清远市2015—2017年钩端螺旋体病监测结果

Surveillance results of leptospirosis in Qingyuan, 2015-2017

目的了解清远市人群和宿主动物钩端螺旋体(钩体)菌群分布和变迁情况,为预防和控制钩体病提供科学依据。方法选择清远市清新区太平镇为监测点,开展宿主动物密度、带菌以及健康人群血清抗体监测,对监测资料进行描述性流行病学分析。结果 2015—2017年,清远市分别报告钩体病例0例、3例和1例;鼠密度分别为11.03%、3.73%和3.93%,差异有统计学意义(P<0.01);采集鼠肾标本450份、猪肾标本154份、蛙肾标本156份,均未培养分离出钩体;分别采集鼠血清150份、199份和101份,钩体抗体阳性率分别为6.00%、43.72%和55.45%,差异有统计学意义(P<0.01),其中2015年以七日热群为主,占53.85%,2016年以秋季热群为主,占25.96%,2017年以波摩那群为主,占41.38%;分别采集220份、210份和214份健康人血清,钩体抗体阳性率分别为20.45%、23.33%和14.02%,差异有统计学意义(P=0.04),其中2015年以秋季热群为主,占25.96%,2016年以七日热群为主,占27.36%,2017年以波摩那群为主,占27.27%。结论清远市近年来钩体病发病水平低,宿主动物和健康人群隐性感染水平高,宿主动物与健康人群血清抗体阳性的主要菌型不尽相同,应警惕由于菌型的更迭引起钩体病暴发流行的可能。

Objective To understand the distribution and variation of leptospira population and host animals in QingyuanCity, so as to provide the evidence for prevention and control of leptospirosis. Methods Taiping Town was selected as amonitoring point and the data of host animal density, status of bacteria and healthy human serum antibody were collected andanalyzed with the descriptive epidemiological method. Results From 2015 to 2017, 0, 3 and 1 leptospirosis cases werereported respectively in Qingyuan City. The density of rats was 11.03%, 3.73% and 3.93% respectively, and the overalldifference was statistically significant（P〈0.001）. A total of 450 mouse kidney specimens, 154 pig kidney specimens and 156 frog kidney specimens were collected and all the specimens were cultured but no leptospira was isolated. From 2015 to 2017,150, 199 and 101 samples of rat serum were collected and the antibody positive rates were 6.00%, 43.72% and 55.45%respectively, and the difference was statistically significant（P〈0.001）. Among them, the hebdomadis accounted for 53.85% in2015; the autumnalis accounted for 25.96% in 2016, and the pomona accounted for 41.38% in 2017. From 2015 to 2017, 220,210 and 214 healthy human serum samples were collected, and the antibody positive rates were 20.45%, 23.33% and 14.02%respectively, and the difference was statistically significant（P=0.04）. Among them, the autumnalis accounted for 25.96% in2015, the hebdomadis accounted for 27.36% in 2016, and the pomona accounted for 27.27% in 2017. Conclusions Theincidence of leptospirosis is low in Qingyuan City from 2015 to 2017, but the levels of latent infection in the host animal andthe healthy population are high. The main bacteria for the host animals and healthy people are different. We should be alert tothe possibility of the outbreak of leptospirosis due to the change of the bacteria type.