江西省上高县钩体病暴发的系统性流行病学调查和研究

A Systematic Geographical Epidemiological Survey and Studies on a Outbreak of Leptospirosis in Jiangxi Province

我们对１９９２年上高县钩体病暴发流行进行了调查。结果表明：此次暴发流行以稻田型为主，主要由七日热群钩体引起。血清学调查表明牛、猪存在感染，流行季节７—９月份，感染地点主要集中于稻田和池塘，发病人群以农民为主，年龄集中于１５～４５岁的青壮年。池塘水和稻田水平均ｐＨ为６．４～６．５，池塘中钩体分离率较高（５／６），７～８月份平均旬雨量为３１．２５～４５．７５ｍｍ，旬均温度为２７．５～２８．５℃，这些条件有利于钩体的生长和繁殖。采集县医院和泗溪乡医院临床确诊的钩体病人血液和牛、猪血液，并用ｄｏｔ—ＥＬＩＳＡ和ＭＡＴ试验对血清进行了检测，同时从病人血液、牛尿、池塘水、污水和河水中分离钩体，结果早期钩体病人血清ｄｏｔ—ＥＬＩＳＡ的阳性率（６４．６％）明显高于ＭＡＴ的阳性率（１４．１％），同时也高于血培养的阳性率（１５．２％）。人血液分离钩体的鉴定结果表明，感染以七日热群钩体为主（１５株），兼有爪哇群（６株）、澳洲群（２株）、流感伤寒群（３株）、明尼群（１株）和赛罗群（２株），从牛尿、池塘水，污水和河水中也分别分离出钩体。血清学实验结果显示ｄｏｔ—ＥＬＩＳＡ是一种快速、简单、特异、敏感的早期钩体病诊断方法和流行病学调查?

A systematic epidemiological survey and studies on a outbreak of Leptospirosis in Shanggao county,Jiangxi province in 1992 was carried out by the Geographical Epidemiological method.The results suggested that Shanggao county,Jiangxi province should be a mixtural epidemic area with epidemic type being rice field; mixtural infections should be caused mainly by Leptospira Hebdomadis, rodents density was 4.49%, Serological survey results indicated that cattles(buffalos)and swines were infected by Leptospira,epidemic months were from July to September,infective spots were mainly rice field and ponds an most of the patients were peasants with their ages mainly 15～45 years old. The pH of the water of the rice fields and ponds ranged from 6.4￣6.5.The isolate rate of Leptospira from ponds water was chigh(5/6).198 sero-samples from patients with early Leptospirosis in clinic,14 sero-samples from cattles(buffalos)and 7 sero-samples from swines were tested by dot-ELISA and MAT, While 30 strains of Leptospire,7 strains of Leptospire and 1 strain of Leptospira were isolated respectively from patients, water of ponds,rice fields and rivers and urines of cattles(buffalos). The results showed that the positive rate of dotELISA(64.6%)was higher than that of blood culture (15.2%) and MAT(14.1%).Most of the Leptospire isolated from the patients were Leptospira Hebdomadis(15 strains),others were Leptospira Javanica (6 strains),Leptospira Australis(2 strains),Leptospira Grippotyphosa(3 strains),Leptospira Mini(1strain) and Leptospira Scjroe(2 strains). The results showed that the dot-ELISA was a rapid,simple,sensative and specific method to diagnose the patients with early Leptospirosis and to carry out the geographicepidemiologic surveillance of Leptospirosis.