陕西省陕南地区一起人间布鲁氏菌病暴发疫情的调查研究

Epidemiological investigation of a human brucellosis outbreak in the southern region of Shaanxi Province

目的调查2021年陕西省陕南地区一起人间布鲁氏菌病(简称布病)暴发疫情的原因,为今后该地区布病疫情防控提供借鉴依据。方法通过现场流行病学调查和实验室检测,对2021年7月份商洛市丹凤县龙驹寨鹿池社区一起布病暴发疫情进行传染源追踪调查和传染途径分析。结果共发现5例确诊病例、6例隐性感染者和1例疑似病例,病例性别比为3∶1,发病到确诊时间间隔87~123 d,中位数为119 d,临床表现以发热为主;12例病例血清抗体滴度从1∶50(++)到1∶1600(++)不等;病例感染途径与清理圈舍有关联(OR=6.4,95%CI:1.195~34.285);畜间检测结果显示53只羊和2只犬均为布病阳性。结论该起布病暴发疫情的主要原因是未及时清理羊只粪便、未定期对圈舍和生活居住环境进行消毒,导致养殖户及其家人、雇工等相继感染布病,建议畜牧部门调整陕南地区人间布病重点地区的牲畜免疫政策,同时人畜间联合加强圈舍、生活居住等环境消毒及个人防护等养殖科学卫生知识的宣传教育。

An outbreak of brucellosis occurred in Shangluo City,Shaanxi Province in July 2021.After epidemiological investigation and laboratory testing,five confirmed cases,six latent infections and one suspected case were confirmed.The sex ratio of cases was 3∶1,and the time interval from onset to diagnosis was 87-123 days,with a median of 119 days.The main clinical manifestation was fever.The serum antibody titers of 12 cases ranged from 1∶50(++)to 1∶1600(++).The infection route of the cases was associated with cleaning of animal pens(OR=6.4,95%CI:1.195-34.285).Animal testing results revealed 53 sheep and 2 dogs positive for brucellosis.The main reason for the outbreak of brucellosis appeared to be insufficient cleaning of sheep manure,and a lack of regular disinfection of pens and living environments,thus resulting in successive infections in farmers,their families and employees.To decrease brucellosis cases,the livestock immunization policies in key areas with high human brucellosis must be adjusted.In the meantime,health and animal husbandry departments should increase publicity and education regarding the scientific and health knowledge of animal breeding,including environmental disinfection of pens and living quarters,and personal protection.