浙江省舟山市一起疑似钩端螺旋体病疫情及其流行病学调查  

An epidemiological investigation of a suspected leptospirosis epidemic in Zhoushan,Zhejiang Province,China

作　　者：刘雷杰 王宇超 应峥 李世波[2] 舒纪为 王忠发 王蓉[4] 张森 LIU Lei-jie;WANG Yu-chao;YING Zheng;LI Shi-bo;SHU Ji-wei;WANG Zhong-fa;WANG Rong;ZHANG Sen(Department of Infectious Disease Prevention and Control,Putuo Center for Disease Control and Prevention of Zhoushan City,Zhoushan,Zhejiang 316100,China;Zhoushan Hospital of Zhejiang Province,Zhoushan,Zhejiang 316021,China;Daishan Center for Disease Control and Prevention,Zhoushan,Zhejiang 316200,China;Department of Viral Research,Ningbo Municipal Center for Disease Control and Prevention,Ningbo,Zhejiang 315010,China;Dinghai Center for Disease Control and Prevention,Zhoushan,Zhejiang 316000,China)

机构地区：[1]舟山市普陀区疾病预防控制中心传染病防制科,浙江舟山316100 [2]浙江省舟山医院,浙江舟山316021 [3]岱山县疾病预防控制中心,浙江舟山316200 [4]宁波市疾病预防控制中心病毒研究所,浙江宁波315010 [5]舟山市定海区疾病预防控制中心,浙江舟山316000

出　　处：《中国媒介生物学及控制杂志》2023年第4期518-522,共5页Chinese Journal of Vector Biology and Control

基　　金：浙江省自然科学基金(LY21H100002);舟山市医药卫生科技计划项目(2022YA12)。

摘　　要：目的了解浙江省舟山市近40年来首例钩端螺旋体(钩体)患者的感染情况,评估其居住周边环境中的宿主动物及居民感染状况。方法应用反转录实时荧光定量PCR(RT-qPCR)方法对2022年1例钩体病疑似病例、其居住地周围居民以及宿主动物(小兽、猪)进行钩体核酸检测,采用反转录PCR扩增23S rRNA靶基因并测序,分析感染基因种。利用酶联免疫吸附试验方法对疑似病例和周围居民进行血清钩体抗体检测。结果疑似病例急性期血清钩体核酸阳性,IgM与IgG均阴性;恢复期血清钩体核酸阴性,IgM与IgG均阳性。居住地周围69名居民血清钩体核酸均为阴性,IgM和IgG阳性率分别为4.35%(3/69)和8.70%(6/69),其中3份IgM阳性居民的尿液钩体核酸均为阳性。小兽肾钩体核酸阳性率为30.00%(15/50),3份猪尿钩体核酸均为阳性。23S rRNA基因测序结果显示:该疑似病例急性期血清、4份鼠肾及2份猪尿样本为博氏钩体;3份居民尿液、5份鼠肾及1份猪尿样本为问号钩体。结论该疑似病例可确诊为钩体病。患者居住地的宿主动物和周围居民均有较高的钩体感染率。Objective To investigate the infection of the first leptospirosis patient in Zhoushan in the past 40 years,and to evaluate the potential risks of host animal and local resident infection.Methods RT-qPCR was used to detect leptospiral nucleic acid in a suspected case,local residents,and host animals(small mammals and pigs)in 2022.The 23S rRNA target gene was amplified by RT-PCR and sequenced to detect the infected genospecies.ELISA was used to detect leptospiral antibodies in the sera of suspected case and residents.Results Leptospiral nucleic acid was tested positive in the acute phase of the suspected patient,but turned negative in the recovery phase.In contrast,IgM and IgG were negative in acute phase but positive in recovery phase.Leptospiral nucleic acid was tested negative in the sera of 69 residents,but was positive in the urine of 3 residents with positive IgM.The positive rate of IgM in sera of residents was 4.35%(3/69)and the positive rate of IgG was 8.70%(6/69).The positive rate of leptospiral nucleic acid in small mammal kidney was 30.00%(15/50),and the three pig urine were positive for leptospiral nucleic acid.The species in the sera of the suspected case in acute phase,4 rat kidney specimens,and 2 pig urine specimens were identified as Leptospira borgpetersenii.The species in 3 urine specimens from local residents,5 rat kidney specimens,and 1 pig urine specimen were identified as L.interrogans.Conclusions The patient was confirmed with leptospirosis.The infection rates of Leptospira in host animals and residents were both high in the patient's place of residence.

关 键 词：钩端螺旋体病 病例鉴定 宿主动物监测 人群感染调查 

分 类 号：R3775[医药卫生—病原生物学] R183[医药卫生—基础医学]