2009-2019年贵州省人间钩端螺旋体病疫情流行特征研究  

Epidemiological haracteristic of human leptospirosis in Guizhou Province from 2009 to 2019

作　　者：姚光海[1] 刘英[1] 黄荷[1] 胡灿[1] 王丹[1] 聂炜[1] 邹志霆[1] 李世军[1] YAO Guang-hai;LIU Ying;HUANG He;HU Can;WANG Dan;NIE Wei;ZOU Zhi-ting;LI Shi-jun(Guizhou Center for Disease Control and Prevention,Guiyang 550001,China)

机构地区：[1]贵州省疾病预防控制中心,贵阳550001

出　　处：《中国人兽共患病学报》2021年第10期903-909,共7页Chinese Journal of Zoonoses

基　　金：国家自然科学技术基金项目(No.81960622、No.81760366);贵州省高层创新型人才培养项目(No.黔科合人才[2016]4021号);贵州省重要传染病实验诊断技术及分子流行病学研究科技创新人才团队专项资金项目(No.黔科合平台人才[2018]5606)。

摘　　要：目的了解2009-2019年贵州省人间钩端螺旋体病的流行特征及趋势,为防控工作提供科学依据。方法用描述性流行病学方法分析贵州省2009-2019年钩端螺旋体病疫情资料及其相关监测资料。结果2009-2019年贵州省人间钩端螺旋体病累计报告病例141例,发病率呈波动下降趋势,年均发病率为0.0359/10万,死亡9例,年均死亡率0.0023/10万。高发地区为黔东南州(113例,0.2840/10万)。全年除1月、3月和4月外的各月均有病例报告,8-10月报告病例最多(117例,占82.98%)。以10~65岁发病最多(130例,占92.20%)。男女病例之比为5.13∶1。职业发病以农民最多(103例,占73.05%),其次是学生(26例,占18.44%)。流行形式主要为稻田型散发。稻田捕鼠942只,捕获率10.93%(942/8621),优势鼠种为黑线姬鼠(412只,占43.74%),分离钩端螺旋体82株,分离率8.70%(82/942),菌株均为黄疸出血群,均分离自黑线姬鼠,黑线姬鼠带菌率为19.90%(82/412)。报告疑似钩体病例的钩体抗体阳性率42.45%(59/139),感染以黄疸出血群为主(36例,占61.02%);发病区健康人群抗体阳性率53.33%,明显高于非发病区的11.89%(χ^(2)=38.85,P=0.00)。结论贵州省人间钩端螺旋体病疫情下降显著,局部区域高发,需警惕历史自然疫源地的潜在流行风险,应加强监测及健康教育等综合干预工作。The present study investigated the characteristics and epidemic trends of leptospirosis to provide a scientific basis for control and prevention.Epidemic data on human leptospirosis and related monitoring data from 2009 to 2019 were examined through epidemiological analysis.A total of 141 cases and 9 deaths occurred from 2009 to 2019.The incidence rate of leptospirosis presented a downward fluctuating trend.The average incidence per year was 0.0359/100000,and the average mortality rate was 0.0023/100000.The highest risk area was Qiandongnan Prefecture(with 113 cases,incidence 0.2840/100000).Cases were reported in all months of the year except January,March and April.Most cases were reported from August to October(117 cases,accounting for 82.98%).Among them,130 cases(92.20%)were in people 10~65 years of age.The gender ratio among cases was 5.13∶1.Farmers were the most common occupation among infected people(103 cases,73.05%),followed by students(26 cases,18.44%).The epidemic pattern was sporadic rice field leptospirosis.A total of 942 rats were trapped in rice fields,and the capture rate was 10.93%(942/8621).The dominant species in the rats was Apodemus agrarius(412,accounting for 43.74%).A total of 82 strains of Leptospira were isolated,with an isolation rate of 8.70%(82/942).All strains isolated from A.agrarius grouped as the icterohaemorrhagiae strain.The leptospiral carriage rate among rats was 19.90%(82/412).The positivity rate of anti-Leptospira antibody was 42.45%(59/139)in suspected leptospirosis cases,and the leptospirosis was mainly icterohaemorrhagiae type(36 cases,61.02%).The positivity rate of leptospirosis antibodies in healthy people in the epidemic area was 53.33%,a value significantly higher than that in the non-epidemic area(11.89%)(χ^(2)=38.85,P=0.00).The incidence of human leptospirosis in Guizhou Province has decreased significantly but was high in some localities.The potential epidemic risk of historical natural foci must be recognized,and comprehensive interventions such as monitoring and

关 键 词：钩端螺旋体病 流行特征 监测 

分 类 号：R372[医药卫生—病原生物学]