四川省钩端螺旋体病39年流行病学分析

Epidemiology Analysis of Leptospirosis of Sichuan Province from 1958 to 1996

对四川省１９５８～１９９６年的钩体病流行情况进行了分析。３９年来，全省８４．０１％的县有病例报告，累计发病６７７４０３例，年均发病率为１９．４９／１０万，死亡７５８８人，年均病死率为１．１２％。流行形式以“稻田型”为主；感染方式主要以收割水稻接触疫水而感染。发病高峰为每年８～９月，青壮年农民发病最多，男与女之比为１．９０∶１。经过疫源地调查，已从２８种动物中分离出钩体。啮齿和食虫动物为“稻田型”钩体的主要传染源；家畜为“洪水型”钩体主要传染源。全省流行菌群有１７群，以黄疸群为主，占６６．３６％。有３９个血清型，其中赖型占５３．９９％。各地流行菌群菌型基本稳定，但不同地区和年代亦有变化。钩体病流行强度与宿主动物数量、带菌率高低、人群免疫水平、水稻收割季节、降雨量密切相关。

Epidemiology analysis of leptospirosis of Sichuan province from 1958 to 1996 was carried out. There were case reports in 84.01% areas and 677 403 cases were found. The mean year morbidity was 19.49/10 000,7 588 Cases died and the yearly mortality was 1.12%.'Rice-field type'was the main epidemic pattern. The main routes of infection was contacting the contaminated water when harvesting rice. The peak epidemic time was the period from August to September annually. The younger peasant was the main target. Leptospira was seperated from twenty-eight types of animals. Rodent and insectivorus animal were the infection soure of 'Rice-field type'leptospirosis, while livestock was the infection source of 'flood type'leptospirosis. There were seventeen groups of leptospirosis. Leptospiral jaundice was the main group, which occupied 66.3%. There were thirty-nine serual type and among them 53.99% was 'Tai type'. On the whole the epidemic strain of leptospira in each area was stable. The prevalence of leptospirosis of Sichuan Province was close related to the amount of the host animal, the rate of bacteria carrier, the immunization of people, the season of harvesting rice and the rainfall.