一起钩端螺旋体病聚集性疫情的调查处置  

Epidemiological investigation and disposal of an outbreak of leptospirosis clustering epidemic

作　　者：李森 寿钧 孟祥杰[1] LI Sen;SHOU Jun;MENG Xiang-jie(The Center for Disease Control and Prevention of Yuhang District,Hangzhou,Zhejiang 31l100,China)

机构地区：[1]杭州市余杭区疾病预防控制中心,浙江余杭311100

出　　处：《疾病预防控制通报》2025年第1期22-25,共4页Bulletin of Disease Control & Prevention(China)

摘　　要：目的调查浙江省杭州市余杭区一起钩端螺旋体(简称钩体)病疫情,为本地区钩端螺旋体病的防制工作提供依据。方法对2022年8月以来在余杭区某村发现的钩体病确诊病例、疑似病例、病原携带者进行流行病学调查,采用病原微生物宏基因组测序(m NGS)和钩端螺旋体核酸检测病原。结果调查发现钩体病确诊病例1例、临床诊断病例2例、病原携带者2例,均分布在余杭区某村,均有同一场所居住生活史,该场所捕获3只鼠,其肾和血的钩体抗体和核酸检测结果均为阴性。3例病例均为采茶工,均有野外暴露史。结论该起疫情感染来源可能为在居住地直接接触了带菌鼠类及其排泄物,也不排除在野外接触被鼠、猪等带菌动物体液污染的水体等环境而造成感染。采取了健康监测、预防性服药、环境清洁、防鼠灭鼠等防控措施,有效地控制了疫情,未引起进一步扩散。Objective To investigate the epidemiological features of an outbreak of leptospirosis in Yuhang district of Hangzhou city in Zhejiang province,and provide evidence for local prevention and control of leptospirosis.Methods The epidemiological investigation was carried out in the confirmed cases,suspected cases and pathogen carriers with leptospirosis who were found in a village in Yuhang district since August 2022.The detecting methods of metagenomic next-generation sequencing(mNGS)and the leptospira nucleic acid test were used for detecting the pathogen.Results There were 1confirmed case,2 clinically diagnosed cases,and 2 pathogen carriers with leptospirosis found after the investigation in a village in Yuhang district,with shared history of living in a same place,and 3 rats were captured in this place.The detection antibody and nucleic acid of leptospira were negative in the samples of kidney and blood of the rats captured in this place.All 3 cases were the tea pickers,with the history of field exposure.Conclusions The source of this epidemic infection may be the direct contact with the infected rats and their excreta in the residential area,It cannot be ruled out that the infection may be caused by contacting with the water or other environments polluted by the body fluids of rats,pigs and other animals with the pathogens in the wild field.The prevention and control measures such as health monitoring,preventive medication,environmental cleaning,and rodent control had been adopted,and the outbreak is effectively under control,and the epidemic doesn't spread.

关 键 词：钩端螺旋体病 流行病学调查 钩端螺旋体 聚集性疫情 

分 类 号：R514.4[医药卫生—内科学] R181.8[医药卫生—临床医学]