2018-2022年北京市人间布鲁氏菌病发病、诊断情况及感染来源分析

Incidence,diagnosis and infection source of human brucellosis in Beijing,2018-2022

目的了解北京市近年来本地人间布鲁氏菌病(布病)发病就诊情况及感染来源,为北京市布病防控提供依据。方法对2018—2022年报告的现住址为北京市的人间布病病例进行流行病学调查,采用描述流行病学分析的方法,对病例发病情况、诊断情况及感染来源进行分析。结果2018—2022年,北京市报告本地布病病例452例,年平均发病率0.21/10万。男性发病率高于女性(χ2=106.294,P<0.001)。发病高峰期集中在3—8月,其中5月为发病最高峰,秋冬季发病呈下降趋势。按器官系统症状发生率排序,居前3位的为全身症状(82.22%)、骨关节系统症状(57.27%)、内分泌系统症状(36.26%)。按单一症状发生率统计,发热症状发生率最高(72.98%),其次为肌肉关节痛(57.27%)、乏力(48.50%)、多汗(36.26%)。发病至诊断时间间隔中位数为31 d,以急性期病例为主(81.96%)。饲养及贩运牛羊(42.48%)为病例感染的主要途径。结论北京市人间布病病例春夏季为发病高峰,以急性期病例为主,畜牧养殖等途径为主要感染来源,应不断开展职业人群布病相关知识健康宣教,持续提高医疗机构布病发现能力,多部门联防联控做好布病防控工作。

Objective To analyze the incidence,diagnosis and infection source of human brucellosis in Beijing,and provide evidence for the prevention and control of human brucellosis.Methods Epidemiological investigations were conducted for the brucellosis cases reported in Beijing from 2018 to 2022.Descriptive epidemiology methods were used to analyze the incidence,diagnosis and infection sources of human brucellosis in Beijing.Results A total of 452 human brucellosis cases were reported in Beijing from 2018 to 2022.The average annual incidence rate was 0.21/100000.The incidence rate was higher in men than women(χ2=106.294,P<0.001).Most cases occurred between March and August with peak in May,and the incidence decreased in autumn and winter.Symptoms in general system(82.22%),osteoarticular system(57.27%)and endocrine system(36.26%)were most common,including fever(72.98%),muscle and joint pain(57.27%),weakness(48.50%)and hidrosis(36.26%).The median of interval between onset and diagnosis was 31 day.Acute cases accounted for 81.96%.The infection routes were mainly feeding and trading cattle and sheep(42.48%).Conclusion Most human brucellosis cases were acute ones and occurred in spring and summer in Beijing.The infections mainly occurred in the process of feeding and trading cattle and sheep.It is necessary to conduct consecutive health education in populations with occupational exposure to Brucella and improve the diagnosis of human brucellosis in medical institutions.Multi-sectoral collaboration is important for the prevention and control of human brucellosis.