2005年江西省钩端螺旋体病监测与分析

Analysis of leptospirosis surveillance results in Jiangxi Province in 2005

目的了解江西省钩体病流行状况,为钩体病流行趋势的预测、预警和制定防治对策提供科学依据。方法对2005年钩体病疫情资料进行分析,对宿主动物进行钩体病原分离培养同时用显微凝集试验检测健康人群钩体抗体水平。结果2005年全省发病87例,发病率0.20/10万,7～8月份为发病高峰,职业以农民为主,年龄以30～49岁组最多,男女性别比约为3∶1。全省鼠密度为4.61%,从鼠肾中培养出8株钩体菌株,阳性率7.55%,全部为致病性钩体菌株。猪肾、牛尿未培养出钩体菌株。健康人群血清抗体阳性以黄疸出血群赖型最多,七日热群七日热型次之。结论江西省钩体病的传染源以野鼠为主要动物宿主,流行形式为稻田型。今后该省钩体病的防治重点:以灭鼠为主,搞好环境卫生,开展健康教育及接种钩体疫苗的综合性防治措施。

Objective This study was designed to get an insight into the epidemic situation of leptospirosis in Jiangxi Province for the provision of a scientific basis for predicting and warning the epidemic tendency of leptospirosis and working out countermeasures for the prevention and control of the epidemic. Methods The data on the epidemic situation of leptospirosis in Jiangxi Province in 2005 were analyzed. Leptospira was isolated from host animal and cultured. The microscopic agglutination test was used to determine the titters of antibody against leptospira among healthy population. Results There occurred 87 cases of leptospirosis across the province in 2005 with an incidence of 0.20/lakh. The peak time of onset of the disease was from July to August, with farmers most often affected. Those who were in the age group of 30 to 49 were affected most with a ratio of male to female of 3 to 1. It was found that the rat density was 4.61% in the province. Eight leptospira strains, which were all pathogenic, were obtained from rat kidney culture collections with a positive rate of 7.55%. No lep- tospira strains were found in the culture collections of pig kidneys and cow urine. Among healthy people, cases with positive antibody of serogroup icterohaemorrhagiae serovar lai were most, and the next was serogroup hebdomadis serovar hebdomadis. Conclusion The main infection source of leptospirosis in Jiangxi Province is vole as a host. Rice field leptospirosis is the main epidemic pattern. In future, the most important work to prevent and cure of the leptospirosis are exterminating rat, reconstructing epidemic focus, making the environment sanitation better, carrying out the health education and inoculating the leptospira vaccine. Emphasis is supposed to be put on the comprehensive measures for the prevention and control of the epidemic, including the improvement of environmental sanitation, the implementation of health education and the leptospira vaccination, with the deratization as the major means.