中国媒介生物学及控制杂志

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2001-2005年衢州市钩端螺旋体病监测研究

方春福;余樟友;王炜; 汪垂章; 雷金宝; 段家福; 毛辉暑   

  1. 浙江省衢州市疾病预防控制中心传染病防制科 衢州324000
  • 出版日期:2008-04-20 发布日期:2008-04-20

Study on the surveillance of leptospirosis in Quzhou from 2001 to 2005

FANG Chun-fu; YU Zhang-you; WANG Wei; WANG Chui-zhang; LEI Jin-bao; DUAN Jia-fu; MAO Hui-shu   

  1. Quzhou Center for Disease Control and Prevention, Quzhou 324000, China
  • Online:2008-04-20 Published:2008-04-20

摘要: 目的 了解钩端螺旋体病(钩体病)流行病学特点与衢州市疫源地情况,为控制钩体病的暴发流行提供依据。方法 运用描述流行病学方法,对1960-2005年的历史疫情进行分析。采用现场调查方法,采集鼠、水鸭、猪、青蛙的双肾标本和牛中段尿做钩体培养分离,青蛙和水鸭血清做抗体测定,分析感染情况和感染菌群。结果 1960-2005年衢州市共报告钩体病11047例,年均发病率11.58/10万,死亡72例,病死率0.65%。7-9月发病例数占全年总病例数的90.26%;农民发病例数占总病例数的88.20%;男女之比为2.74∶1;常山及开化县是衢州市最主要的疫区。2001-2005年监测点野外鼠密度为3.93%,黑线姬鼠占51.40%,动物标本培养阳性率0.49%,动物血清抗体阳性率14.02%。人血清中菌群为七日热群和黄疸出血群,动物中主要菌群为黄疸出血群、秋季热群、赛罗群、流感伤寒群。结论 钩体病发病年度与地区波动十分明显,主要是受局部暴发疫情的影响。夏秋季为高发季节,青壮年农民为重点人群。近6年来的洪水低发,与动物间的低带菌率一致,但衢州市动物感染菌群复杂,多种动物均可携带,受气候影响导致暴发的危险始终存在。

关键词: 钩端螺旋体病, 动物带菌, 流行病学方法, 监测

Abstract: Objective To study the epidemiological features and the situation of Quzhou leptospirosis foci, and provide the control measures of leptospirosis outbreak. Methods Analyze the leptospirosis epidemic situation of 1960-2005 by descriptive epidemiological method in Quzhou. In order to determine the main serogroup of leptospirosis carried by the host animals, we collected kidney samples of rats, teals, pigs, frogs and the serum of teals and frogs as well as the midstream urine of cattle. All samples were used to cultivate the pathogen and test the antibody. Results 11 047 cases were reported in Quzhou from 1960-2005, and the annual incidence was 11.58/100 000. Of which, 72 cases died and the mortality was 0.65%. The cases from July to September accounted for 90.26% of the total, and the farmer patients accounted for 88.20%. The proportion of male to female was 2.74∶1. The Changshan and Kaihua county were the main epidemic area. From 2001-2005, the rat density was 3.93% in the open air, and apodemus agrarius accounted for 51.40% of the total. The positive rate of samples was 0.49% and that of serum antibody was 14.02%. The pathogen of patients serum were mainly hebdomadis and icterohemorrhage, while that of host animals were icterohemorrhage and autumnal fever. Conclusion The leptospirosis incidence mainly affected by local outbreak. The peak of incidence was in summer and autumn, and the high-risk group was the man aged from 20 to 50 years old, especially the peasants. In the recent years, the incidence remained low and the carrier rate of host animals was also low, but because many host animals could carry much bacteria, the risk of outbreak still exist.