重庆市钩端螺旋体病流行因素监测分析  

Epidemic factors monitoring of leoptopirosis in Chongqing

作　　者：龙江[1] 贾庆良[1] 李勤[1] 汪新丽[1] 吴国辉[1] 毛德强[1] 韩力苏[1] 季恒清[1] 

机构地区：[1]重庆市疾病预防控制中心,400042

出　　处：《重庆医学》2005年第12期1803-1806,共4页Chongqing medicine

基　　金：卫生部资助项目(wkg-1999-01-01)

摘　　要：目的分析重庆市钩体病的发病规律和影响因素,为制定针对性的防制措施提供依据,防止钩体病疫源地向三峡库区和长江下游地区扩散.方法选择1个钩体疫区县和2个三峡库区县作为监测点,用显微镜凝集试验(AMT)检测病人、健康人群及耕牛血清抗体.用夹夜法捕鼠,鉴定鼠种,计算鼠密度,分离培养病原体,同时用PCR法进行比较.结果1961～2004年重庆市钧体发病率在0.09/10万～12.16/10万之间,死亡率在0～0.44/10万之间,病死率在0%～10.34%之间波动.彭水县1998年和2000年的洪灾年出现2次局部爆发.监测点鼠密度在1.6%～4.4%之间波动,食虫目小兽(51%)、褐家鼠(25%)和黑线姬鼠(12%)为优势鼠种.鼠带菌率为1.7%(10/583),褐家鼠和食虫目小兽中分离出钩体病原,均为澳洲群澳洲型.病人血清检测阳性率为73.33%(33/45),血清群以澳洲群和黄疸出血群为主;健康人群感染率为45%(598/1330),疫区点血清抗体阳性率(74.7%)显著高于库区点(28.0%).牛血清检测优势菌群为澳洲群.结论鼠类是重庆市钩体病的主要传染源,主要传播因素为稻田作业.主要流行菌群为澳洲群,库区人群免疫水平较低.三峡库区蓄水后水流变缓,接触疫水的频率增加,可能引起钩体疫情暴发流行.Objective To analyse the outbreak regulation and the influential factors of leoptopirosis in Chongqing,and to provide evidence for making countermeasures of prevention and cure and preventing the spread from infectious focus to Three Gorges dam area and Downstream region of Changjiang River. Methods One epidemic county of leoptopirosis and two reservoir counties of Three Gorges was chosen as monitoring sites. Serum antibody of patients, health crowd and farm cattles were measured by using AMT. To catch the rats by using clamps in night, identify rat＇s species, calculate rat＇s density, separate and cultivate the pathogen, compare with PCR at the same time. Results The incidence rate of leoptopirosis fluctuated between 0. 09/100 000- 12. 16/ 100 000, the mortality rate of leoptopirosis fluctuated between 0/100 000-0.44/100 000, the fatality rate of leoptopirosis fluctuated between 0% - 10.34 % from 1961 to 2004 . There were two local outbreaks in 1998 and 2000 as flooded years in Pengshui county. Mouse density in monitoring sites fluctuated between 1.6%-4.4% , Insectivora（51% ）,Sewer rat and Apodemus agrarius（12% ） were predominant species. The germ-carrying rate of rats was 1. 7% （10/583）,Leoptopira was separated from Sewer rat and Apodemus agrarius , both are group of Australia types of Australia. Positive rate of patients serum was 73.33% （33/45）, the main serum group were Australia group and jaundice bleed group; healthy crowd influence rate was 45% （598/1330）, serum antibody positive rate of infectious focus（74.7%） was higher than that of the reservoir area （28.0%） apparently. Australian crowd was predominant bacterium crowd in ox serum detection. Conclusion Rats are the main infection source of leoptopirosis in Chongqing. The main transmission route is paddy field homework. Australia types is the predominant type , The crowd＇s immune level in the reservoir area is relatively low. Water is slow in rheology after the conservation storage of reservoir area of Three Gorge

关 键 词：钩端螺旋体病 流行因素 三峡库区 监测 

分 类 号：R181.8[医药卫生—流行病学]