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基孔肯雅热防控技术指南试题（附答案）一、单项选择题（每题2分，共20分）1.基孔肯雅热的病原体属于以下哪类病毒？A.黄病毒科B.披膜病毒科甲病毒属C.布尼亚病毒科D.正粘病毒科2.基孔肯雅热的主要传播媒介是？A.淡色库蚊B.三带喙库蚊C.埃及伊蚊和白纹伊蚊D.中华按蚊3.基孔肯雅热患者急性期最典型的症状是？A.剧烈而持续的关节疼痛B.腹泻C.皮肤瘀斑D.意识障碍4.基孔肯雅热病毒在伊蚊体内的外潜伏期（从吸血到具有传染性的时间）通常为？A.1-2天B.3-5天C.6-10天D.11-14天5.以下哪项实验室检测方法可用于基孔肯雅热急性期（病程≤5天）的病原学确诊？A.血清特异性IgG抗体检测B.病毒核酸RT-PCR检测C.中和试验D.补体结合试验6.基孔肯雅热病例报告的时限要求是？A.2小时内网络直报B.6小时内网络直报C.12小时内网络直报D.24小时内网络直报7.针对基孔肯雅热暴发疫情，疫点内伊蚊布雷图指数应控制在多少以下？A.1B.3C.5D.108.基孔肯雅热患者隔离治疗的主要目的是？A.防止人传人B.减少病毒扩散至媒介蚊虫C.避免交叉感染其他疾病D.便于集中观察病情9.以下哪种环境最易滋生埃及伊蚊？A.稻田B.大型池塘C.室内小型积水容器D.流动的河流10.基孔肯雅热的潜伏期通常为？A.1-3天B.4-7天C.8-10天D.11-14天二、多项选择题（每题3分，共30分，少选、错选均不得分）1.基孔肯雅热的流行病学特征包括？A.主要流行于热带、亚热带地区B.输入性病例是我国疫情的主要来源C.人群普遍易感，感染后可获得长期免疫力D.发病高峰与媒介伊蚊活动季节一致2.基孔肯雅热的临床表现可分为以下哪些阶段？A.急性期（病程1-10天）B.恢复期（病程2-6个月）C.慢性期（病程＞6个月）D.潜伏期（病程＜48小时）3.以下哪些措施属于基孔肯雅热的一级预防（病因预防）？A.开展伊蚊密度监测B.对患者进行隔离治疗C.社区普及防蚊灭蚊知识D.对疫点进行药物喷洒灭蚊4.基孔肯雅热实验室检测的主要方法包括？A.病毒分离培养B.实时荧光RT-PCR检测病毒核酸C.血清特异性IgM抗体检测D.血常规检测白细胞计数5.针对基孔肯雅热输入性病例的防控措施包括？A.入境时体温监测B.询问旅行史和蚊虫叮咬史C.对病例居住地500米范围内进行媒介调查D.对病例密切接触者进行医学观察6.伊蚊孳生环境治理的关键措施包括？A.清除室内外废弃容器B.对无法清除的积水投放灭蚊幼剂C.定期疏通下水道D.稻田养鱼灭蚊7.基孔肯雅热重症病例的高危因素包括？A.年龄＜1岁或＞65岁B.合并糖尿病、高血压等基础疾病C.妊娠D.曾接种过黄热病疫苗8.以下关于基孔肯雅热媒介控制的说法正确的是？A.成蚊杀灭优先选择室内滞留喷洒B.外环境灭蚊可采用超低容量喷雾C.灭蚊幼剂应选择对环境友好的生物制剂（如苏云金杆菌H-14）D.布雷图指数＞5时需启动应急灭蚊措施9.基孔肯雅热病例的临床诊断需综合考虑以下哪些因素？A.发病前14天内到过流行地区B.急性起病伴高热（＞38.5℃）C.对称性小关节剧烈疼痛D.血常规显示白细胞计数升高10.基孔肯雅热疫情暴发时的应急响应措施包括？A.划定疫点、疫区范围B.开展病例主动搜索C.实施媒介伊蚊密度应急控制D.启动公众健康风险沟通三、判断题（每题2分，共20分，正确打“√”，错误打“×”）1.基孔肯雅热可通过接触患者血液或分泌物直接传播。（）2.白纹伊蚊的活动高峰为日出后2小时和日落前2小时。（）3.基孔肯雅热患者急性期（病程≤5天）血清中病毒载量最高，最易感染媒介蚊虫。（）4.对基孔肯雅热疑似病例，仅需检测IgM抗体即可确诊。（）5.伊蚊幼虫主要孳生在清水中，污水中无法生存。