Dengue haemorrhagic fever outbreak in Karachi, Pakistan, 1994
Dengue haemorrhagic fever outbreak in Karachi, Pakistan, 1994
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DOI：
10.1016/0035-9203(95)90412-3
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发表时间：
1995-11-01
影响因子：
2.2
通讯作者：
Chow, VTK
中科院分区：
文献类型：
--
作者：
Chan, YC;Salahuddin, NI;Chow, VTK
巴基斯坦卡拉奇的第一次经血清学和病毒学证实的登革出血热暴发的报告，始于1994年8月，在一段时期的异常大雨之后，一直持续到11月。这种疾病主要影响成年人，他们表现为严重的血小板减少、牙床出血和点状出血。对某医院16例患者急性期血清进行的初步调查显示，用登革2型抗原和单抗建立的IgM捕获酶联免疫吸附试验检测出15例患者存在登革热免疫球蛋白M抗体。用半套式聚合酶链式反应(PCR)检测另一家医院10名患者的急性血清中登革病毒核糖核酸(RNA)的存在。在检测的10份血清中，2份登革1型病毒阳性，1份登革2型病毒阳性。将这3份阳性血清接种C6/36细胞，回收登革热病毒。接种登革1型病毒阳性血清的细胞在第3代盲传后第9天出现细胞病变。用登革2型病毒特异性单抗对感染细胞进行免疫荧光染色，结果表明该病毒为登革1型病毒。从登革2型病毒阳性的血清中未发现病毒。简要描述了3名登革热病毒阳性患者的临床情况。卡拉奇疫情的严重程度尚不清楚，但据报道，医生看过的患者人数有数千人。没有死亡病例的估计数字，但至少有两名严重出血的患者在一家医院暴发期间死亡。在疫情爆发前的异常暴雨之后，蚊子密集繁殖，但没有关于涉及的蚊子种类的信息。Newline˜Valerie A.PritchardAddiioNAL摘要：报告了巴基斯坦卡拉奇第一次经血清学和病毒学证实的登革出血热疫情，该疫情始于1994年8月，在一段时期的异常暴雨之后，一直持续到11月。这种疾病主要影响成年人，他们表现为严重的血小板减少、牙床出血和点状出血。对某医院16例患者急性期血清进行的初步调查显示，用登革2型抗原和单抗建立的IgM捕捉法，检测出15例患者存在登革热IgM抗体。另一家医院的10名患者的急性血清通过半套式聚合酶链式反应(PCR)检测登革热病毒RNA的存在。在检测的10份血清中，2份登革1型病毒阳性，1份登革2型病毒阳性。将这3份阳性血清接种白纹伊蚊C6/36细胞，回收登革热病毒。接种登革1型病毒阳性血清的细胞在第3代“盲传”后第9天出现细胞病变。用登革2型病毒特异性单抗对感染细胞进行免疫荧光染色，结果表明该病毒为登革1型病毒。从登革2型病毒阳性的血清中未发现病毒。现对3例登革热病毒阳性患者的临床情况作简要描述。卡拉奇疫情的规模尚不清楚，但据报道，医生看过的患者有数千人。没有死亡病例的估计数字，但至少有两名严重出血的患者在一家医院暴发期间死亡。
A report of the first serologically and virologically confirmed dengue haemorrhagic fever outbreak in Karachi, Pakistan which began in August 1994, following a period of unusually heavy rains, and continued through November. The disease affected mainly adults who presented with severe thrombocytopenia, bleeding gums and petechial haemorrhage. Initial investigation of acute-phase sera from 16 patients in one hospital showed that 15 of them had dengue immunoglobulin M (IgM) antibodies by the IgM capture enzyme-linked immunosorbent assay using dengue type 2 antigen and monoclonal antibody. Acute sera obtained from 10 patients in another hospital were tested for the presence of dengue viral ribonucleic acid (RNA) by a semi-nested polymerase chain reaction (PCR). Of the 10 sera examined, 2 were positive for dengue type 1 virus and 1 for dengue type 2 virus. These 3 positive sera were inoculated into C6/36 cells for recovery of dengue virus. Cells inoculated with the 2 sera positive for dengue type 1 virus showed a cytopathic effect on the ninth day after 3 'blind' passages. Immunofluorescent staining of infected cells with dengue serotype-specific monoclonal antibodies identified the viruses as dengue type 1. No virus was recovered from the serum which was positive for dengue type 2 virus by PCR. The clinical condition of the 3 dengue virus-positive patients is briefly described.The magnitude of the Karachi outbreak was not known, but the number of patients seen by physicians was reported to be in the thousands. No estimate was available for the number of fatal cases but at least 2 patients with severe bleeding had died during the outbreak in one hospital. Intense breeding of mosquitoes following the unusually heavy rains preceding the outbreak was noted but no information on the mosquito species involved was available.newline˜Valerie A. PritchardADDITIONAL ABSTRACT:A report is given of the first serologically and virologically confirmed dengue haemorrhagic fever outbreak in Karachi, Pakistan, which began in August 1994, following a period of unusually heavy rains, and continued through November. The disease affected mainly adults who presented with severe thrombocytopenia, bleeding gums and petechial haemorrhage. Initial investigation of acute-phase sera from 16 patients in one hospital showed that 15 of them had dengue IgM antibodies by the IgM capture ELISA using dengue type 2 antigen and monoclonal antibody. Acute sera obtained from 10 patients in another hospital were tested for the presence of dengue viral RNA by a semi-nested polymerase chain reaction (PCR). Of the 10 sera examined, 2 were positive for dengue type 1 virus and 1 for dengue type 2 virus. These 3 positive sera were inoculated intoAedes albopictusC6/36 cells for recovery of dengue virus. Cells inoculated with the 2 sera positive for dengue type 1 virus showed a cytopathic effect on the 9th day after 3 'blind' passages. Immunofluorescent staining of infected cells with dengue serotype-specific monoclonal antibodies identified the viruses as dengue type 1. No virus was recovered from the serum which was positive for dengue type 2 virus by PCR. The clinical condition of the 3 dengue virus-positive patients is briefly described. The magnitude of the Karachi outbreak was not known, but the number of patients seen by physicians was reported to be in the thousands. No estimate was available for the number of fatal cases but at least 2 patients with severe bleeding had died during the outbreak in one hospital.