2019年广东省一起布鲁氏菌病暴发疫情调查分析  

Epidemiological investigation of a brucellosis outbreak in a county in Guangdong

作　　者：王雷 易瑶 陈旭光 孙长云 张萌[3] 曾凤梅 曾育富[5] 何栋梁[6] 邓爱萍[3] Wang Lei;Yi Yao;Chen Xuguang;Sun Changyun;Zhang Meng;Zeng Fengmei;Zeng Yufu;He Dongliang;Deng Aiping(Shaoguan Prefectural Center for Disease Control and Prevention,Shaoguan 512028,Guangdong,China;Guangdong Field Epidemiology Training Program,Guangzhou 511430,Guangdong,China;Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,Guangdong,China;Renhua County Center for Disease Control and Prevention,Shaoguan 512300,Guangdong,China;Wuhua County Center for Disease Control and Prevention,Meizhou 514411,Guangdong,China;Meizhou Prefectural Center for Disease Control and Prevention,Meizhou 514071,Guangdong,China)

机构地区：[1]韶关市疾病预防控制中心,广东韶关512028 [2]广东省现场流行病学培训项目,广东广州511430 [3]广东省疾病预防控制中心,广东广州511430 [4]仁化县疾病预防控制中心,广东韶关512300 [5]五华县疾病预防控制中心,广东梅州514411 [6]梅州市疾病预防控制中心,广东梅州514071

出　　处：《疾病监测》2020年第2期167-171,共5页Disease Surveillance

摘　　要：目的调查2019年广东省某县一起食源性布鲁氏菌病(布病)暴发疫情,为防控类似事件提供建议。方法通过个案调查、医院就诊系统查询等方式开展病例搜索,对调查对象开展布鲁氏菌感染初筛及确证实验;对结果进行描述与分析。结果共发现30例病例及6例隐性感染者;病例发病时间为7月10日至8月18日,呈现持续同源的暴发模式;临床表现主要为发热(70.00%)、肌肉、关节痛(46.67%)、乏力(43.33%)等;共从调查对象血液中分离出21株布鲁氏菌且均为羊3型;经分析,仅生饮H家羊奶是感染的危险因素,与未饮者相比相对危险度(RR)值为16.91(2.38~119.96),与煮沸饮者相比,RR值为36.36(5.07~260.58),且感染与饮奶存在剂量反应关系(χ^2=4.437,P=0.035)及时间上的关联。结论该布病暴发疫情为患者饮用受羊种3型布鲁氏菌污染的未煮沸羊奶所致。Objective To investigate and verify a food-borne outbreak of brucellosis caused by drinking raw goat milk in a county of Guangdong province, and provide suggestions for the prevention and control of similar outbreaks. Methods The case finding was conducted through case investigation and hospital information system retrieval, the screening and confirmation of Brucella infection was conducted, and descriptive and analytical epidemiological methods were used to analysis. Results A total of 30 cases and 6 latent infection cases were found. The cases occurred during 10 th July-18 th August in 2019 in this outbreak represented a homologous infection source. The main clinical manifestations of the cases were fever(70.00%), muscle and joint pain(46.67%), fatigue(43.33%), etc. A total of 21 Brucella strains were isolated from the blood samples of the people surveyed, all the strains were B.melitensis type 3. According to the analysis, the only definite risk factor was drinking raw goat milk from H’s farm compared with drinking no H’s milk [RR=16.91(2.38-119.96)] and compared with drinking boiled milk [RR=36.36(5.07-260.58)]. Besides, the Brucella infection was related to goat milk drinking in a dose-response manner(χ^2=4.437, P=0.035) and associated with drinking time. Conclusion This was an outbreak of brucellosis caused by drinking raw goat milk contaminated by B. melitensis type 3.

关 键 词：布鲁氏菌病 暴发疫情 羊3型布鲁氏菌 食源性感染 

分 类 号：R516.7[医药卫生—内科学]