河南省黄河流域稻田型钩端螺旋体病流行特征及流行趋势分析

Analysis of Epidemic Feature of Leptespirosis in Northern Bank of Huanghe River in Henan Province

河南省黄河流域为钩端螺旋体病的低发疫区。１９９２年以来，黄河北岸广大稻田区发生本病流行。其主要表现为：１．流行形式为稻田型；流行期为４～１１月，流行高峰在８月份；临床表现复杂，以流感伤寒型为主，黄疸出血型及肺大出血型比例较高。２．疑似病例及健康人隐性感染的血清群均以黄疸出血群为主，其它有波摩拿群、秋季群等。当地优势鼠种为黑线姬鼠，其带菌率夏季为１６．６７％，秋季为２７．２７％，携带菌群主要为黄疸出血群，与人间主要流行菌群一致。３．原阳县为流行的中心地区，其流行强度明显高于毗邻的其他发病县。４．易感人群普遍接种相应型别钩体疫苗，开展以灭鼠为主的爱国卫生运动，进行疾病防治的宣传等综和防治措施，可有效地预防本病流行，降低发病率，１９９４年以后发病呈下降趋势。

Since 1992, outbreak of leptespirosis continuously occured in northern bank of Huanghe river in Henan province, The main epidemic characteristics were: 1. The major epidemic form was rice fieled type.The cases occured from July to November, and the epidemic peak period was in August. The incidence rate of the adult groups(>15 years) was signicantly higher than that of the young people(<15 years),and 97.5% cases were peasants. 2. 112 sera samples were examined by MA test,and the posi tive rate was 48. 15%. Of these positives, 75. 92% was icterohaemorrhagiae serogroups and 14. 82% was autumnalis serogroups.The possible infectious source of leptespirosis was Apodemus agrarius, and seven leptespira interrogans serovar icterohaemorrhagiae were isolated.3. The vaccine could reduce the morbidity of leptespirosis.