海南省首例人感染猪链球菌病流行病学调查

Epidemiological survey on first case human Streptococcus suis infection in Hainan

目的对海南省首例人感染猪链球菌病例进行流行病学调查分析,为制定防控措施提供依据。方法通过现场访谈,调查病例发病史、感染途径、感染来源;利用VITEK2-compact全自动微生物检验方法,对15份病例血液培养菌,生猪肉、猪鼻拭子、内脏及血液进行检测。结果病例男性,41岁,泥水工,2017年1月28日发病,临床表现及特征主要为发热、畏寒、气促,腹泻、呼吸不畅,面色潮红、四肢紫绀、全身疼痛、四肢无力等。病情重、进展快、病程短,因多器官功能衰竭(MOF)于2月8日抢救无效死亡。病例发病前屠宰生猪时手指切割受伤。在病例的血液,屠宰生猪肉,以及所屠宰生猪同圈其他生猪的鼻拭子中均培养出猪链球菌。结论该病例为海南省首例人感染猪链球菌病病例;感染途径为被感染猪链球菌的生猪肉通过伤口感染。建议医疗机构发现休克、败血症病例,应尽快开展血病原菌培养,详细询问猪接触史和尽快控制中毒性休克,可以降低死亡率;防控策略主要是加强病例监测,加大畜牧检疫,从严查处私宰行为,广泛开展健康宣传教育工作,增强人民群众防护意识。

Objective To epidemiologically investigate and analyse of the first case of human Streptococcus suis infection in Hainan Province, summary of preventive and control measures taken, to provide the basis for the establishment of preventive and control measures. Methods The history of the patient’s medical treatment and pig contact, the source of infection, the way of transmission, the epidemiological investigation of the close contacts, the collection of 15 blood specimens of the cases,the laboratory examination of the pig and the external environment specimens were conducted. Results The patient was 41 years old, a mud worker, onset on January 28, 2017. The clinical manifestations and characteristics were fever, chills, shortness of breath, diarrhea, dyspnea, redness of face, cyanosis of limbs, general pain, weakness of limbs, etc, severe, rapid progress,short course of disease, due to multiple organ failure(MOF), the patient rescue ineffective death on February 8. Streptococcus suis was cultured in the blood of the case, in raw pork slaughtered, and in nasal swabs from other pigs slaughtered in the same pigpen. Conclusion This case is the first case of human Streptococcus suis infection in Hainan Province. The way of infection is the raw pork infected with Streptococcus suis through the wound. Medical institutions should develop blood culture as soon as possible in case of shock and septicemia, inquire about contact history of pigs and control toxic shock as soon as possible,which can reduce mortality rate. The main strategies of prevention and control are to strengthen case surveillance, increase animal husbandry and quarantine, strictly investigate and punish private slaughtering, widely carry out health publicity and education work, and enhance the people’s awareness of protection.