2014年福建省3起布氏菌病暴发疫情调查

Investigation on three human brucellosis outbreaks in Fujian Province,2014

目的调查福建省2014年3起布氏菌病暴发疫情,查明病例感染来源,疫情严重程度和传播危险因素,为今后更好的预防控制布氏菌病疫情提供依据。方法联合农业部门开展流行病学暴发调查方法,通过病例搜索,个案访谈及问卷调查等方式收集资料。结果共发现11例病例,5例隐性感染者。涉事养羊场职业人群感染情况,漳州感染率为41%(7/17),宁德感染率为75%(3/4),感染还波及婴幼儿(3例)、学生(2例)、个体户(1例)等一般人群。感染方式中无防护的死胎处理及喝生羊奶感染率均为100%。此外,3家涉事养羊场的羊只布病抗体阳性率分别为46%(121/262)、45%(5/11)、33%(2/6)。结论 3起布氏菌病暴发疫情传染源为本地及来自陕西的染疫羊只,无防护的死胎处理、接胎及喝生羊奶是主要的传播途径,羊只感染率高、民众预防知识匮乏、动物检疫等措施空白是疫情扩散的危险因素。建议卫生与农业部门开展人-畜布病监测一体化,扩大监测范围及抽检比例,及时发现疫情并进行妥善处理。

The aim is to clarify the infection source, the severity of disease as well as risk factors of transmission among three cases of human brucellosis outbreak in Fujian Province in 2014, then provide scientific bases for further prevention and control measures. We conducted case searching, case interview and questionnaire to collect information by combining with agri- cultural sector. Outbreaks took place among cities of Zhangzhou, Ningde and Longyan, two were happened on sheep farms while one was on a common family. Totally 11 patients and 5 latent infection were found. Among oeaepatioms of involving sheep farm, Zhangzhou got a infection rate of 41 % （7/17） while Ningde was 75 % （3/4）. Infants （3 cases）, students （2 cases） as well as the self-employed （1 case） were involved by these epidemics. Both unprotected stillbirth treatment and unboiling goat＇s milk drinking got a 100% infection rate. In addition, the brucellosis antibody positive rate among these three sheep farms was 46%（121/262）, 45%（5/11） and 33% （2/6）. We surmised that the direct source of infection was local infected sheep and the one from Shannxi Province, unprotected handling lambing and stillbirth treatment as well as unboiling goat＇s milk drinking were the main route of transmission. Meanwhile, high sheep infection rate, lack of brucellosis awareness and protective measure, animal quarantine gap were all devoted to these three outbreaks.