目的 综合分析1例发热伴血小板减少综合征（SFTS）病例的流行病学特征和应急处置情况,为制定该病的应急处置措施和防控策略提供依据。方法 对病例、密切接触者和共同暴露者开展流行病学调查和实验室检测。在病例居住和工作场所及可疑暴露地开展寄生蜱和游离蜱等媒介密度监测,并对采集到的蜱虫开展布尼亚病毒（SFTSV）核酸检测。对病例居住和工作场所周边医疗机构开展病例搜索和应急监测,对居住和工作场所周边健康人群开展血清学监测。通过酶联免疫吸附法开展抗体IgM和IgG检测,用RT-PCR方法开展核酸检测和Sanger测序方法开展核酸测序。结果 病例发病前14 d无疫区旅居史和确诊/疑似病例接触史,血样经RT-PCR检测为发热伴血小板减少综合征布尼亚病毒核酸阳性。居住和工作场所采集到犬只寄生蜱,经鉴定为血红扇头蜱,布旗法未采集到游离蜱,所采集到蜱虫和犬只均未检出SFTSV。检出1名工厂同事和1名健康人员为抗体IgM阳性,SFTSV核酸均为阴性。经Sanger测序方法检测病毒为HB2012-197,与湖北流行株近似同源。病例搜索和应急监测未发现其他病例,居住和工作所在地区从未有过本地感染病例和暴发疫情的报告。结论 病例本地感染的证据不足,感染来源与湖北关联可能性大,后续应加强病例和媒介的监测,提高早发现、早调查、早防控能力。病例发病至确诊时间久,提示医疗机构应加强该病培训,提升疾病早诊断能力。

Objective To comprehensively analyze the epidemiological characteristics and emergency treatment of a case of severe fever with thrombocytopenia syndrome (SFTS), analyze the suspected sources of infection, and provide a basis for the development of emergency treatment measures and prevention and control strategies of SFTS.Methods Epidemiological investigation and laboratory tests were carried out among the cases, close contacts and co-exposed persons. The density of parasitic ticks and free ticks was monitored at the living and working places of the cases and the suspected exposure sites, and SFTSV nucleic acid test was performed on the collected ticks. Case search and emergency monitoring was carried out in medical institutions around the living and working places of the cases, and serological monitoring was carried out among healthy people around the living and working places. The flag method was used to monitor tick density in places exposed to suspected cases, and case search and emergency monitoring were carried out in medical institutions and communities. IgM and IgG antibodies were detected by ELISA, nucleic acid was detected by RT-PCR and nucleic acid was sequenced by Sanger sequencing.Results The case had no travel history or contact history with confirmed/suspected cases 14 days before onset of the disease. The blood sample was positive for SFTS bunyavirus nucleic acid by RT-PCR. Parasitic ticks were collected from dogs in residential and workplace, and identified as Rhipicephalus sanguineus. Free-living ticks were not collected by flagging method, and SFTSV was not detected in ticks and dogs. PCR nucleic acid test was performed on the blood sample of the patient, and the result was positive for SFTS bunyavirus nucleic acid test, confirming the case of SFTS. One factory colleague and one healthy person were found to be IgM positive and SFTSV nucleic acid negative. The nucleic acid of the virus was detected as HB2012-197 by Sanger sequencing method, which was approximately homologous to the epidemic strain in Hubei Province. Case searches and emergency surveillance have found no additional cases, and no locally acquired cases or outbreaks have ever been reported in the area where one lives or works.Conclusion The evidence of local infection is insufficient, and the source of infection is likely to be associated with Hubei Province. Follow-up surveillance of cases and vectors should be strengthened to improve the ability of early detection, early investigation and early prevention and control. It took a long time for the case to be diagnosed, suggesting that medical institutions should strengthen training on the disease and improve the ability of early diagnosis of the disease.