广西2004年洪涝期钩体病流行病学分析

Epidemiological analysis of leptospirosis during flooding in Guangxi in 2004 and control measures.

目的了解广西洪涝期钩端螺旋体（钩体）病的流行态势，掌握其流行病学特征，制定洪涝期钩体病的防制对策。方法对2004年洪涝期广西各地、市、县上送的疑似钩体病患者血清进行钩体显微镜凝集试验（MAT），并收集病例个案资料进行分析。结果2004年广西洪涝期钩体显微镜凝集试验（MAT）总阳性率为19．05％（16／84），病死率为5．95％（5／84）；流行高峰在7—9月，主要流行菌型为黄疸出血群覆流感伤寒群；MAT〉1：400病例大多数分布在青壮年，各年龄组中以〉50-年龄组MAT阳性率最高迭35．00％（7／20），其次为30，年龄组的30．00％（3／10）。结论2004年洪涝期广西钩体流行特征为任何年龄均可感染钩体，流行菌群有一定相对独立的地域性，感染途径与接触疫水或疫土有关。洪涝期应对受灾高危人群采取相应的预防措施，以达到降低钩体病发病率和病死率的目的。

Objective To understand the prevalence and epidemiological features of leptospirosis during flooding period in Guangxi Zhuang Autonomous Region so as to provide evidence for making prevention and control strategies. Methods Serum samples obtained from suspected leptospirosis patients across Guangxl were collected and assayed with microscopic agglutination test （MAT） , the results were analyzed. Results During the flood season in 2004 in Guangxi the overall seroprevalenee rate of leptospirosis was 19.05%0 （16/84） and the fatality rate was 5.95% .The prevalent peak was between July and September.The most common serogroups were L icterohae morrhagiae and L. grippotyphosa. MAT fiter was 〉 1：400 and mostly occurred to adults. The positive rate of MAT was the highest at the age group of 〉 50 years （35% ,7/20） ,followed by the age group of 30 - 50 years （30% ,3/ 10） .There no significant differences were observed between the two sexes Conclusion During the flooding season of 2004, leptaspirosis infection attacked all age groups. The predominant serogroups of leprospira varied geographically. The route of transmission was associated with contact with contaminated water and terrains. Appropriate intervention measures should be taken in flood- hit areas in order to reduce the incidence and fatality.