山东省烟台市1起人间布鲁菌病爆发疫情的调查  

Investigation on an outbreak of human brucellosis in Yantai City Shandong Province

作　　者：刘涛[1] 牟晓东[1] 冷启艳[1] 姜梅[1] 徐小雯[1] 刘靖宇[1] Liu Tao;Mou Xiaodong;Leng Qiyan;Jiang Mei;Xu Xiaowen;Liu Jingyu(Department for Infectious Disease Control and Prevention,Center for Disease Control and Prevention of Yantai City in Shandong Province,Yantai 264003,China)

机构地区：[1]山东省烟台市疾病预防控制中心传染病防治科,264003

出　　处：《中华地方病学杂志》2019年第4期310-315,共6页Chinese Journal of Endemiology

摘　　要：目的分析烟台市养殖场内1起布鲁菌病爆发疫情的流行病学特征,探讨发病原因和传播途径,为烟台市布鲁菌病的防控提供依据。方法2014年,在烟台市发生布鲁菌病疫情的养殖场内开展现场流行病学调查,对养殖场内暴露人群进行病例搜索。流行病学调查按照山东省布鲁菌病流行病学个案调查表进行,收集病例一般情况、临床表现和高危暴露行为等信息;采集血液样本进行虎红平板凝集试验(RBPT)和试管凝集试验(SAT)。布鲁菌病诊断依据《布鲁氏菌病诊断标准》(WS 269-2007)。结果首例病例为男性,58岁,养殖场工人。病例搜索共发现疑似病例38例;血清RBPT为阳性且SAT≥1∶100(++)者11例,为确诊病例。确诊病例均为男性,年龄中位数为52岁,范围为40~60岁;其中养殖工人5例、建筑工人6例;发病时间主要集中在6、7月份,共7例;临床表现主要包括多汗、肌肉关节酸痛、乏力、睾丸肿大等。养殖场内的147只羊中,47只经实验室血清学检测为阳性,占31.97%,是主要传染源。养殖工人的高危暴露行为包括徒手接生(5例)、为牲畜配种(1例);建筑工人的高危暴露行为包括进出羊舍(6例)和羊舍内搬运物资(6例)。结论此次聚集疫情是由人群直接接触受布鲁菌感染的羊只或经呼吸道接触受污染的环境感染引起的,应加强重点人群的布鲁菌病防治健康教育,提高人群防病意识。Objective To analyze the epidemiological characteristics of an outbreak caused by human brucellosis in a farm in Yantai City,to explore the causes and transmission routes,and to provide evidence for prevention and control of brucellosis in Yantai City.Methods In 2014,an on-site investigation was conducted in a farm where brucellosis occurred in Yantai City,and case searches were conducted on exposed populations in the farm.According to the investigation questionnaire on epidemiology of brucellosis in Shandong Province,general information,clinical manifestation and high-risk behavior exposure information of the cases were collected;blood samples were collected and tested by tiger red plate agglutination test(RBPT)and tube agglutination test(SAT).Brucellosis was diagnosed according to the "Diagnostic Criteria for Brucellosis"(WS 269-2007).Results The first case was male,58 years old,farm worker.A total of 38 suspected cases were found.Eleven patients with positive RBPT and SAT≥1∶100(++)were confirmed cases.The confirmed cases were all male,with a median age of 52 years,ranging from 40 to 60 years old;5 farm workers and 6 construction workers;the onset time was mainly in June and July,a total of 7 cases;clinical manifestations mainly included excessive sweating,muscle and joint pain,fatigue,testicular swelling,etc.Of the 147 sheep in the farm,47 were positive by laboratory tests,accounting for 31.97%,which were the main sources of infection.High-risk exposures for farm workers included hand-delivered births(5 cases)and breeding for livestock(1 case);high-risk exposures for construction workers included entry and exit of sheep houses(6 cases)and handling of supplies in sheep houses(6 cases).Conclusions The epidemic is caused by direct contact with Brucella-infected sheep or caused by respiratory contact with brucellosis contaminated environment.It is necessary to strengthen the health education for prevention and control of the disease in key populations and improve the awareness of the disease.

关 键 词：布鲁杆菌属 爆发 危险因素 

分 类 号：R516.7[医药卫生—内科学]