2011—2015年山西省布鲁菌病流行特征分析

Epidemiological characteristics of brucellosis in Shanxi Province from 2011 to 2015

目的 了解2011 - 2015 年山西省布鲁菌病（简称布病）流行特征，为制定防治策略与措施提供依据。方法 收集2011 - 2015年山西省布病疫情数据和监测数据，采用回顾性分析方法，分析布病的人群分布、地区分布、时间分布、疫情爆发情况，血清学和病原学检测结果。结果 2011 - 2015年，山西省共报告布病33 697例，年均发病率为18.65／10万，死亡病例1例；疫情波及11个市、119个县（区），其中以大同市的疫情最为严重；布病发病呈明显的季节性，发病高峰期在3 - 7月；男女比例为3.69 ∶ 1.00（26 515／7 182），发病年龄以40- ＜ 70岁居多，占75.77%（25 531／33 697），患者年龄分布比较差异有统计学意义（H = 146.263，P ＜ 0.05）；农民为高发职业，占82.90%（27 935／33 697）。2011 - 2015 年共上报布病爆发疫情16起，波及5个市、7个县。血清学监测144 136人，平均阳性率为5.85%（8 426／144 136），确诊病例6 759人。人血标本分离布鲁菌164株，均为羊种3型布鲁菌。结论 山西省近年布病疫情严重，总体呈逐年增加趋势，部分地区有布病爆发疫情，羊3型布鲁菌为目前山西省流行的菌株。

Objective To explore epidemiological characteristics of brucellosis in Shanxi Province during 2011 - 2015, and to provide evidences for making control and prevention strategy. Methods Data and surveillance data of disease outbreaks in Shanxi Province from 2011 to 2015 were collected. The retrospective analysis method was used to analyze the population distribution, regional distribution, time distribution, outbreak situation, serological and pathogenic test results of brucellosis. Results During 2011 - 2015, totally 33 697 brucellosis cases were reported, with an average annual incidence of 18.65/100 000, and one death case was reported. Brucellosis distributed in 119 counties （districts） of 11 cities. The area with most reported brucellosis cases was Datong City. The incidence of the disease had seasonal fluctuation and the incidence peak was from March to July. The male/female ratio of the cases was 3.69 ∶ 1.00 （26 515/7 182）. Totally 75.77% （25 531/33 697） were at the ages of 40 - 〈 70 years. The yearly proportion of the cases occurred in the age groups was significantly different （H = 146.263, P 〈 0.05）. Farmer was the predominant occupation group among the cases [82.90% （27 935/33 697）]. Totally 16 cases of human brucellosis outbreaks were occurred during the five years. The epidemic spread to seven counties in five cities. Totally 144 136 cases received serological test, the positive rate was 5.85% （8 426/144 136）, and 6 759 cases were found. Totally 164 strains of Brucella melitensis were isolated in human blood culture samples. All of which were Brucella melitensis biotype 3. Conclusions In recent years, the epidemic situation of brucellosis in Shanxi is severe, the total incidence has presented a rising tendency. There are outbreaks of human brucellosis in some countries. Brucella melitensis biotype 3 is the epidemic strain in Shanxi.