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德克萨斯州人类委内瑞拉马脑炎的临床情况

Clinical aspects of human Venezuelan equine encephalitis in Texas.

作者信息

Bowen G S, Fashinell T R, Dean P B, Gregg M B

出版信息

Bull Pan Am Health Organ. 1976;10(1):46-57.

PMID:949558
Abstract

The Venezuelan equine encephalitis epidemic which occurred in Texas in 1971 produced a wide range of predominantly mild clinical symptoms. This epidemic, which peaked on 13-14 July, was most intensely felt in the far-south counties of Cameron and Hidalgo. In all, 88 laboratory-confirmed human cases were reported to the U.S. Center for Disease Control by the Texas State Department of Health. The ratio of male to female cases was about two to one. An attack of 20.8 cases per 100,000, observed in both the 20-29 and 30-39 age groups, was higher than attack rates experienced by other age groups and by the population at large. Together, Cameron and Hidalgo counties experienced a much higher overall attack rate (21.7 cases por 100,000) than did affected counties in the Corpus Christi area (4.9 cases per 100,000). Knowledge about when various patients were first exposed points to an incubation period ranging from 27.5 hours to four days. In those 79 cases for which clinical data were available, the most common clinical manifestations were found to be fever, severe headache, myalgia, and chills. Evidence of mild to moderate central nervous system involvement was found in 10 out of 25 children and young people under 17 years of age, and in six out of 54 adults. Two children still had residual paralysis six weeks after onset of illness, but by 10 months these sequelae had disappeared. Seven of the 54 adults, however, still complained of tiring easily a year after onset of illness. Leukopenia, as demonstrated by a count of less rhan 4,500 white blood cells per cubic millimeter, was observed in 75 per cent of the patients examined.

摘要

1971年在得克萨斯州发生的委内瑞拉马脑炎疫情引发了一系列主要为轻度的临床症状。此次疫情于7月13日至14日达到高峰,在最南端的卡梅伦县和伊达尔戈县感受最为强烈。得克萨斯州卫生部共向美国疾病控制中心报告了88例实验室确诊的人类病例。男女病例之比约为二比一。在20至29岁和30至39岁年龄组中观察到的发病率为每10万人20.8例,高于其他年龄组及总体人群的发病率。卡梅伦县和伊达尔戈县的总体发病率(每10万人21.7例)远高于科珀斯克里斯蒂地区受影响县的发病率(每10万人4.9例)。关于不同患者首次接触病毒的时间信息显示潜伏期为27.5小时至4天。在可获取临床数据的79例病例中,最常见的临床表现为发热、严重头痛、肌痛和寒战。在25名17岁以下儿童和青少年中,有10人出现轻度至中度中枢神经系统受累迹象,在54名成年人中有6人出现此类迹象。两名儿童在发病六周后仍有残留麻痹,但到10个月时这些后遗症已消失。然而,54名成年人中有7人在发病一年后仍抱怨容易疲劳。在接受检查的患者中,75%的人白细胞减少,即每立方毫米白细胞计数低于4500个。

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