河南省5起人感染猪链球菌病疫情特征分析

Incidence characteristics of five events of human infection with streptococcus suis in Henan province

目的分析河南省人感染猪链球菌病疫情,为进一步制定防控方案提供依据。方法采用现场调查的方法收集病例相关信息,采集病例血液和脑脊液标本开展细菌培养和核酸检测,使用Arc-Gis10.7绘制病例地区分布。结果2019年河南省发生首起人感染猪链球菌病疫情,截至2021年底共发生5起,累计报告病例5例,死亡1例,病死率20.0%。疫情发生时间集中在6-9月,分布在商丘、新乡和驻马店3个省辖市5个县区;患者中位年龄53岁,男女比例4:1,均有明确的生猪及其制品暴露史。4例临床分型为脑膜炎型,1例为休克型脑膜炎型,从感染到发病潜伏期中位数为4.0天(最短1.0天,最长7.0天);从首次就诊到明确诊断,平均转诊2.2次,诊断延误中位数6.0天(最短4.0天,最长14.0天);感染菌株均为猪链球菌2型。结论河南省人感染猪链球菌病呈现散发态势,无防护的屠宰、加工生猪及相关制品是感染猪链球菌的高危因素,应定期开展针对高危人群的健康教育,提高医疗机构的诊断识别能力。

Objective To analyze the incidence characteristics of human infections with streptococcal suis in Henan province with the purpose of providing an evidence for formulating prevention and control plans.Methods The method of field investigation was used to collect case related information;patients’blood and cerebrospinal fluid samples were collected to carry out bacterial culture and nucleic acid detection,and the regional distribution map of cases was drawn using software ArcGIS10.7.Results The first case of human infection with Streptococcus suis in Henan province occurred in 2019.So far,a total of 5cases have been reported,including 1 death,with the case fatality rate of 20.0%.The cases of the disease intensively occurred from June to September,and distributed in 5 counties/districts of Shangqiu city,Xinxiang city and Zhumadian city.The median age of the patients was 53 years;the male to female ratio was 4:1.All cases had clear exposure history of live pigs and their products one week before infection.The cases were clinically classified as four cases of meningitis and one case of meningitis with toxic shock.The median incubation period from infection to onset was 4.0 days(1.0-7.0 d).Each patient was referred 2.2times from the first visit to the final diagnosis,with an average diagnosis-delay interval of 6.0 days(4.0-14.0 d).Laboratory tests showed that all of them were Streptococcus suis type 2.Conclusion The incidence of human streptococcus suis infection is sporadic in Henan province;the high-risk behaviors of Streptococcus suis infection include unprotected slaughter,processing of live pigs and related products;conducting health education for high-risk groups and improving the diagnostic ability of medical institutions should be carried out.