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目的了解济南市布病的流行病学特征,为有针对性地制定科学的防控措施提供依据。方法采用描述流行病学方法对济南市布病疫情数据和流行病学调查数据进行分析。结果 2011-2015年,济南市累计报告布病病例789例,无死亡病例,年均发病率为2.27/10万,发病呈现明显的上升趋势(r=0.96,P<0.001)。发病集中在商河县(186例)、章丘市(182例)和历城区(160例)。每月均有病例报告,3-7月发病588例,占74.52%。男女性别发病数比为2.64∶1;40~64岁年龄段发病507例,占64.26%;农民发病698例,占88.47%。病例的主要临床表现为发热(86.19%)、乏力(75.52%)、多汗(65.38%)和肌肉关节酸痛(62.24%)等,肝脾肿大和睾丸肿大的发生率较低。病例中从事牛羊养殖屠宰和皮毛加工者486例,占84.97%,有明确牛羊肉和生奶食用史且无牛羊接触史者26例,占4.55%。6.79%的病例工作时有个人防护,17.47%的病例对牲畜圈舍进行消毒处理,1.61%的病例对牲畜粪便进行无害化处理。肝脾肿大病例的确诊时间中位数(31天)要长于无肿大者(17天)。牛羊养殖屠宰等高危人群的布鲁氏菌感染率为2.94%。结论济南市布病发病呈现快速上升趋势,发病有明显季节性和人群特征,高危人群的个人防护意识亟需加强。
Objective To understand the epidemiological characteristics of brucellosis in Ji’nan city and provide the basis for making scientific prevention and control measures. Methods Descriptive epidemiological methods were used to analyze the epidemic data and epidemiological data of brucellosis in Jinan City. Results From 2011 to 2015, 789 cases of brucellosis were reported in Ji’nan city without any deaths. The average annual incidence rate was 2.27 / 100 000, showing a significant upward trend (r = 0.96, P <0.001). The incidence was concentrated in Shanghe County (186 cases), Zhangqiu City (182 cases) and Licheng District (160 cases). There are monthly reports of cases, from March to July 588 cases, accounting for 74.52%. The male / female sex ratio was 2.64: 1; 507 cases were in the age group of 40-64 years, accounting for 64.26%; 698 cases were farmers, accounting for 88.47%. The main clinical manifestations were fever (86.19%), fatigue (75.52%), hyperhidrosis (65.38%) and muscle and joint pain (62.24%). The incidence of hepatosplenomegaly and testicular enlargement was low. There were 486 cases of cattle and sheep slaughtering and fur processing in the cases, accounting for 84.97%. There were 26 cases (4.55%) of the history of cattle, sheep and sheep with a clear history of beef, mutton and raw milk consumption. 6.79% of the cases had personal protection while working, 17.47% of the cases disinfected the livestock pens and 1.61% of the cases detoxified livestock waste. The median time to diagnosis for hepatosplenomegaly was longer (31 days) than for those without enlargement (17 days). The rate of brucellosis in high-risk groups such as cattle and sheep breeding and slaughtering was 2.94%. Conclusion The incidence of brucellosis in Jinan City shows a rapid upward trend with obvious seasonal and population characteristics. The awareness of personal protection in high-risk groups urgently needs to be strengthened.