2005-2018年湖北省钩端螺旋体病监测分析  

Analysis on leptospirosis surveillance in Hubei Province from 2005 to 2018

作　　者：杨瑞[1,2] 程均福 刘力[1] 吴杨[1] 刘漫[1] 童叶青[1] YANG Rui;CHENG Jun-fu;LIU Li;WU Yang;LIU Man;TONG Ye-qing(Hubei Center for Disease Control and Prevention,Wuhan 430079,China;Chinese Center for Disease Control and Prevention,Chinese Field Epidemiology Training Program,Beijing 110050,China)

机构地区：[1]湖北省疾病预防控制中心,湖北武汉430079 [2]中国疾控中心中国现场流行病学培训项目,北京100050

出　　处：《中华卫生杀虫药械》2020年第5期473-476,共4页Chinese Journal of Hygienic Insecticides and Equipments

基　　金：湖北省技术创新专项(编号:2017ADC061)。

摘　　要：目的分析湖北省钩端螺旋体病的流行状况,为防治钩体病提供参考依据。方法按照《全国钩端螺旋体病监测方案》开展鼠、家畜、青蛙等宿主动物带菌情况调查及健康人群血清学监测,收集2005—2018年湖北省钩体病病例报告数据。采用SPSS 16.0和Excel 2003软件进行图表和数据的统计处理。结果 2005—2018年累计报告钩体病病例312例,主要集中在恩施州(236例)、宜昌市(38例)、黄冈市(19例),占总报告病例数的93.91%;病例报告时间范围在4—10月,男女性别比为4.2∶1,职业以农民为主,占总报告病例数的92.95%。累计捕鼠2 711只,鼠密度1.40%,捕获鼠以黑线姬鼠和褐家鼠为主;监测鼠肾标本阳性率为1.82%,检出主要钩体菌群为黄疸出血56601型;监测猪肾标本1 919份,阳性11份;健康人群血清检测以黄疸出血群(阳性率18.5%)、流感伤寒群(阳性率13.48%)和七日热群(阳性率9.76%)为主,三者之间的差异具有统计学意义(χ~2=89.02,P<0.001)。结论湖北省钩体病发病数呈下降趋势,但健康人群钩体病隐性感染仍然存在,宿主动物,如鼠、猪、蛙中均可分离出钩体菌,洪涝灾害较多时,具备钩体病暴发或流行的条件。Objective To analyze the prevalence of leptospirosis in Hubei Province,and to provide reference for the prevention and treatment of the leptospirosis.Methods According to the "national leptospirosis surveillance program",the presence of the leptospirosis in mice,livestock,frogs and other host animals were investigated and the serological monitoring in healthy population was carried out.Collecting data of leptospirosis cases in Hubei Province from 2005 to 2018.SPSS 16.0 and Excel 2003 were used for statistical processing of charts and data.Results From 2005 to 2018,a total of 312 cases of leptospirosis were reported,mainly in Enshi(236 cases),Yichang(38 cases) and Huanggang(19 cases),accounting for 93.91% of the total reported cases.Cases were reported between April and October,with a gender ratio of 4.2∶1,mainly among farmers,accounting for 92.95% of the total reported cases.A total of 2 711 rats were captured,with a density of 1.40%,and the main species were Apodemus agrarius and Rattus tanezumi.The positive rate of the monitored rat kidney samples was 1.82%,and the main strain was Leptospira icterohemorrhagiae 56601.1 919 samples of pig kidney were monitored,with 11 were positive.In the leptospirosis serogroup of health population,L.icterohemorrhagiae(positive rate 18.5%),L.hebdomadis(positive rate 18.5%) and L.grippotyphosa(positive rate 9.76%) were dominant strains,with statistically significance among the three types(χ~2 = 89.02,P< 0.001).Conclusion The incidence of leptospirosis in Hubei Province has been decreasing.However,Leptospira still exists in healthy people and can be isolated from the host animals such as mice,pigs,frogs,etc.There are some risks for the outbreaks or epidemics of leptospirosis during flood in Hubei Province.

关 键 词：钩端螺旋体病 宿主动物 监测 血清学 

分 类 号：R183.5[医药卫生—流行病学] R184.3[医药卫生—公共卫生与预防医学]