Clinical features of fatal cases of Chapare virus hemorrhagic fever originating from rural La Paz, Bolivia, 2019: A cluster analysis
Clinical features of fatal cases of Chapare virus hemorrhagic fever originating from rural La Paz, Bolivia, 2019: A cluster analysis
复制标题
DOI：
10.1016/j.tmaid.2020.101589
复制
发表时间：
2020-07-01
影响因子：
12
通讯作者：
Rodriguez-Morales, Alfonso J.
中科院分区：
文献类型：
--
作者：
Pablo Escalera-Antezana, Juan;Rodriguez-Villena, Omar J.;Rodriguez-Morales, Alfonso J.
简介：2003年，在玻利维亚发现了一种新的乳房病毒（以前称为沙粒病毒），并命名为Chapare（CHAPV）。它与严重和致命的出血热有关，临床特征与马丘坡（MACV）相似。在2019年年中，CHAPV是五例病例的原因，其中两例经实验室确认，其中三例死亡。在这里，我们报告的主要临床结果，流行病学特征和潜在的生态方面，该集群的情况下，在农村拉巴斯，玻利维亚。方法：对于这项观察性，回顾性和横断面研究，信息是从医院和卫生部获得的实验室诊断和相关的情况下，在2019年。结果：2例CHAPV阳性，其中2例为CHAPV阳性。患者的中位年龄为42岁（IQR 25-45），五分之四为男性。所有患者均住院，入住ICU，并出现发热、上消化道出血，其中2例患者出现ARDS，需要机械通气。3例患者死亡（病死率，CFR 60%）。这些病例发生在生态流行病学条件适合啮齿动物传播疾病（包括CHAPV感染）的地区。玻利维亚农村地区的社会环境和职业因素可能导致人畜共患病外溢和传播给人类的风险。
Introduction: In 2003 an emerging mammarenavirus (formerly arenaviruses) was discovered in Bolivia and named Chapare (CHAPV). It was associated with severe and fatal hemorrhagic fever, being similar in clinical features to Machupo (MACV). In mid-2019, CHAPV was the cause of a cluster of five cases, two of them laboratory confirmed, three of them fatal. Here, we report the main clinical findings, epidemiological features and the potential ecological aspects, of that cluster of cases in rural La Paz, Bolivia.Methods: For this observational, retrospective and cross-sectional study, information was obtained from the Hospitals and the Ministry of Health for the cases that were laboratory-diagnosed and related, during 2019. RT-PCR was used for the detection of the RNA of CHAPV in the blood samples.Results: Two cases were RT-PCR + for CHAPV. The median age of patients was 42 y-old (IQR 25-45), four out of five were male. All patients were hospitalized, admitted to the ICU and had fever, upper digestive hemorrhage, with two of them, presenting ARDS, and requiring mechanical ventilation. Three patients died (case fatality rate, CFR 60%).Conclusions: Mammarenaviruses led to a high fatality rate. These cases occurred in areas with suitable ecoepidemiological conditions for rodent-borne diseases, including CHAPV infection. Socioenvironmental and occupational factors in rural areas of Bolivia may contribute with the risk of zoonotic spillover and transmission to humans.