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Clinical features of fatal cases of Chapare virus hemorrhagic fever originating from rural La Paz, Bolivia, 2019: A cluster analysis.
Travel Medicine and Infectious Disease ( IF 12.0 ) Pub Date : 2020-02-12 , DOI: 10.1016/j.tmaid.2020.101589
Juan Pablo Escalera-Antezana 1 , Omar J Rodriguez-Villena 2 , Ariel Weimar Arancibia-Alba 3 , Lucia Elena Alvarado-Arnez 1 , D Katterine Bonilla-Aldana 4 , Alfonso J Rodríguez-Morales 5
Affiliation  

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.



中文翻译:

2019 年源自玻利维亚拉巴斯农村的查帕雷病毒出血热致命病例的临床特征:聚类分析。

简介

2003 年,在玻利维亚发现了一种新兴的乳房病毒(以前称为沙粒病毒)并命名为查帕雷(CHAPV)。它与严重和致命的出血热有关,在临床特征上与 Machupo (MACV) 相似。2019 年年中,CHAPV 是一组 5 例病例的起因,其中 2 例经实验室确诊,3 例死亡。在这里,我们报告了玻利维亚拉巴斯农村病例群的主要临床发现、流行病学特征和潜在的生态方面。

方法

对于这项观察性、回顾性和横断面研究,从医院和卫生部获得了 2019 年实验室诊断和相关病例的信息。 RT-PCR 用于检测 CHAPV 的 RNA。血液样本。

结果

两个病例是针对 CHAPV 的 RT-PCR +。患者的中位年龄为 42 岁(IQR 25-45),五分之四是男性。所有患者均住院、入住ICU并出现发热、上消化道出血,其中两名患者出现ARDS,需要机械通气。三名患者死亡(病死率,CFR 60%)。

结论

乳腺核病毒导致高死亡率。这些病例发生在具有适合啮齿动物传播疾病(包括 CHAPV 感染)的生态流行病学条件的地区。玻利维亚农村地区的社会环境和职业因素可能会导致人畜共患病外溢和传染给人类的风险。

更新日期:2020-02-12
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