中国东北地区远东蜱传斑点热流行病学调查  

Investigation on the epidemiology of Far-East tick-borne spotted fever in the Northeastern area of China

作　　者：吴益民[1] 张志强[1] 王洪军[1] 杨青[1] 冯立[1] 王建伟[1] 

机构地区：[1]沈阳军区疾病预防控制中心,110034

出　　处：《中华流行病学杂志》2008年第12期1173-1175,共3页Chinese Journal of Epidemiology

摘　　要：目的了解远东蜱传斑点热在东北地区感染情况、分布及其流行规律。方法选择东北三省9市（县）作为调查地区，采集正常人群血清、鼠血清、游离蜱及疑似患者血液等标本，用间接免疫荧光法检测蜱传斑点热抗体，豚鼠接种法分离立克次体。结果调查地区总体人群蜱传斑点热检出率17．46％，除瑷辉县外其余8市（县）人群以黑龙江立克次体抗体为优势；人群当年蜱传斑点热感染率为9．4％，2年内蜱叮咬率林业工人为92．8％，军人为33．5％，抗体阳性率与蜱叮咬率呈正比关系；鼠种调查经鉴定为3科12种，以黑线姬鼠为优势种占58．6％，大林姬鼠占13．7％，其他鼠种占27．7％。鼠血清阳性率为27．3％，不同鼠种阳性率各有差异，黑线姬鼠为21．9％，大林姬鼠23．1％，棕背鼠平33．3％，大仓鼠55．6％。从蜱及疑似病例血液标本中分离到黑龙江立克次体共20株，证实远东蜱传斑点热病例16例。结论东北三省东部与北部普遍存在远东蜱传斑点热感染，存在蜱传斑点热的自然疫源地。Objective To study the infection rate, epidemiological features of Far-East tick-borne spotted fever in the Northeastern area of China and to provide evidence for prevention and control. Methods Nine cities from the three Northeastern provinces were chosen. Human serum, rat, serum, free tick sample as well as blood from suspected patients were determined by indirect immuno-fluoresence assay. Rickettsiae was identified by guinea pigs plant method. Results The overall rate of infection among human beings was 17.46 %, with R. heilongjiangensis antibody the major one among the nine cities. The annual infection rate was 9.4 %. In a two year period, the rates of being bitten by ticks among forestry workers was 92.8 % , and 33.5 % among soldiers. The antibody positive rate and tick-bite rate were positively correlated. The serum positive rate in rats was 27.3 %. 20 strains were isolated from blood which confirmed that 16 cases were related to R. heilongjiangensis and another 16 cases were Far East tick-borne spotted fever. Clinical features of the patients were also analyzed. Conclusion Nine cities from the east part of the Northeastern areas of China were confirmed of having R. heilongjiangensis infection （3.4 %-27.4 % ）. Our results also demonstrated that in those above-mentioned areas,there had been an existing natural loci of Far East tickborne spotted fever.

关 键 词：黑龙江立克次体 斑点热 流行病学调查 

分 类 号：R181.3[医药卫生—流行病学]