点击标题下「SIFIC官微」可快速关注欧盟疾病预防控制中心风险评估：德国和美国出现来自西非的拉萨热输入性病例
Imported cases of Lassa fever from West Africa to Germany and USA, ECDC risk assessment
检索：王珍丽 侯马市人民医院
翻译：臧金成 河南省洛阳市洛阳市中心医院
刘明星 江苏省苏州市苏州大学附属第一医院
王珍丽 侯马市人民医院
审核：陈志锦 广东医科大学附属东莞市厚街医院
Following the spread of the disease to new areas in West Africa, Togo, and the risk of secondary transmission in healthcare facilities due to the delays in the diagnosis of viral haemorrhagic fevers, Lassa fever should be considered for any patient presenting with suggestive symptoms and with a travel history in West Africa, even with differential diagnosis, states the ECDC risk assessment.
欧盟疾病预防控制中心风险评估阐明，继拉萨热在西非多哥的新地区蔓延，由于病毒性出血热的诊断延误而存在医疗机构继发传播的风险，有先驱症状和西非出行史的均应考虑拉萨热，在这基础上进行鉴别诊断。
Secondary transmission in healthcare settings (nosocomial transmission) should be prevented through appropriate infection control measures. Travellers to West Africa should be informed of the risk of exposure to Lassa fever virus and personal protective measures.
医疗机构的继发传播（院内传播）应该采取适当的感染控制措施进行预防。赴西非的旅客应了解接触拉萨热病毒的风险和个人防护措施。
Imported cases of Lassa fever to Germany and USA
德国和美国出现拉萨热输入性病例
On 25 February 2016, a healthcare worker working in Oti district, Togo was transported to Cologne (Germany), with suspected malaria, and few days later died of severe multi-organ dysfunction. On 9 March 2016, Lassa fever was confirmed. A secondary transmission was confirmed on 15 March 2016 in a member of the company preparing the corpse for flight repatriation to the US.
2016年2月25日， 一位多哥奥蒂区的医务人员因疑似疟疾被转院至德国科隆，几天后死于多器官功能衰竭，该病人于3月9日被确诊为拉萨热。2016年3月15日，一名筹备将尸体空运回美国的公司员工被确诊继发感染拉萨热。
On 18 March 2016, two additional contacts of the first case tested positive for Lassa virus. However, samples were later found to have been false-positive. Neither patient was ever PCR positive.
3月18日，首例拉萨热病毒阳性者的两位密切接触者已接受检测，尽管两位病人的PCR检测均曾经为阳性，但后来发现样本检测结果只是假阳性。
On 13 March 2016, CDC confirmed another case of Lassa fever in a surgeon medically evacuated to USA from the same district in Togo.
3月13日，疾病预防控制中心确诊另一例拉萨热病例，为多哥同一地区撤离至美国的一名外科医生。
Current Lassa virus outbreaks in West Africa
西非拉萨热的疫情现状
Lassa fever is endemic in parts of West Africa including Sierra Leone, Liberia, Guinea, Nigeria and Benin. The disease was previously not reported in Togo. In 2016, there are ongoing outbreaks of Lassa fever in Nigeria, Benin and probably Togo.
拉萨热主要流行于塞拉利昂、利比里亚、几内亚、尼日利亚和贝宁等西非国家。虽然多哥之前没有拉萨热的相关报告，但在2016年，几内亚、贝宁甚至乎多哥，拉萨热疫情均呈持续蔓延趋势。
However, neighbouring countries are also at risk, where the animal reservoir for Lassa virus, the ‘multimammate rat’, is spread.
另一方面，由于拉萨热病毒动物宿主为“多乳鼠”，周边国家也存在传播风险。
The disease
疾病
Lassa fever is an acute viral haemorrhagic illness, endemic in West Africa. The Lassa virus is transmitted by the multimmamate rat.
拉萨热是一种流行于西非的急性病毒性出血疾病。拉萨病毒是通过多乳鼠进行传播的。
The disease can be severe: although about 80% of those who become infected with Lassa virus have mild or no symptoms, one in five infections results in severe disease, death occurs in around 15–20% of the severe hospitalised cases.
拉萨热疾病的病情可能很严重，尽管感染拉萨热病毒的人中，80%症状轻微或者没有症状，但是大约五分之一的病人病情危重，重症住院病人的死亡率约15—20%。
The virus is present in rodent excreta and transmission occurs most commonly through ingestion or inhalation of contaminated items; it is also transmitted from human to human by contaminated blood.
拉萨热病毒存在于啮齿类动物的排泄物中，并通过食用受污染的食物传播；人与人之间也可通过被污染的血液传播病毒。
Case assessment criteria include consumption of foods and drinks contaminated by rodent urine or droppings and exposure to multimmamate rats or to patients presenting with haemorrhagic fever.
病例鉴别标准包括被啮齿类动物的尿液、粪便污染的食物和水的饮食史，和多乳鼠或拉萨热病人接触史。
ECDC risk and threat assessment
欧盟疾病预防控制中心风险与威胁评估
As transmission of Lassa virus mainly occurs through contact with bodily fluids or droplets, healthcare personnel involved in invasive care procedures are at increased risk of exposure. The risk level for secondary transmission depends on the closeness and duration of contact, on the type of activity performed by medical staff, as well as people handling or preparing the body of a person infected by Lassa fever (i.e undertakers), and on the personal protective equipment used.
由于拉萨热是通过体液和飞沫传播，所以参与侵入性操作的医务人员暴露风险增加。继发传播风险的等级取决于接触的亲密度和持续时间、医务人员实施的诊疗类型、处理拉萨热病人尸体（殡仪业者）和个人防护用品的使用。
Secondary transmission in healthcare settings (nosocomial transmission) should be prevented through ad-hoc isolation and using personal protective equipment, as well as transportation of patients with confirmed infection to specialised treatment centres.
医疗机构内继发感染（院内感染）的防控措施包括：设置特定的隔离病房、使用个人防护用品、还有将拉萨热确诊患者转运至指定的救治中心。
Travellers to West Africa should be informed of the risk of exposure to Lassa fever virus, particularly in areas currently experiencing outbreaks. They should avoid consumption of foods and drinks contaminated by rodent droppings, exposure to rodents or to patients presenting with haemorrhagic fever.
赴西非的游客应该了解拉萨热病毒的接触风险，特别是这些地区目前正经历着拉萨热疫情。他们应避免饮食被老鼠排泄物污染的食物和饮料，避免接触啮齿动物和拉萨热患者。
文献来源
conference from：
http://ecdc.europa.eu/en/Pages/home.aspx
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