收稿日期: 2023-03-06
网络出版日期: 2023-08-17
基金资助
浙江省自然科学基金(LY21H100002);舟山市医药卫生科技计划项目(2022YA12)
An epidemiological investigation of a suspected leptospirosis epidemic in Zhoushan, Zhejiang Province, China
Received date: 2023-03-06
Online published: 2023-08-17
Supported by
Natural Science Foundation of Zhejiang Province of China(LY21H100002);Medical and Health Technology Project of Zhoushan(2022YA12)
目的: 了解浙江省舟山市近40年来首例钩端螺旋体(钩体)患者的感染情况,评估其居住周边环境中的宿主动物及居民感染状况。方法: 应用反转录实时荧光定量PCR(RT-qPCR)方法对2022年1例钩体病疑似病例、其居住地周围居民以及宿主动物(小兽、猪)进行钩体核酸检测,采用反转录PCR扩增23S rRNA靶基因并测序,分析感染基因种。利用酶联免疫吸附试验方法对疑似病例和周围居民进行血清钩体抗体检测。结果: 疑似病例急性期血清钩体核酸阳性,IgM与IgG均阴性;恢复期血清钩体核酸阴性,IgM与IgG均阳性。居住地周围69名居民血清钩体核酸均为阴性,IgM和IgG阳性率分别为4.35%(3/69)和8.70%(6/69),其中3份IgM阳性居民的尿液钩体核酸均为阳性。小兽肾钩体核酸阳性率为30.00%(15/50),3份猪尿钩体核酸均为阳性。23S rRNA基因测序结果显示:该疑似病例急性期血清、4份鼠肾及2份猪尿样本为博氏钩体;3份居民尿液、5份鼠肾及1份猪尿样本为问号钩体。结论: 该疑似病例可确诊为钩体病。患者居住地的宿主动物和周围居民均有较高的钩体感染率。
刘雷杰, 王宇超, 应峥, 李世波, 舒纪为, 王忠发, 王蓉, 张森 . 浙江省舟山市一起疑似钩端螺旋体病疫情及其流行病学调查[J]. 中国媒介生物学及控制杂志, 2023 , 34(4) : 518 -522 . DOI: 10.11853/j.issn.1003.8280.2023.04.014
Objective: To investigate the infection of the first leptospirosis patient in Zhoushan in the past 40 years, and to evaluate the potential risks of host animal and local resident infection. Methods: RT-qPCR was used to detect leptospiral nucleic acid in a suspected case, local residents, and host animals (small mammals and pigs) in 2022. The 23S rRNA target gene was amplified by RT-PCR and sequenced to detect the infected genospecies. ELISA was used to detect leptospiral antibodies in the sera of suspected case and residents. Results: Leptospiral nucleic acid was tested positive in the acute phase of the suspected patient, but turned negative in the recovery phase. In contrast, IgM and IgG were negative in acute phase but positive in recovery phase. Leptospiral nucleic acid was tested negative in the sera of 69 residents, but was positive in the urine of 3 residents with positive IgM. The positive rate of IgM in sera of residents was 4.35% (3/69) and the positive rate of IgG was 8.70% (6/69). The positive rate of leptospiral nucleic acid in small mammal kidney was 30.00% (15/50), and the three pig urine were positive for leptospiral nucleic acid. The species in the sera of the suspected case in acute phase, 4 rat kidney specimens, and 2 pig urine specimens were identified as Leptospira borgpetersenii. The species in 3 urine specimens from local residents, 5 rat kidney specimens, and 1 pig urine specimen were identified as L. interrogans. Conclusions: The patient was confirmed with leptospirosis. The infection rates of Leptospira in host animals and residents were both high in the patient's place of residence.
