论文部分内容阅读
目的 探讨和分析近期河南省钩端螺旋体病 (简称钩体病 )的流行特点、影响因素及防治对策。方法 对河南省 1993～ 2 0 0 3年钩体病的疫情资料、流行病学个案调查资料和监测资料予以整理和分析。结果 1993～ 2 0 0 3年河南省共发生钩体病 2 2 98例 ,年均发病率为 0 2 3/ 10万 ,死亡 5 7例 ,病死率为 2 4 8%。发病及死亡总体呈下降趋势。病例集中在黄河北岸的新乡地区 ,占总发病例数 94 82 %。 8～ 10月为发病高峰 ,占全部病例的 92 13%。临床分型以流感伤寒型为主 ,占总病例数的 91 5 8%。病人血清抗体阳性率为 6 2 5 0 % ,黄疸出血群为 6 6 6 0 %。年均鼠密度为 4 0 9% ,黑线姬鼠 ,褐家鼠为优势鼠种 ,在鼠肾中分离出 13株钩端螺旋体 ,均为黄疸出血型。结论 我省钩体病人间主要流行菌群为黄疸出血型 ,鼠类是主要传染源 ,流行形式为稻田型 ,以接触疫水为传播途径。疫区范围缩小是我省钩体病发病和死亡呈下降趋势的主要原因。
Objective To investigate and analyze the recent epidemic characteristics, influential factors and prevention and cure strategies of leptospirosis in Henan Province. Methods The epidemic data, epidemiological case investigation data and monitoring data of leptospirosis from 1993 to 2003 in Henan Province were sorted out and analyzed. Results A total of 2,298 cases of leptospirosis were found in Henan Province from 1993 to 2003, with an annual average incidence of 0 2 3/100 000, 57 deaths and a case fatality rate of 24.8%. The overall incidence and mortality showed a downward trend. The cases were concentrated in Xinxiang, the northern bank of the Yellow River, accounting for 94.82% of the total cases. 8 to October peak incidence, accounting for 92 13% of all cases. The clinical type was mainly influenza type, accounting for 91 58% of the total number of cases. The positive rate of serum antibody in patients was 6250% and that of jaundice hemorrhage was 66.0%. The average annual rat density was 40.9%. Apodemus agrarius and Rattus norvegicus were the dominant species. Thirteen Leptospira species were isolated from the rat kidney, all of which were in the form of hemorrhagic jaundice. Conclusion Mycobacterium leprosy is the main epidemic bacterium in our province. The main source of infection is rodent, and the epidemic form is rice paddy. Narrowing the scope of the epidemic area is the main reason for the incidence and mortality of leptospirosis in our province is a downward trend.