最近审阅: 26 十月 2020
最近更新: 31 十二月 2019
19 Dec 2019

刚果民主共和国埃博拉疫情暴发最新消息

世界卫生组织(World Health Organization, WHO)已确定始于2018年8月的刚果民主共和国(Democratic Republic of the Congo , DRC)埃博拉疫情暴发构成国际关注的突发公共卫生事件。这是西非2014-2016 暴发埃博拉疫情以来的第二大规模暴发。

截至 2019 年 12 月 3 日,DRC 北基伍省和伊图里省报告了 3313 例病例(3195 例确诊,118 例疑似),其中 2207 例死亡(病死率为67%)。本次疫情暴发期间, 妇女和儿童感染人数过多。总病例数中,56% 为女性,28% 为 <18 岁的儿童。共有163 名卫生工作者遭到感染。

WHO指出,长期的人道主义危机和这一地区安全局势的恶化,有时限制了应对活动的开展。暴力活动报道有所增加,包括对埃博拉治疗中心大规模、有组织的袭击。暴力、广泛的内乱和有针对性的攻击,过去数周内严重破坏了多个地点的响应,可能会对于近期的进展造成逆转。

目前正在采用 rVSV-ZEBOV 疫苗对卫生工作者和埃博拉患者接触者进行环状接种。WHO 已对该疫苗进行资格预审,这有助于加速其在最易爆发埃博拉疫情的国家中获得许可、药物获取和得到应用推广的步骤。欧洲药品管理局也已向 rVSV-ZEBOV 疫苗授予欧盟条件性上市许可,可对具有埃博拉病毒感染风险的成年人进行主动免疫。目前第二种疫苗接种(Ad26.ZEBOV / MVA-BN-Filo,2 剂异源化疫苗接种方案)亦加以应用。

实验性埃博拉治疗 mAb114、remdesivir、ZMapp、REGN-EB3和法匹拉韦被批准在同情性用药框架下,用于疫情暴发。来自随机对照试验的初始数据显示,与 ZMapp 和 remdesivir 相比,REGN-EB3和mAb114与更高的存活率相关。患者将于现存治疗中心被给予此两种表现更好的药物之一。

WHO评定认为,疾病在国家和区域间传播的风险极高,但全球风险水平较低。根据现有信息,世界卫生组织 (WHO) 建议,不要对前往和与刚果民主共和国进行贸易加以任何限制。

查看流行病学

原始更新来源external link opens in a new window

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
  • 腹泻
  • 恶心/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
更多 首要检查

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
更多 需考虑的检查

治疗流程

急性处理

撰稿人

Senior Lecturer (Honorary Consultant)

Liverpool School of Tropical Medicine and Royal Liverpool University Hospital

Liverpool

UK

利益声明

NJB is an author of several references cited in this monograph. 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. He is affiliated with the Liverpool School of Tropical Medicine. Views expressed in this monograph 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.

Specialist Trainee in Infectious Diseases

Royal Liverpool University Hospital

Liverpool

UK

利益声明

MF declares that he has no competing interests.

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).

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.

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. CB declares that he has no competing interests.

同行评议者展开全部内容

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.

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.

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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