沈安梅, 谢博, 刘俊, 蔡凤珠, 张耀光, 朱民. 上海市浦东新区1例输入性恶性疟二次再燃的调查[J]. 上海预防医学, 2018, 30(10): 852-856, 863. DOI: 10.19428/j.cnki.sjpm.2018.18547
引用本文: 沈安梅, 谢博, 刘俊, 蔡凤珠, 张耀光, 朱民. 上海市浦东新区1例输入性恶性疟二次再燃的调查[J]. 上海预防医学, 2018, 30(10): 852-856, 863. DOI: 10.19428/j.cnki.sjpm.2018.18547
SHEN An-mei, XIE Bo, LIU Jun, CAI Feng-zhu, ZHANG Yao-guang, ZHU Min. One case of recurrence of imported falciparum malaria in Pudong New Area of Shanghai[J]. Shanghai Journal of Preventive Medicine, 2018, 30(10): 852-856, 863. DOI: 10.19428/j.cnki.sjpm.2018.18547
Citation: SHEN An-mei, XIE Bo, LIU Jun, CAI Feng-zhu, ZHANG Yao-guang, ZHU Min. One case of recurrence of imported falciparum malaria in Pudong New Area of Shanghai[J]. Shanghai Journal of Preventive Medicine, 2018, 30(10): 852-856, 863. DOI: 10.19428/j.cnki.sjpm.2018.18547

上海市浦东新区1例输入性恶性疟二次再燃的调查

One case of recurrence of imported falciparum malaria in Pudong New Area of Shanghai

  • 摘要:
    目的通过对1例输入性恶性疟二次再燃的发病与治疗情况调查,寻证输入性恶性疟出现再燃的原因,采取有效的治疗方法,进一步推进消除疟疾工作。
    方法对患者进行流行病学个案调查和疫点调查,患者血样制作血涂片进行疟原虫镜检、疟疾快速诊断实验检测恶性疟原虫特异性抗原(RDT)、巢式PCR检测恶性疟原虫。
    结果该患者从2008年始有明确的多次的非洲和东南亚出差史,具有寒战、高热、出汗后退热等典型疟疾症状,实验室RDT、血涂片、PCR检测均为恶性疟阳性,被确诊为输入性恶性疟;患者2016年12月19日首次发病,经青蒿琥酯治疗后体温正常,但3周后再燃发病,继续青蒿琥酯抗疟治疗后体温正常,本次发病是患者第2次再燃发病,经联合抗疟用药后痊愈。
    结论输入性疟疾比例逐年上升及其再燃病例增多,严重威胁着患者的生命安全,加强输入性疟疾的管理,根治传染源防止传播,已成为当前消除疟疾阶段的主要任务。

     

    Abstract:
    ObjectiveTo investigate the onset and treatment for the case of recurrent imported falciparum malaria, and to ascertain its causes and effective treatment so as to promote elimination of malaria.
    MethodsOn the basis of investigation of the epidemiological case, we collected data from hospital. Shanghai CDC made blood smears for microscopic examination of Plasmodium falciparum, RDT and nested PCR were used to detect Plasmodium falciparum.
    ResultsThe patient had a clear history of multiple trips to Africa and Southeast Asia, suffering from typical malaria symptoms such as chills, hyperthermia and fever. The lab tests of the RDT, blood smears and nested PCR were Plasmodium falciparum positive. The patient was diagnosed with imported falciparum malaria with first onset on December 19, 2016. After treatment with Artesunate, the body temperature became normal but 3 weeks later the patient had recurrence. After continuing treatment with Artesunate, the body temperature was normal again. This was the second time the patient had the disease and after combined use of antimalaria drugs, was cured.
    ConclusionThe proportion of imported falciparum malaria is rising year by year with increase in recurrence cases, which severely threatens patients′ lives. To strengthen management of imported malaria, eradicate the source of infection and prevent its spread has become the main task at the current stage of malaria elimination.

     

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