广西2006年人感染猪链球菌病流行原因及防制措施

The prevalent status of human infection of streptococcosis suis in Guangxi in 2006 and control measures

目的了解广西2006年人感染猪链球菌病疫情的流行病学特点,为制订防制对策提供依据。方法对报告的6例人感染猪链球菌病病例进行个案调查、标本细菌培养和基因检测,对所收集的资料进行数据录入和流行病学分析。结果6例病例均为中老年男性,以肉品加工从业人员和农民为主,地区分布分散,以夏秋季节为高发,传播途径与直接接触猪肉有关,5例(83.33%)有划破手或手上有伤口,66.67%的病例无法追溯到可疑猪肉的来源。临床分型脑膜脑炎型和中毒休克型各3例,主要临床表现为发热、头痛、头晕、畏寒、神志不清、颈项强直、皮肤瘀点瘀斑、四肢酸痛和休克等,大部分病例有血常规WBC和中性粒细胞比例增高,脑膜脑炎型病例脑脊液呈化脓性改变,病死率33.33%,后遗症发生率50.00%。流行原因主要包括农民由于经济困难私宰病死猪,有关部门对猪肉上市流通的监管力度不够、农民及猪肉销售人员在接触猪肉时防护意识不足等。经采取一系列综合性措施每起人间疫情均得到了有效控制。结论广西有效控制该病关键在于畜间疫情的控制、猪肉检疫、流通的监管以及加强农业部门与卫生部门的有效沟通。

Objective To understand the epidemiological characteristics of Streptococcus suis in humans in 2006 in Guangxi. Methods Six individual kcases infected with streptococcus suis reported in Guangxi were epidemiuologically surveyed. The specimens from patients were cultured and genetically analyzed. And the data was computerized and analyzed using epidemiological tools. Results All six cases reported were middle - aged males with careers of pork processing or farmers. Geographic clustering was not found in the six cases. And most of them were reported in summer and autumn. The infection was associated with contact of pork. The hands of five of the cases were wounded when directly contact with pork （83.33 % ）. The sources of the suspected pork were not traceable in 66.67 % of the cases.3 of those cases developed into cerebral meningitis and toxic shock, with the clinical manifestations of fever, chill, headache, dizziness, confusion, stiff neck, rash of skin, muscle pain and shock. Elevating white blood cell counts and neutrophils proportion was observed in most of the cases. Purulent CSF was found in the cases with cerebral meningitis, for which the case fatality rate was 33.33%, and the incidence of sequelae was 50.00%. The causes of the epidemics were mainly related to illegal slaughter of sick/dead swine by the farmers due to poor economic status, incomplete inspection of pork market and weak awareness of protection when handling pork. Conclusion To control the disease, it is crucial to control the epidemics in animals, strengthen pork quarantine and marketing inspection and making joint effort with health and the agricultural sections.