陕西省1959～1999年钩端螺旋体病流行病学分析

The Epidemiological Analysis of Leptospirosis in Shanxi Province,1959～1999

目的 了解陕西省钩端螺旋体病 (简称钩体病 ) 40年发病、死亡、三间分布情况及预防接种对该病的影响。方法 用病原培养和血清凝集试验调查疫区宿主动物。结果 195 9～ 1999年钩体病共发生 5 973 5例。年平均发病率 6 185 3 /10万 ,1960～、 1970～、 1980～、 1990～、 4个时期平均发病率为 2 8 4761/10万、1 863 1/10万、 0 63 5 0 /10万和 0 42 3 0 /10万 ,发病率逐期下降。累计死亡 65 8人 ,年平均病死率 1 14 %。累计发病 3 6个县 ,发病县数有扩大的趋势。主要发病季节、职业、性别、年龄和地区分别是 9、 10月 ( 91 81% )、农民 ( 83 40 % )、男性 ( 74 2 7% )、青壮年 ( 79 0 2 % )和汉中地区 ( 91 81% )。结论 构体病流行强度在使用菌苗 ( 1965年 )后较使用菌苗前减弱 (P <0 0 1)。啮齿动物为主要传染源 ,黑线姬鼠为优势种 ,黄疸出血群为主要的血清型。

Objective To find out incidence,death and three dimension distribution of Leptospirosis in Shanxi Province from 1959～1999,and to understand the effect on the disease after prevention and inoculation.Methods The host animal in epidemic area was investigated through direct culture of the pathogen and hemagglutination test.Results There were 59735 cases of Leptospirosis during 1959～1999.The average annual incidence rate was 6 18 per one hundred thousand.The annual incidence rate were 28 48,1 86,0 64,0 42 per one hundred thousand during the periods of 1960～,1970～,1980～and1990～respectively,which showed that the incidence rate decreased year by year.The accumulated cases of death were 658 and the average annual death rate was 1 14%.36 counties were involved in the epidemic of Leptospirosis with an incerasing trend of county number.September and October(91 81%)were the major season,farmer(83 49%)was the major occupation,and Hanzhong(91 81%) was the major district of the incidence of the disease.And the disease was chiefly in man(74 27%) and young and middle ages(79 02%).Conclusions The incidence of Leptospirosis was decreased after the application of vaccine in 1965.Rodent was the major source of infection.Apodemus agrarius was the predominant species.