Date Palm Sap Linked to Nipah Virus Outbreak in Bangladesh, 2008
Date Palm Sap Linked to Nipah Virus Outbreak in Bangladesh, 2008
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DOI：
10.1089/vbz.2011.0656
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发表时间：
2012-01-01
影响因子：
2.1
通讯作者：
Luby, Stephen P.
中科院分区：
文献类型：
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作者：
Rahman, Muhammad Aziz;Hossain, Mohammad Jahangir;Luby, Stephen P.
简介：我们调查了2008年2月孟加拉国Manikgonj和Rajbari地区的一组脑炎患者，以确定疾病的病因和危险因素。我们根据是否存在抗尼帕病毒（NiV）的免疫球蛋白M抗体将患者归类为确诊的尼帕病例，或通过NiV RNA的存在或通过从2008年2月6日至3月10日期间出现症状的脑脊液或咽拭子中分离出NiV。我们将报告发热伴惊厥或精神状态改变、在此期间居住在暴发地区并在收集血清样本之前死亡的人列为可能病例。在病例对照研究中，我们将确诊和可能的尼帕病例患者与对照组进行了比较，对照组在参考期内没有患病。我们使用运动传感器红外摄像机观察蝙蝠的椰枣sape.Results的接触：我们确定了4个确诊和6个可能的病例患者，其中9人（90%）死亡。这些病例的中位年龄为10岁; 8名为男性。疫情同时发生在相距44公里、被一条河隔开的两个社区。发病前2-12天饮用生枣椰汁是唯一与疾病最密切相关的危险因素（调整后的比值比为25，95%置信区间为3.3-无穷大，p < 0.001）。病例患者报告没有与蝙蝠身体接触的历史，尽管社区成员经常报告看到蝙蝠。红外相机照片显示，狐蝠经常访问这些社区的树液收集供人类consumption.Conclusion：这是第二次尼帕疫情在孟加拉国的枣椰树树液已被牵连的传播媒介。新鲜的椰枣树汁不应该被饮用，除非已经采取了有效的措施来防止蝙蝠在采集过程中接触到树液。
Introduction: We investigated a cluster of patients with encephalitis in the Manikgonj and Rajbari Districts of Bangladesh in February 2008 to determine the etiology and risk factors for disease.Methods: We classified persons as confirmed Nipah cases by the presence of immunoglobulin M antibodies against Nipah virus (NiV), or by the presence of NiV RNA or by isolation of NiV from cerebrospinal fluid or throat swabs who had onset of symptoms between February 6 and March 10, 2008. We classified persons as probable cases if they reported fever with convulsions or altered mental status, who resided in the outbreak areas during that period, and who died before serum samples were collected. For the case-control study, we compared both confirmed and probable Nipah case-patients to controls, who were free from illness during the reference period. We used motion-sensor-infrared cameras to observe bat's contact of date palm sap.Results: We identified four confirmed and six probable case-patients, nine (90%) of whom died. The median age of the cases was 10 years; eight were males. The outbreak occurred simultaneously in two communities that were 44km apart and separated by a river. Drinking raw date palm sap 2-12 days before illness onset was the only risk factor most strongly associated with the illness (adjusted odds ratio 25, 95% confidence intervals 3.3-infinity, p < 0.001). Case-patients reported no history of physical contact with bats, though community members often reported seeing bats. Infrared camera photographs showed that Pteropus bats frequently visited date palm trees in those communities where sap was collected for human consumption.Conclusion: This is the second Nipah outbreak in Bangladesh where date palm sap has been implicated as the vehicle of transmission. Fresh date palm sap should not be drunk, unless effective steps have been taken to prevent bat access to the sap during collection.