李丽,张羽頔,顾沛云,等.上海市长宁区10例猴痘病例临床及流行病学分析[J].上海预防医学,2024,36(1):21-24.. doi: 10.19428/j.cnki.sjpm.2024.23490
引用本文: 李丽,张羽頔,顾沛云,等.上海市长宁区10例猴痘病例临床及流行病学分析[J].上海预防医学,2024,36(1):21-24.. doi: 10.19428/j.cnki.sjpm.2024.23490
LI Li,ZHANG Yudi,GU Peiyun,et al.Analysis of 10 cases of monkeypox in Changning District, Shanghai[J].Shanghai Journal of Preventive Medicine,2024,36(01):21-24.. doi: 10.19428/j.cnki.sjpm.2024.23490
Citation: LI Li,ZHANG Yudi,GU Peiyun,et al.Analysis of 10 cases of monkeypox in Changning District, Shanghai[J].Shanghai Journal of Preventive Medicine,2024,36(01):21-24.. doi: 10.19428/j.cnki.sjpm.2024.23490

上海市长宁区10例猴痘病例临床及流行病学分析

Analysis of 10 cases of monkeypox in Changning District, Shanghai

  • 摘要:
    目的 分析上海市长宁区人感染猴痘确诊病例的临床与流行病学特征,探讨其临床特征和流行病学特征。
    方法 收集在2023年7月20日—9月30日由上海市长宁区医疗机构发现报告或居住在本区的猴痘病例10例的临床资料,进行流病学个案调查并由就诊医疗机构采集咽拭子、肛拭子和皮疹拭子标本,应用实时荧光定量PCR法进行猴痘病毒核酸检测。应用描述性流行病学分析方法分析病例的流行病学特征。
    结果 10例人感染猴痘确诊病例均为青年男性,平均年龄35.4岁,均为男男同性性行为(MSM)人群,无职业聚集性。病例主要临床症状以发热、皮疹、腹股沟淋巴结肿大、肌肉酸痛为主,9例病例出现皮疹,7例出现发热症状。10例病例中出现发热、皮疹、淋巴结肿大、肌肉酸痛者1例;出现发热、皮疹、淋巴结肿大者3例;出现发热、皮疹、全身酸痛者2例;仅出现皮疹者2例;出现发热、皮疹者1例;无症状1人。其中9例出现皮疹的病例出疹部位均为生殖器或肛周,四肢或躯干同时出现皮疹的情况较少。所有病例发病前21 d内均有非固定性伴侣MSM史,末次可疑高危暴露到出现可疑症状的间隔时间为4~10 d,平均间隔时间6.90 d。从出现发热到出疹的间隔时间为0~5 d,平均1.87 d。
    结论 人感染猴痘以发热、皮疹及腹股沟淋巴结肿大为主要临床表现;MSM是感染猴痘的高危人群,其感染来源可能与MSM暴露有关,发病早期症状较轻,容易漏诊,同时调查过程中患者存在隐瞒事实的情况,造成疫情防控难度增加。

     

    Abstract:
    Objective To analyze the clinical and epidemiological characteristics of confirmed cases of human monkeypox infection in Changning District, Shanghai, and to explore their clinical and epidemiological characteristics.
    Methods Clinical data from 10 reported cases of monkeypox in individuals residing in Changning District or identified by local medical institutions between July 20 and September 30, 2023, were collected. Epidemiological case investigations were conducted, and throat swabs, anal swabs, and rash swabs were collected by the treating medical institutions. Real-time fluorescence quantitative PCR was used for monkeypox virus nucleic acid testing, and descriptive epidemiological analysis was applied to analyze the epidemiological characteristics of the cases.
    Results All 10 confirmed cases of human monkeypox infection were all young males with an average age of 35.4 years, all of whom belonged to the men who have sex with men (MSM) population, with no occupational clustering. The primary clinical symptoms included fever, rash, enlarged inguinal lymph nodes, and muscle soreness. Nine cases presented with a rash, and seven cases experienced fever symptoms. Among the 10 cases, one experienced fever, rash, enlarged lymph nodes, and muscle soreness; two had fever, rash, and enlarged lymph nodes; two had fever, rash, and systemic soreness; two had only a rash; one had fever or rash; and one was asymptomatic. Among the nine cases with a rash, the rash was mainly localized to the genital or anal area, with fewer cases presenting rashes on the limbs or trunk simultaneously. All cases reported a history of non-exclusive MSM behavior within 21 days before the onset of the disease. The interval between the last suspected high-risk exposure and the onset of symptoms was 4 to 10 days, with an average interval of 6.9 days. The time from the onset of fever to the appearance of a rash was 0 to 5 days, with an average of 1.87 days.
    Conclusion The main clinical manifestations of human infection with monkeypox are fever, rash, and enlarged inguinal lymph nodes. The MSM population is a high-risk group for monkeypox infection, and its source of infection may be associated with MSM exposure. Early-stage symptoms are mild, leading to potential underdiagnosis. Additionally, patients may conceal information during the investigation process, which increases the difficulty of epidemic prevention and control.

     

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