目的 对山东省莒县报告的1例猴痘确诊病例进行流行病学调查,分析传播原因,为猴痘防控提供参考依据。方法 按照《猴痘防控方案》(2023版)对莒县报告的1例猴痘疑似病例开展流行病学调查,采集病例疱疹液、血液及咽拭子标本各1份,病例家中环境标本5份和病例一般接触者的咽拭子标本1份,采用实时荧光定量RT-PCR检测猴痘病毒核酸。结果 猴痘疑似病例A为感染了HIV的男男性行为者,其在与某酒吧1名男性发生高风险性行为4 d后出现发烧、皮疹、疱疹等症状。病例A身上有8处痘疱,疱疹液猴痘病毒核酸阳性,病例A家中1份环境样本猴痘病毒核酸阳性,病例A被诊断为猴痘确诊病例。病例A共有1名密切接触者和1名一般接触者,1名密切接触者无法追踪,1名一般接触者咽拭子猴痘病毒核酸阴性,经过居家健康监测,其未出现发烧、皮疹等症状,判定其未感染猴痘。结论 该病例主要经性途径感染猴痘,应加强医务人员培训,提高其对猴痘诊断的敏感性。

Objective To conduct an epidemiological investigation on a confirmed case of monkeypox reported in Ju County,Shandong Province,to analyze the reasons for transmission,and to provide reference for the prevention and control of monkeypox. Method According to the Monkeypox Prevention and Control Protocol (2023 Edition),an epidemiological investigation was carried out on a reported monkeypox case in Ju County.Specimens such as one vesicular fluid,one blood sample,and one throat swab from the case,five environmental samples from the case's home,and one throat swab from general contacts were collected.Real-time fluorescence quantitative RT-PCR was used for monkeypox virus nucleic acid detection. Results The suspected monkeypox case A was an HIV-infected man who had engaged in high-risk sexual behavior with another man at a bar.Four days later,he developed symptoms including fever,rash,and vesicles.Case A had eight pocks,and the vesicular fluid tested positive for monkeypox virus nucleic acids.One environmental sample from Case A's home also tested positive for monkeypox virus nucleic acids,and Case A was diagnosed with confirmed monkeypox.Case A had one close contact and one general contact.The close contact could not be traced.The general contact tested negative for monkeypox virus nucleic acids in throat swabs and did not develop symptoms such as fever or rash after home health monitoring,indicating no infection. Conclusion The case was maily infected with monkeypox through sexual transmission.Sexual contact is the main route of transmission for monkeypox.Training for medical personnel should be strengthened to improve their sensitivity in diagnosing monkeypox.