（）6.基孔肯雅热慢性期关节痛可反复发作，部分患者可持续数年。（）7.灭蚊时，室内应重点处理床底、衣柜背面等隐蔽场所。（）8.布雷图指数是指每百户内有伊蚊幼虫孳生的容器数。（）9.基孔肯雅热目前尚无特效抗病毒药物，治疗以对症支持为主。（）10.输入性病例的密切接触者无需隔离，仅需医学观察7天。（）四、简答题（每题8分，共24分）1.简述基孔肯雅热急性期与登革热的鉴别诊断要点。2.列举伊蚊密度监测的主要指标及判定标准。3.说明基孔肯雅热疫点处置的核心技术流程。五、案例分析题（6分）2023年8月，某市报告1例基孔肯雅热输入性病例（男性，45岁，7天前从东南亚回国）。病例居住地为旧城区，周边存在大量露天积水缸、废弃轮胎等蚊虫孳生环境，经调查，该区域布雷图指数为12，白纹伊蚊密度（诱蚊灯法）为8.5只/灯·小时。问题：（1）针对该输入性病例，需重点开展哪些防控措施？（2）若3天后该区域新增2例本地感染病例，应如何调整防控策略？参考答案一、单项选择题1.B2.C3.A4.C5.B6.D7.C8.B9.C10.B二、多项选择题1.ABCD2.ABC3.ACD4.ABC5.ABC6.ABC7.ABC8.BCD9.ABC10.ABCD三、判断题1.×（仅通过媒介伊蚊传播）2.√3.√4.×（需结合流行病学史、临床表现和病原学检测）5.×（白纹伊蚊可在污水中孳生）6.√7.√8.×（布雷图指数=（阳性容器数/检查户数）×100）9.√10.√（密切接触者无直接传播风险，观察期为最长潜伏期7天）四、简答题1.鉴别要点：①流行病学史：登革热流行区与基孔肯雅热流行区存在重叠，但基孔肯雅热更集中于非洲、东南亚；②临床表现：基孔肯雅热以剧烈对称性小关节痛（可伴关节肿胀）为特征，登革热以肌肉/骨骼痛（“碎骨热”）为主；基孔肯雅热皮疹多为斑丘疹，登革热可出现出血性皮疹；③实验室检测：基孔肯雅热白细胞多正常或降低，血小板多正常；登革热常伴血小板显著减少（＜100×10⁹/L）；④特殊检查：基孔肯雅热关节超声可见滑膜增厚，登革热无此表现。2.监测指标及标准：①布雷（Breteau）指数：检查100间房屋内的所有积水容器，阳性容器数/检查户数×100。安全阈值＜5，＞5时存在暴发风险；②诱蚊灯（Movitrap）索引：每灯/小时捕获成蚊数。白纹伊蚊密度＞5只/灯·小时需加强防控；；；③成蚊叮刺指数：人诱30分钟捕获成；蚊数，＞1只/30分钟提示高风险；；④幼虫容器；；；指数：阳性容器数/检查容器；；；总数×100，安全值＜3。3.核心流程：（1）病例确认：通过实验室检测核实诊断，明确感染来源（输入性/本地）；；（2）疫点划定：以病例居住地为中心，半径100-200米范围为核心；；；疫点，周边500米为扩展；；；区域；；（3）媒介调查：48小时内完成；；；布雷；；；指数、诱蚊；；；；灯指数等指标检测；；（4）应急灭蚊：对核心疫点实施室内外；；；超低容量喷雾（成蚊）+投放灭；；；蚊幼剂（；；；幼虫）；；；；（5）孳；；；生；；；环境治理：发动社区清除；；；；积水容器，无法清除的；；；；加盖或定期换水；；；；；（6）健康宣教：指导；；；居民使用蚊帐、驱蚊液，避免；；；；蚊虫叮咬；；；；；（7）监测评估：灭蚊后48小时；；；；复查媒介；；；；密度，直至布雷；；；；指数＜5；；；；；（8）持续；；；；观察：追踪；；；；；疫点内；；；；；14；；；；；；；天内；；；；；；；新发病例。五、案例分析题（1）重点措施：；①病例管理：将患者安置在有防蚊设施的病房，避免蚊虫叮咬；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；；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