在医疗诊所或其家中登记的患者，这是卫生部被动和主动疾病监测计划的一部分。纳入标准的临床标准是诊断为疑似病毒相关的急性未分化发热性疾病，病程≤5天。共有598名患者纳入该研究。从每位患者处获取人口统计学信息、病史、临床数据和血样。较常见的临床特征为发热、头痛、肌痛、关节痛、眼球后疼痛和寒战。通过新生小鼠和细胞培养试验检测血清中的病毒。病毒分离株最初使用多克隆抗体通过免疫荧光进行鉴定。使用病毒特异性单克隆抗体的ELISA和核苷酸序列分析来确定病毒的具体种类。此外，观察厚薄血涂片以查找疟原虫。从10例患者中分离出委内瑞拉马脑炎（VEE）病毒I型ID变种病毒，其中包括1993年10月、11月和12月的3例，1994年1月和2月的5例，以及1995年6月的2例。IgM和IgG抗体的ELISA表明，VEE病毒是另外4例确诊病例和4例疑似病例的病因，包括1994年1月至3月的5例和1994年8月的3例。16例疟疾病例检测呈阳性。18例VEE病例发生在新兵（n = 7）、农业工人（n = 3）、学生（n = 3）和普通劳动者（n = 5）中。这些数据表明，VEE病毒的一种地方性毒株是秘鲁亚马逊盆地地区伊基托斯市所研究的至少3%（598例中的18例）发热性疾病病例的病因。
