2021年山东省菏泽市曹县一起皮肤炭疽疫情调查报告  

Investigation report on an outbreak of cutaneous anthrax in Caoxian County,Heze City,Shandong Province in 2021

作　　者：张奇 王爽[2] 程立肖 房明[2] 于晓琳 梁昊 王耀 李忠[2] 徐爱强[2] 寇增强[2] 温红玲 Zhang Qi;Wang Shuang;Cheng Lixiao;Fang Ming;Yu Xiaolin;Liang Hao;Wang Yao;Li Zhong;Xu Aiqiang;Kou Zengqiang;Wen Hongling(Key Laboratory for Infectious Disease Prevention and Control(Key Laboratory of China's"13th Five-Year",Shandong University),Department of Microbiological Laboratory Technology,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Key Laboratory for Infectious Disease Prevention and Control,Shandong Provincial Center for Disease Control and Prevention,Jinan 250014,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院微生物检验学系,山东省传染性疾病"十三五"高等学校感染性疾病防控重点实验室,济南250012 [2]山东省疾病预防控制中心,山东省传染性疾病预防控制重点实验室,济南250014

出　　处：《中华地方病学杂志》2023年第6期493-497,共5页Chinese Journal of Endemiology

基　　金：国家科技重大专项任务"全国重点省区细菌性传染病病原谱流行规律及变异集成研究"(2018ZX10713003-002)。

摘　　要：目的分析山东省菏泽市曹县一起皮肤炭疽疫情的暴发原因与流行病学特征,为炭疽防控提供科学依据。方法采用现场流行病学调查方法,使用《炭疽流行病学个案调查表》,根据全民健保系统报告的炭疽疑似病例流行病学接触史及密切接触者进行个案调查(n=83)。采集病例皮肤焦痂涂抹物、病牛组织、屠宰场地土壤样本及屠宰器具涂抹物,分别进行Real-time PCR检测、病原菌分离培养。炭疽判定标准参照《炭疽诊断》(WS 283-2020)进行。结果本次疫情共发现皮肤炭疽病例13例,其中临床诊断病例12例,确诊1例(Real-time PCR检测阳性且分离出1株炭疽芽孢杆菌)。经流行病学调查确定,本次疫情传染源为病牛,传播途径为屠宰病牛、接触被污染的用具及相关牛产品,患者主要是从事牛屠宰或牛产品收售相关职业。实验室共收集样本84份,其中皮肤焦痂涂抹物13份、环境样本64份、牛肉样本7份。PCR检测结果阳性36份,阳性率为42.86%(36/84)。其中皮肤焦痂涂抹物标本阳性率为100.00%(13/13),环境样本阳性率为29.69%(19/64),牛肉样本阳性率为4/7。共分离到8株炭疽芽孢杆菌,其中环境标本6株、疑似病例1株、牛肉1株,总检出率为9.52%(8/84)。排查密接者83人,对涉疫的13个家庭用含氯消毒剂(5000 mg/L)进行喷洒消毒(200 ml/m^(2)),累计消毒涉疫家庭40户次,消毒面积约10765 m^(2),焚烧处理疑似污染衣物45件,对152件厨具进行了浸泡处理。结论屠宰染疫牛、接触被污染的用具及相关产品为本次皮肤炭疽暴发的主要原因。加强市场监管,深化畜间防疫,开展炭疽防治知识的宣传教育,增强从业人员的防病意识是预防炭疽发生的关键。Objective To analyze the cause and epidemiological characteristics of an outbreak of cutaneous anthrax in Caoxian County,Heze City,Shandong Province,and to provide scientific basis for anthrax prevention and control.Methods Using on-site epidemiological investigation methods and the"Anthrax Epidemiological Case Investigation Form",case investigations were conducted based on the epidemiological contact history and close contacts of suspected anthrax cases reported by the national health care system(n=83).Scorched skin smears,diseased cattle tissues,soil samples from the slaughter site and smears from slaughter utensils were collected from cases for Real-time PCR testing and pathogenic bacteria isolation and culture,respectively.Anthrax determination criteria were carried out with reference to"Anthrax Diagnosis"(WS 283-2020).Results A total of 13 cases of cutaneous anthrax were found in this outbreak,including 12 clinically diagnosed cases and one confirmed case(positive Real-time PCR test and isolation of a strain of Bacillus anthracis).The epidemiological investigation determined that the source of infection in this outbreak was diseased cattle,the transmission route was through slaughter of diseased cattle,contact with contaminated utensils and related cattle products,and the patients were mainly engaged in occupations related to cattle slaughter or cattle product collection and sale.A total of 84 samples were collected,including 13 skin scabs,64 environmental samples and 7 beef samples.Thirty-six positive PCR tests were performed,with a positive rate of 42.86%(36/84).Among them,100.00%(13/13)were positive for skin scab smear specimens,29.69%(19/64)for environmental samples and 4/7 for beef samples.A total of 8 strains of Bacillus anthracis were isolated,including 6 environmental specimens,1 suspected case and 1 beef strain,with an overall detection rate of 9.52%(8/84).Eighty-three close contacts were investigated.Thirteen households involved in the epidemic were disinfected by spraying(200 ml/m)with chlorine-co

关 键 词：炭疽 暴发 疫情处置 联防联控 

分 类 号：R754.2[医药卫生—皮肤病学与性病学] R181.8[医药卫生—临床医学]