最后审阅: 2 十一月 2022
最后更新: 11 十一月 2022
11 十一月 2022

乌干达出现由苏丹型埃博拉病毒引发的埃博拉病毒病暴发

乌干达在 2022 年 9 月 20 日宣布苏丹型埃博拉病毒病暴发。这是乌干达自 2012 年以来由苏丹型埃博拉病毒引发的首次疫情暴发。

截至 2022 年 11 月 7 日,已报告 136 例确诊病例,包括 53 例确诊死亡病例(病例死亡率为 38.9%)。据报告,医务工作者中已确诊 18 例病例和 7 例死亡病例。当前,超过 1300 名接触者在乌干达 7 个区接受监测,其中受影响最严重的是穆本德区。

世界卫生组织评估该次疫情暴发风险在国家层面为“极高”,在地区层面为“高”,而全球范围的风险为“低”。

当前可用的治疗方法和疫苗仅获批用于治疗和预防扎伊尔型埃博拉病毒病。目前正在研发针对苏丹型埃博拉病毒的候选疫苗,并考虑在乌干达展开随机对照试验进行测试。

先前苏丹型埃博拉病毒病暴发的病例死亡率为 53%-65% 不等,最大规模的一次暴发于 2000 年发生在乌干达(425 例)。苏丹型埃博拉病毒是继扎伊尔型埃博拉病毒之后导致疫情暴发的第二常见病毒属。

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小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 先前 21 天暴露在埃博拉病毒环境下
  • 发热
  • 肌痛
  • 结膜充血

其他诊断因素

  • 疲劳
  • 厌食
  • 腹泻
  • 呕吐
  • 剧烈头痛
  • 腹痛或烧心
  • 咳嗽、呼吸困难、胸痛
  • 咽痛
  • 虚脱
  • 呼吸急促
  • 斑丘疹
  • 出血
  • 肝肿大
  • 淋巴结肿大
  • 呃逆
  • 心动过速
  • 低血压
  • 神经系统体征

危险因素

  • 先前 21 天在流行区生活或工作或者从流行区归来
  • 接触感染者的体液
  • 职业暴露
  • 屠宰感染(或潜在感染)动物或摄入此类动物的肉
  • 生物恐怖主义

诊断性检查

首要检查

  • 逆转录聚合酶链反应 (RT-PCR)
  • 疟疾检查

需考虑的检查

  • 血清电解质水平
  • 血清肌酐和尿素
  • 血乳酸
  • 动脉血气分析 (ABG)
  • 全血细胞计数(FBC)
  • 凝血功能检查
  • 尿液分析
  • 肝功能检查 (LFT)
  • 血清淀粉酶水平
  • 血糖
  • 血液培养
  • 抗原捕获酶联免疫吸附测定 (ELISA)
  • IgM 和 IgG 抗体
  • 胸部 X 线检查

治疗流程

急症处理

撰稿人

作者

Nicholas J. Beeching, MA, BM BCh, FRCP, FRACP, FFTM RCPS (Glasg), FESCMID, DCH, DTM&H

Consultant and Emeritus Professor of Tropical and Infectious Diseases

Royal Liverpool University Hospital

Liverpool School of Tropical Medicine

Liverpool

UK

利益声明

NJB is partially supported by the National Institute of Health Research Health Protection Unit in Emerging and Zoonotic Infections at the University of Liverpool and Public Health England. Views expressed in this topic are those of the contributor and do not necessarily represent the official position of the National Health Service, the National Institute for Health Research, the Department of Health, or Public Health England. NJB is an author of references cited in this topic.

Manuel Fenech, MD, MRCP, DTM&H

Specialist Trainee in Infectious Diseases

Royal Liverpool University Hospital

Liverpool

UK

利益声明

MF declares that he has no competing interests.

Tom E. Fletcher, MBE, MBChB, MRCP, DTM&H

Wellcome Trust/MoD Research Fellow

Liverpool School of Tropical Medicine

Liverpool

UK

利益声明

TEF is an author of a number of references cited in this monograph. TEF is a consultant/expert panel member to the World Health Organization, and is funded by the UK Surgeon General and the Wellcome Trust. TEF has received research grants from the Medical Research Council and the UK Public Health Rapid Support Team (UK-PHRST).

Catherine F. Houlihan, MSc, MB ChB, MRCP, DTM&H

Clinical Lecturer

University College London

Honorary Clinical Lecturer

London School of Hygiene and Tropical Medicine

London

UK

利益声明

CFH declares that she has no competing interests.

鸣谢

Dr Nicholas J. Beeching, Dr Manuel Fenech, Dr Tom E. Fletcher, and Dr Catherine F. Houlihan would like to thank Dr Colin Brown (Infectious Disease Lead, Kings Sierra Leone Partnership) for his helpful comments and insights.

利益声明

CB declares that he has no competing interests.

同行评议者

William A. Petri, Jr, MD, PhD, FACP

Wade Hampton Frost Professor of Epidemiology

Professor of Medicine, Microbiology, and Pathology

Chief

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

利益声明

WAP declares that he has no competing interests.

Luis Ostrosky-Zeichner, MD, FACP, FIDSA, FSHEA

Professor of Medicine and Epidemiology

UT Health Medical School

Medical Director of Epidemiology

Memorial Hermann Texas Medical Center

Houston

TX

利益声明

LO-Z declares that he has no competing interests.

Stephen Mepham, MRCP (UK), FRCPATH, DTM&H, MD

Consultant in Microbiology and Infectious Diseases

Royal Free London NHS Foundation Trust

London

UK

利益声明

SM declares that he has no competing interests.

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