2018-2023年陕西省安康市恙虫病发病及流行特征分析  

Incidence and epidemic characteristics of tsutsugamushi disease in Ankang City,Shaanxi Province from 2018 to 2023

作　　者：原凌云[1] 杨敏 陈果[1] 李明刚 陈元慧 邹好 屈娅荣[2] 杨力 焦欢[2] Yuan Lingyun;Yang Min;Chen Guo;Li Minggang;Chen Yuanhui;Zou Hao;Qu Yarong;Yang Li;Jiao Huan(Department of Infection Disease,Ankang Center for Disease Control and Prevention,Ankang 725000,China;Vector Control Division,Ankang Center for Disease Control and Prevention,Ankang 725000,China)

机构地区：[1]安康市疾病预防控制中心传染病防制科,安康725000 [2]安康市疾病预防控制中心病媒生物防制科,安康725000

出　　处：《中华地方病学杂志》2025年第3期215-220,共6页Chinese Journal of Endemiology

摘　　要：目的了解陕西省安康市恙虫病发病及流行现状。方法2018—2023年,通过中国疾病预防控制信息系统收集安康市各级各类医疗机构报告的恙虫病病例资料。同时,对报告病例开展个案流行病学调查,调取患者电子病历核实其诊断。2023年,采用夹夜法在安康市3个恙虫病高发乡镇开展鼠类及恙螨监测,计算鼠带恙螨率、恙螨指数;采集鼠类的血液、肝脏、脾脏、肾脏,提取血液及脏器混合物的DNA,采用实时荧光定量PCR检测恙虫病东方体。结果2018—2023年安康市共报告恙虫病病例330例,报告发病率从2018年的0.56/10万上升至2023年的5.02/10万。其中,男性139例、女性191例,男女性别比为0.73∶1.00;病例年龄主要集中在45~70岁年龄组,占81.52%(269/330);职业以农民为主,占86.97%(287/330);发病时间主要集中在4—10月,共报告病例317例,占96.06%(317/330)。病例主要临床表现为发热(93.20%,274/294)、溃疡或焦痂(75.85%,223/294)、头疼(44.56%,131/294)、淋巴结肿大(44.22%,130/294);首诊误诊率为73.81%(217/294)。鼠类及恙螨监测中,共捕获鼠452只,其中携带恙螨鼠91只,鼠带恙螨率为20.13%(91/452);共捕获恙螨1463只,恙螨指数为3.24(1463/452)。实时荧光定量PCR结果显示,452只鼠血液及脏器混合物样本中,1份脏器混合物样本检出恙虫病东方体。结论安康市恙虫病发病水平较高,发病率整体呈上升趋势。病例以女性、中老年、农民为主,首诊误诊率较高。恙虫病高发乡镇鼠类有携带恙螨情况。Objective To study the incidence and epidemiological characteristics of tsutsugamushi disease in Ankang City,Shaanxi Province.Methods From 2018 to 2023,data on tsutsugamushi disease cases reported by various medical institutions at all levels in Ankang City were collected through the China Disease Prevention and Control Information System.At the same time,individual epidemiological investigation of reported cases was carried out,and electronic medical records of patients were retrieved to verify their diagnosis.In 2023,the rodents and chigger mites were monitored in 3 townships with high incidence of tsutsugamushi disease in Ankang City by night clamping method,and the chigger mites rate and chigger mites index were calculated.Blood,liver,spleen and kidney samples of rodents were collected,DNA of blood and organ mixture was extracted,and quantitative real-time PCR was used to detect Orientia tsutsugamushi.Results A total of 330 cases of tsutsugamushi disease were reported in Ankang City from 2018 to 2023,and the reported incidence rate increased from 0.56/100000 in 2018 to 5.02/100000 in 2023.Among them,139 were males and 191 were females,with a sex ratio of 0.73∶1.00.The age was mainly 45-70 years old,accounting for 81.52%(269/330).The occupation was mainly farmers,accounting for 86.97%(287/330).The onset time was mainly concentrated from April to October,with a total of 317 cases,accounting for 96.06%(317/330).The main clinical manifestations were fever(93.20%,274/294),ulcer or eschar(75.85%,223/294),headache(44.56%,131/294),and lymph node enlargement(44.22%,130/294).The misdiagnosis rate at the first diagnosis was 73.81%(217/294).A total of 452 rodents were captured,of which 91 rodents carried chigger mites,and chigger mites rate was 20.13%(91/452).A total of 1463 chigger mites were captured,and the chigger mites index was 3.24(1463/452).Quantitative real-time PCR was performed on blood and organ mixture samples collected from 452 rodents,and one of the organ mixture samples tested positive for Orientia tsut

关 键 词：恙虫病 流行特征 临床表现 鼠带恙螨率 恙螨指数 

分 类 号：R384.3[医药卫生—医学寄生虫学]