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目的分析某部一起军营急性呼吸道腺病毒7型感染暴发的临床特征和病原学诊断,为此类疫情的防控提供依据。方法参训官兵共663人,采用统一的流行病学个案调查表,对166例患者进行现场调查,描述疾病特征;对其中32例急性期患者咽拭子标本进行病原学检测,82例患病进行病毒血清抗体检测。结果 166例患者分布在整个营区,有明显的宿舍聚集现象,发病率为25.0%。166例患者全部有发热症状,其中伴咳嗽占15.7%、咽痛占38.0%、头痛占20.5%、肺炎占1.8%、结膜炎占1.2%。咽拭子标本经PCR检测腺病毒基因阳性占53.1%;经HepG2、Hela细胞培养,50.0%出现细胞病变;30例患者经IgM抗体筛查明确为腺病毒感染(36.6%);中和试验证实20例(24.4%)腺病毒抗体恢复期比急性期有4倍以上升高。隔离患者、全面消毒后10 d,无新发病例。结论此次暴发疫情由腺病毒7型引起,经过及时而合理的预防措施能快速控制疾病的流行。
Objective To analyze the clinical features and etiological diagnosis of an outbreak of Acute Respiratory Adenovirus Type 7 infection in a military camp and provide basis for the prevention and control of such epidemic. Methods A total of 663 officers and soldiers participated in the training. A total of 166 epidemiological questionnaires were used to conduct on-site investigation of 166 patients and describe the characteristics of the disease. Thirty-two throat swab specimens were pathologically tested and 82 Virus serum antibody test. Results A total of 166 patients were found in the entire camp area, with obvious dormitory aggregation. The incidence rate was 25.0%. All 166 patients had fever symptoms, including 15.7% with cough, 38.0% with pharyngodynia, 20.5% with headache, 1.8% with pneumonia and 1.2% with conjunctivitis. The throat swab specimens were positive for adenovirus gene by PCR (53.1%). After HepG2 and Hela cells were cultured, 50.0% cells were cytopathic. Thirty patients were confirmed as adenovirus infection by IgM antibody screening (36.6%). Neutralization test confirmed In 20 patients (24.4%) adenovirus antibody recovery period more than 4 times higher than the acute phase. Isolation of patients, after a total disinfection 10 d, no new cases. Conclusion The outbreak was caused by adenovirus type 7, and the timely and reasonable preventive measures can rapidly control the epidemic.