175例恙虫病病例的临床和流行病学特征研究

Clinical and epidemiological investigation of 175 tsutsugamushi disease cases

目的了解安徽省恙虫病的流行状况和临床特征,为其防治提供科学依据。方法根据《恙虫病预防控制技术指南(试行)》病例定义,采用《恙虫病流行病学个案调查表》对175例恙虫病病例开展回顾性调查。结果 175例病例中,男女比1.08∶1,年龄最小2岁,最大82岁,平均(46.15±18.06)岁;病例以农民为主,129例(73.7%);发病时间主要集中在10～11月;22例(12.6%)有外出史,117例(66.9%)有田间作业史。临床表现主要为发热175例(100.0%)、溃疡/焦痂115例(65.7%)、头痛148例(84.6%)、皮疹141例(80.6%)和淋巴结肿大56例(32.0%)等。结论安徽省恙虫病流行于秋收季节,以田间作业农民发病为主;多急性起病,有发热、特异性焦痂或溃疡、皮疹和淋巴结肿大等临床表现。

Objective To investigate the epidemiological and clinical characteristics of 175 cases of Tsutsugamushi Disease in Anhui Province,so as to provide scientific information for making prevention and control measures. Methods According to 'Guide to Prevention and Control of Tsutsugamushi Disease (Trial)' case definition,a retrospective investigation was carried out on 175 cases based on the 'Epidemiology Questionnaire of Case for Tsutsugamushi'. Results In 175 cases,the sex ratio of men to women was 1.08:1. The age range was from 2 to 82 with a mean of (46.15±18.06). Most patients were farmers,accounted for 73.7%. The peak time of onset was from Oct to Nov. The cases were distributed over 10 counties in northern Anhui Province. 22 cases had gone out,117 cases had worked on farm. The chief clinical manifestations were fever,ulcer/scab,headache,skin rash and lymph node enlargement. Conclusions The tsutsugamushi disease is popular in harvest season in Anhui Province,mainly occurred in farmers. It comes fast and has manifestations of fever,specific scab/ulcer,skin rash and lymph node enlargement.