云南省祥云县恙虫病流行病学特点、临床特点及血清型和基因型分析

Epidemiological,clinical,serotype and genotype analysis of scrub typhus in Xiangyun County,Yunnan Province

目的研究云南省祥云县恙虫病流行病学特点、临床特点及血清型和基因型。方法以2020年1月—2021年12月在中国疾病预防控制中心大疫情网上报的1033例云南省祥云县恙虫病患者作为研究对象,总结云南省祥云县恙虫病流行病学特点、患者临床特点、血清型以及基因型分布情况。结果云南省祥云县恙虫病的发病以男性患者居多,年龄多集中在41~60岁,职业以农民居多,夏季的发病数较高。患者以高热、皮肤溃疡或焦痂以及畏寒等临床症状为主。实验室检查结果显示,61.28%的患者嗜酸性粒细胞计数<0.5×10^(9)/L,55.57%的患者血红蛋白<120 g/L,63.41%的患者C反应蛋白>8 mg/L,50.73%的患者ALT>50 U/L。恙虫病东方体血清型以Kato为主,基因型以groEL为主,与既往临床报道的AH-GD-OT-S6(GQ499933)、UT332(EF551306)、Kato(AY191586)、Karp(M31887)和ZJ-TT-OT-O21(GQ499953)株在同一个分支上。结论云南省祥云县已经成为恙虫病流行的重要地区之一,开展恙虫病的血清型及基因型检测对恙虫病疫情防控工作有重要意义。

Objective This study aimed to study the epidemiological characteristics,clinical characteristics,serology and genotype of scrub typhus in Xiangyun Country,Yunnan Province.Methods In this study enrolled 1033 scrub typhus patients reported online by the Chinese Center for Disease Control and Prevention from January 2020 to December 2021 to study the distribution characteristics of scrub typhus epidemiology,clinical symptoms,laboratory data,serological and genetic test results in Xiangyun Country,Yunnan Province.Results The prevalence of scrub typhus in Xiangyun Country,Yunnan Province was mostly men,aged between 41 and 60 years,farmers,and the incidence was higher in summer.The main clinical symptoms of the patients were high fever,skin ulcers or eschar,and chills.Laboratory tests showed that 61.28% patients had eosinophils<0.5×10^(9)/L,55.57% patients had hemoglobin<120 g/L,63.41% patients had C-reactive protein>8 mg/L,and 50.73% patients had ALT>50 U/L.Serology was dominated by Kato and genotypes were dominated by groEL.GroEL genotypes of scrub typhuswere in the same branch as AH-GD-OT-S6(GQ499933),UT332(EF551306),Kato(AY191586),Karp(M31887),and ZJ-TT-OT-O21(GQ499953)strains from clinicalreports.Conclusions Xiangyun County of Yunnan Province has become one of the most important endemic areas of Scrub typhus.It is of great significance for the prevention and control of scrub typhus to detect the serotype and genotype of the disease.