2013-2017年江苏省人间布鲁菌病监测点监测结果分析

Analysis of surveillance results of human brucellosis monitoring sites in Jiangsu Province from 2013 to 2017

目的了解江苏省人间布鲁菌病(布病)监测点疫情及重点职业人群布鲁菌感染情况,为制订布病防控对策提供依据。方法2013-2017年,根据《全国布鲁氏菌病监测工作方案》要求,在江苏省设立无锡宜兴市、淮安淮阴区两个布病监测点进行布病监测。收集2013-2017年宜兴市和淮阴区两个监测点的布病疫情资料(来源于江苏省法定传染病报告系统),进行流行病学分析;采集监测点内一般职业人群(健康体检者)和布病重点职业人群(从事牲畜交易,牲畜屠宰,皮毛、乳、肉加工者等)血液样本,采用虎红平板凝集试验(RBPT)和试管凝集试验(SAT)进行血清学检测。结果2013-2017年,江苏省宜兴市和淮阴区两个监测点共报告布病病例18例,其中男性13例、女性5例,男女性别比为2.6∶1.0;发病年龄主要集中在35~64岁,占72.22%(13/18);发病时间集中在1-6月份,占94.44%(17/18);职业分布以农民为主,占77.78%(14/18);未发生布病聚集性疫情和爆发疫情。在两个监测点共调查一般职业人群17743例,血清学检测均为阴性,未发现布病感染者,且无布病相关体征、症状者。2013-2017年布病重点职业人群血清学检测阳性者共113例,总阳性率为7.83%(113/1444),各年份阳性率呈逐年下降趋势(t=6.463,P<0.05)。其中,宜兴市血清学检测106例,阳性率为11.79%(106/899);淮阴区7例,阳性率为1.28%(7/545),不同地区间比较差异有统计学意义(χ2=51.926,P<0.01)。从事牲畜交易,牲畜屠宰,皮毛、乳、肉加工的职业人群阳性率分别为5.10%(20/392)、9.74%(49/503)、8.01%(44/549),不同职业间比较差异有统计学意义(χ2=6.618,P<0.05);且从事牲畜屠宰和皮毛、乳、肉加工职业人群的血清学检测阳性率高于从事牲畜交易的职业人群(P均<0.05)。结论江苏省布病监测点重点职业人群布病阳性率总体呈下降趋势,但从事牲畜屠宰和皮毛、乳、肉加工的职业人群更易受布鲁菌感染,仍需加强对布病重点职业人群的健康宣教及对外来牲畜的检验检疫工作,预防人间布病的流行。

Objective To explore the epidemic situation and brucellosis in key occupational populations of brucellosis monitoring sites in Jiangsu Province,and provide a basis for development of prevention and control strategies against brucellosis.Methods From 2013 to 2017,according to the requirements of the"National Brucella Surveillance Programme",two brucellosis monitoring sites in Yixing City of Wuxi and Huaiyin District of Huai'an,Jiangsu Province were established to monitor brucellosis.Brucellosis epidemic data were collected and analyzed of the two monitoring sites in Yixing City and Huaiyin District from 2013 to 2017(data were from Jiangsu Provincial Legal Infectious Disease Reporting System).Blood samples were collected from the general occupational populations(health check-up population)and the key occupational populations(people engaged in livestock trading,livestock slaughtering,and the fur,milk and meat processing)in the monitoring sites.Tiger red plate agglutination test(RBPT)and serum tube agglutination test(SAT)were used for serological examination.Results From 2013 to 2017,a total of 18 cases of brucellosis were reported at the two monitoring sites in Yixing City and Huaiyin District,Jiangsu Province,including 13 males and 5 females,with a male to female sex ratio of 2.6∶1.0;the age of onset was mainly 35-64 years,accounting for 72.22%(13/18);the time of onset was mainly from January to June,accounting for 94.44%(17/18);and the occupational distribution was mainly farmers,accounting for 77.78%(14/18);there was no epidemic and outbreaks of brucellosis.A general occupational populations survey was conducted in 17743 cases,serological tests were negative,no infection and no signs and symptoms were found in the two monitoring sites.In 2013-2017,a total of 113 cases of serological tests were positive in the key occupational populations of brucellosis in Jiangsu Province,with a positive rate of 7.83%(113/1444),and the overall trend was downward year by year(t=6.463,P<0.05).Among them,the positive rates in Yixing City and Huaiyin District were 11.79%(106/899)and 1.28%(7/545),respectively.The difference between different regions was statistically significant(χ2=51.926,P<0.01).The positive rates of occupational groups engaged in livestock trading,livestock slaughtering,and the fur,milk and meat processing were 5.10%(20/392),9.74%(49/503),and 8.01%(44/549),respectively.The differences were statistically significant between different occupations(χ2=6.618,P<0.05);and the positive rates of livestock slaughtering occupations and the fur,milk and meat processing occupations were higher than that of livestock trading occupations(P<0.05).Conclusions The positive rate of brucellosis in key occupational populations has showed a general downward trend,the livestock slaughtering occupations and the fur,milk and meat processing occupations are more susceptible to Brucella infection.It is still necessary to strengthen the health education for the key occupational populations of brucellosis and inspection and quarantine work for prevention of the epidemic of brucellosis in humans.