| 1 | Garba B, Bahaman AR, Khairani-Bejo S, et al. Retrospective study of leptospirosis in Malaysia[J]. EcoHealth, 2017, 14 (2):389- 398. |
| 2 | Zhang CC, Li Z, Xu YH, et al. Genetic diversity of Leptospira interrogans circulating isolates and vaccine strains in China from 1954-2014[J]. Hum Vaccines Immunother, 2019, 15 (2):381-387. |
| 3 | 李喆, 徐颖华, 辛晓芳. 我国钩端螺旋体分子分型研究进展[J]. 疾病监测, 2022, 37 (4):512-516. |
| 3 | Li Z, Xu YH, Xin XF. Progress in research of molecular typing of Leptospira in China[J]. Dis Surveill, 2022, 37 (4):512-516. |
| 4 | 朱光琦, 陈琳迪, 舒纪为, 等. 致病性钩端螺旋体病例分析及病原学鉴定[J]. 中华临床感染病杂志, 2023, 16 (1):59-62, 66. |
| 4 | Zhu GQ, Chen LD, Shu JW, et al. Case analysis and pathogenic identification leptospirosis[J]. Chin J Clin Infect Dis, 2023, 16 (1):59-62, 66. |
| 5 | 中华人民共和国卫生部. WS 290-2008钩端螺旋体病诊断标准[S]. 北京: 人民卫生出版社, 2008. |
| 5 | Ministry of Health of People's Republic of China. WS 290-2008 Diagnostic criteria for leptospirosis[S]. Beijing: People's Medical Publishing House, 2008. (in Chinese) |
| 6 | 中国疾病预防控制中心传染病预防控制所. 全国病媒生物病原学监测方案(试行)[Z]. 北京: 中国疾病预防控制中心, 2020. |
| 6 | National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention. National vector etiology surveillance program (Trial)[Z]. Beijing: Chinese Center for Disease Control and Prevention, 2020. (in Chinese) |
| 7 | 王蓉, 马敏, 王忠发, 等. 一种高效检测致病性钩端螺旋体PCR改良方法及效果评价[J]. 中国媒介生物学及控制杂志, 2023, 34 (1):77-81. |
| 7 | Wang R, Ma M, Wang ZF, et al. Evaluation of an improved PCR assay in detection of pathogenic Leptospira[J]. Chin J Vector Biol Control, 2023, 34 (1):77-81. |
| 8 | 中华人民共和国国家质量监督检验检疫总局. SN/T 3741.1-2013国境口岸鼠类携带病原体检测方法第1部分: 致病性钩端螺旋体PCR检测方法[S]. 北京: 中国标准出版社, 2014. |
| 8 | General Administration of Quality Supervision, Inspection and Quarantine of the People's Republic of China. SN/T 3741.1-2013 Detection for pathogens of rodents at frontier ports Part 1: Detection for pathogenic leptospira[S]. Beijing: Standards Press of China, 2013. (in Chinese) |
| 9 | Rajapakse S. Leptospirosis: Clinical aspects[J]. Clin Med J, 2022, 22 (1):14-17. |
| 10 | Haake DA, Levett PN. Leptospirosis in humans[M]//Adler B. Leptospira and leptospirosis. Berlin: Springer, 2015: 65-97. DOI: 10.1007/978-3-662-45059-8_5. |
| 11 | 李兰娟, 黄祖瑚. 感染病学[M].2版. 南京: 江苏凤凰科学技术出版社, 2021: 1008-1010. |
| 11 | Li LJ, Huang ZH. Infectious diseases[M].2nd ed. Nanjing: Jiangsu Phoenix Science and Technology Press, 2021: 1008-1010. |
| 12 | Sahimin N, Sharif SA, Mohd Hanapi IR, et al. Seroprevalence of anti-Leptospira IgG and IgM antibodies and risk assessment of leptospirosis among urban poor communities in Kuala Lumpur, Malaysia[J]. Am J Trop Med Hyg, 2019, 101 (6):1265-1271. |
| 13 | 杨盛旭, 卢苗贵, 梅慧娟, 等. 一起钩端螺旋体病暴发疫情流行病学调查[J]. 预防医学, 2018, 30 (5):524-525. |
| 13 | Yang SX, Lu MG, Mei HJ, et al. An epidemiological investigation of a leptospirosis outbreak[J]. Prev Med, 2018, 30 (5):524-525. |
| 14 | 李钟梁, 姜理平, 张孟田, 等. 浙江省磐安县钩端螺旋体病暴发后监测分析[J]. 中国媒介生物学及控制杂志, 2013, 24 (3):272-274. |
| 14 | Li ZL, Jiang LP, Zhang MT, et al. Surveillance of Leptospira after leptospirosis outbreak in Pan'an county, Zhejiang[J]. Chin J Vector Biol Control, 2013, 24 (3):272-274. |
| 15 | Zhang CC, Xu JM, Zhang TL, et al. Genetic characteristics of pathogenic Leptospira in wild small animals and livestock in Jiangxi province, China, 2002-2015[J]. PLoS Negl Trop Dis, 2019, 13 (6):e0007513. |
| 16 | Xu JL, Chen JT, Xiong CR, et al. Pathogenic Leptospira infections in Hubei province, central China[J]. Microorganisms, 2022, 11 (1):99. |
| 17 | Xu GY, Qiu HY, Liu WJ, et al. Serological and molecular characteristics of pathogenic Leptospira in rodent populations in Fujian province, China, 2018-2020[J]. BMC Microbiol, 2022, 22 (1):151. |
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