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目的了解环泰山区域恙虫病东方体(Ot)感染情况,确定是否存在恙虫病疫源地。方法应用PCR技术和血清学等方法调查泰山西南麓、东南麓部分村庄及泰山景区人、鼠Ot感染情况,病人发病情况采用个案表调查。结果血清抗-Ot8例现症病人全部阳性,14例既往病人4例阳性,均为Gilliam型;115名健康人抗-Ot阳性率为8.70%,发病区域和无发病区域分别为26.92%和3.37%,差异有统计学意义(P<0.05)。PCR检测Ot基因,4份病人焦痂3份阳性,100份鼠脾,4份阳性,其中黑线姬鼠3份,小家鼠1份。序列同源性分析和系统发生树分析显示,2份阳性鼠标本的PCR产物核苷酸序列完全相同,与Sdu-1型的核苷酸序列同源性为99.77%,与Kawasaki型的同源性为95.74%。另2份阳性鼠标本的核苷酸序列与TA686型的同源性分别为86.27%和77.11%。病人发热、皮肤焦痂或溃疡发生率较高,达98.08%和92.31%。结论环泰山区域人、鼠间均存在Ot自然感染,恙虫病自然疫源地已经形成,病人集中出现在每年的9～11月,10月份为主要发病月,属典型的秋冬型疫源地;宿主动物呈非单一性,黑线姬鼠为Ot的主要储存宿主;人群中存在Ot隐性感染;Ot血清型为Gilliam型,基因型Kawasaki相似型为流行株,鼠间还存在TA686型相似株,呈基因多样性倾向。
Objective To understand the prevalence of Otomyosis tsutsugamushi in Hutai Mountain area and determine whether there is an epidemic area of tsutsugamushi disease. Methods PCR and serological methods were used to investigate Ot infection in the southwest foot of Mount Tai, parts of the southeastern part of Taishan and Taishan area, and the case incidence was investigated by using case tables. Results Serum anti-Ot 8 cases were all positive, 14 cases of past patients were positive, all Gilliam type; 115 healthy people anti-Ot positive rate was 8.70%, the incidence of disease-free areas were 26.92% and 3.37 %, The difference was statistically significant (P <0.05). Ot gene was detected by PCR. 3 patients were screened positive in 4 patients, 100 spleen and 4 were positive, including 3 Apodemus agrarius and 1 Mus musculus. Sequence homology analysis and phylogenetic tree analysis showed that the PCR products of two positive mice had the same nucleotide sequence and the homology with the nucleotide sequence of Sdu-1 was 99.77%, which was homologous with Kawasaki type Sex is 95.74%. The nucleotide sequences of the other two positive mice had 86.27% and 77.11% homology with TA686 respectively. Patients fever, skin eschar or ulcer incidence was higher, reaching 98.08% and 92.31%. Conclusions Ot natural infection exists in both Habitat and Rat in Hutai Mountain area. Natural epidemic foci of scrub typhus have been formed. Patients are concentrated in September to November each year and October is the main onset month, belonging to the typical autumn and winter foci. The host animal was non-monosomial, Apodemus agrarius was the main storage host of Ot, Ot recessive infection was present in the population, Ot type was Gilliam type, genotype Kawasaki similar type was epidemic strain, TA686 type similar strain existed in mice , Showing a tendency of genetic diversity.