贵州省2015~2019年钩端螺旋体病流行特征及监测分析

Epidemiological characteristics and surveillance of Leptospirosis in Guizhou Province from 2015 to 2019

目的:分析贵州省2015~2019年人钩端螺旋体病(简称钩体病)流行病学特征与鼠类宿主动物带菌情况,为钩体病的防控提供科学依据。方法:收集2015~2019年钩体病例个案,进行描述性流行病学分析。在钩体病高发地区对宿主动物的带菌情况进行监测,并分析与人间疫情的相关性。结果:2015~2019年,贵州省共报告钩体病118例,死亡2例。年发病率在0.0142/10万~0.0770/10万之间波动。病例的职业主要为农民,共96例(81.36%),其中男女性别比为3.72∶1。贵州省钩体病有明显季节性,每年集中于9~10月发病。以黔东南州报告病例为主,共102例,占全省的86.44%。疑似病例经血清学检测阳性56例,阳性率为52.83%,有11个血清群,以黄疸出血群为主(34例,占60.71%)。黑线姬鼠密度较2010~2014年上升,是钩体病的主要动物宿主,携带黄疸出血群钩体,分离阳性率为14.7%。结论:贵州省钩体病高发地区仍以黑线姬鼠为主要传染源,建议在黑线姬鼠密度高的地区开展灭鼠,同时做好健康宣教,做好秋季田间劳动防护,减少农民接触疫水的机会。

Objective: The purpose of present study was to analyze the epidemiological characteristics of human leptospirosis in Guizhou Province from 2015 to 2019 and bacteria carrying rate among mice host, so as to provide scientific basis for the prevention and control of leptospirosis. Methods: Descriptive epidemiological analysis was applied to the data of leptospirosis cases in Guizhou Province from 2015 to 2019. Monitoringthe carrying status of host animals was carried out in the areas with high incidence of leptospirosis, and the relationship between the animalcarriers and human epidemic situation was analyzed. Results: Years from 2015 to 2019 have seen 118 cases of leptospirosis and 2 deaths in Guizhou Province. The annual incidence rate fluctuated between 0.0142/100000 to 0.0770/100000. Leptospirosis most commonly affected farmers(with96 cases, 81.36%).The gender ratio was 3.72∶1. In Guizhou Province, leptospirosis had obvious seasonality, and the cases of leptospirosis were intensively reported from September to October every year. 102 cases(86.44%) were reported in Qiandongnan Prefecture. 56 blood samples of suspected cases were tested positive, the positive rate was 52.83%. There were 11 serum groups, mainly icterohaemorrhagiae group(34 cases, accounting for 60.71%). The main host was Apodemusagrarius. Density of Apodemusagrarius was higher than that of 2010 to 2014. The positive rate of isolation from Apodemusagrariu was 14.7%. Conclusion: Apodemusagrariuswas still the main carrier of leptospira in areas with high incidence of leptospirosis in Guizhou. Rat-extermination was recommended in areas with high density of Apodemusagrarius. At the same time, health education and personal protection should be strengthened to reduce farmers’ access to contaminated water in autumn.