福建省2015-2020年钩端螺旋体病流行状况分析

Incidence of leptospirosis in Fujian province,2015-2020

目的分析2015-2020年福建省钩端螺旋体(钩体)病流行状况,为钩体病风险评估和防控策略提供依据。方法钩体病数据来源于中国疾病预防控制信息系统的传染病监测系统和2015-2020年17个监测点,采用描述性流行病学和空间自相关方法进行分析,对捕获的鼠脏器进行钩体培养,鼠血清、健康人血清和医院送检的患者血清进行血清抗体检测,分析鼠间和人群钩体病感染状况。结果2015-2020年福建省钩体病发病率总体呈下降趋势,共报告176例。发病具有明显的季节性,表现为双峰分布。病例以农民为主,占49.43%(87/176),年龄以30~69岁组为主(85.80%,151/176),男女性别比为3.51∶1(137∶39)。空间自相关分析提示钩体病有高值或低值聚集区存在,整体聚集性较明显。2015-2020年监测点鼠的捕获率平均为6.96%(1519/21838),黄毛鼠、黄胸鼠和针毛鼠为主要鼠种,鼠血清钩体抗体阳性率平均为28.64%(252/880),感染菌群爪哇群占56.75%(143/252)、秋季群占17.46%(44/252)。健康人群血清钩体抗体阳性率为16.13%(254/1575),感染菌群秋季群和澳洲群占71.65%(182/254)。医院送检患者钩体病的确诊率为2.23%(188/8431),感染菌群秋季群占56.38%(106/188)、七日热群占19.68%(37/188)。结论2015-2020年福建省钩体病疫情总体呈下降趋势,呈明显的地域聚集性和季节性,高值聚集区主要集中在闽北、闽西及闽中地带。鼠类感染菌群主要为爪哇群和秋季群,健康人群血清钩体抗体阳性率逐年下降,秋季群和七日热群是福建省人群钩体感染的主要菌群。

Objective To analyze the incidence of leptospirosis in Fujian province from 2015 to 2020 and provide the scientific evidences for the risk assessment,prevention and control of leptospirosis.Methods The incidence data of leptospirosis in Fujian during 2015-2020 were collected from China Information System for Disease Control and Prevention for a descriptive analysis,and software ArcGIS 10.3.1 was used for spatial autocorrelation analysis,and rats were captured in 17 surveillance areas during the same period,and the rat organs were collected for pathogen culture,the level of Leptospira antibody was detected in serum samples of rats,healthy population and the serum samples of patients sent by the hospitals.The infection status of Leptospira in human and rats were analyzed.Results The incidence of leptospirosis in Fujian showed a downward trend from 2015 to 2020.A total of 176 cases of leptospirosis were reported.There were obvious seasonality and bimodal distribution.The majority of cases were farmers,accounting for 49.43%(87/176).Most cases were aged 30-69 years(85.80%,151/176).The male to female ratio of the cases was 3.51∶1(137∶39).Spatial autocorrelation analysis showed that leptospirosis had high or low clustering areas.From 2015 to 2020,the average capture rate of rats in 17 surveillance areas was 6.96%(1519/21838),Rattus losea,Rattus flavipectus and Niviventer fulvescens were the main species.The average positive rate of Leptospira antibody in rats was 28.64%(252/880).Java and Autumnalis were the predominant serogroups,accounting for 56.75%(143/252)and 17.46%(44/252),respectively.The average positive rate of Leptospira antibody in healthy population was 16.13%(254/1575),and Autumnalis and Australis were the predominant serogroups,accounting for 71.65%(182/254).The confirmation rate of leptospirosis in patient serum samples sent by the hospitals was 2.23%(188/8431),Autumnalis(56.38%,106/188)and Hebdomadis(19.68%,37/188)were the major serogroups.Conclusions The incidence of leptospirosis in Fujian showed a downward trend from 2015 to 2020,there were obvious area clustering and seasonality.The high clustering areas were mainly distributed in northern,western and central Fujian.Java and Autumnalis were the predominant serogroups in rats.The infection rate in healthy population decreased year by year.Autumnalis and Hebdomadis were the main serogroups in population in Fujian.