Deparis X, Chungue E, Pauck S, Roche C, Murgue B, Gleize L
Unité d'épidémiologie, Institut Territorial de Recherches Médicales Louis Malardé, Papeete, Tahiti, Polynésie franaise.
Trop Med Int Health. 1998 Jul;3(7):566-70. doi: 10.1046/j.1365-3156.1998.00264.x.
Dengue fever is present in tropical and subtropical regions and its geographical extension and the simultaneous increase of its mortality are worrisome. In endemic or epidemic countries, the aim of dengue-specific epidemiological surveillance is to confirm as soon as possible the circulation of a new viral dengue serotype, i.e. the beginning of an epidemic. The efficiency of the control strategy is improved by an earlier epidemic alert. In French Polynesia, dengue-3 virus circulated since 1989 at low level and, in May 1996, a specific epidemiological surveillance was undertaken because of the threat of a dengue-4 epidemic. From each suspected dengue case reported by 18 Polynesian physicians located in the Société Islands, a blood sample was taken for virological assay and clinical data were reported. Between May and November 1996, the virology unit of the Institut Malardé isolated 21 viruses (2 dengue-3 and 19 dengue-2) from 302 suspected cases. The dengue-specific epidemiological surveillance confirmed that dengue-2 virus was circulating and reduced the time of the epidemiological alert by 2 or 3 months compared to previous epidemics. Taking into account the day of illness, a logistic regression undertaken on the clinical data showed that the absence of cough was the only predictive sign of dengue diagnosis. The performance of this dengue-specific epidemiological surveillance system led us to consider its implementation in all concerned countries. A collaboration with international reference laboratories could be a solution for the developing countries.
登革热存在于热带和亚热带地区，其地理范围的扩大以及死亡率的同时上升令人担忧。在流行或爆发疫情的国家，登革热特异性流行病学监测的目的是尽快确认新的登革热病毒血清型的传播情况，即疫情的开始。更早的疫情警报可提高控制策略的效率。在法属波利尼西亚，登革热3型病毒自1989年以来一直处于低水平传播，1996年5月，由于登革热4型疫情的威胁，开展了特异性流行病学监测。从社会群岛18名波利尼西亚医生报告的每例疑似登革热病例中采集血样进行病毒学检测，并报告临床数据。1996年5月至11月期间，马勒德研究所病毒学部门从302例疑似病例中分离出21株病毒（2株登革热3型和19株登革热2型）。登革热特异性流行病学监测证实登革热2型病毒正在传播，与以往疫情相比，将流行病学警报时间缩短了2至3个月。考虑到发病日期，对临床数据进行的逻辑回归分析表明，无咳嗽是登革热诊断的唯一预测指标。这种登革热特异性流行病学监测系统的成效促使我们考虑在所有相关国家实施该系统。与国际参考实验室合作可能是发展中国家的一个解决办法。
