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目的 探讨钩端螺旋体病的流行因素与防治策略。 方法 用公认的方法进行鼠情调查和对病人、动物进行病原学、血清学研究。 结果 15年中湖南全省年均发病率为 9.86 /10万 ;长沙地区则年均发病率为 19.0 6 /10万 ,近全省发病率的 2倍 ;鼠密度为 6 .33% ,流行前期、后期鼠密度无显著性差异 ;病人钩体培养阳性率 17.2 9% ,至少分属 8个血清群 ,以流感伤寒和秋季热群为主 ;鼠肾中分离钩体阳性率为 11.78% ,至少分属 5个血清群 ,黑线姬鼠主要携带黄疸出血群 ,其次 ,黄毛鼠携带爪哇群 ,家犬带菌率为 2 2 .5 0 % ,鼠与犬带菌率差异无显著性 ;钩体病人双份血清抗体 ,黄疸出血群、犬群等 6个群抗体均数差异有非常显著性 ;爪哇群其抗体差异有显著意义 ;在对动物血清抗体调查中 ,检测了犬、猪、牛具有某一抗体阳性的分别为 6 0 %、5 3.33%和 84% ,其差异有显著性。犬抗体分属 6个血清型 ,以澳洲为主 ;猪则分属 5个血清型 ,以巴达维亚为主 ;牛分属 11个血清型 ,以巴达维亚为主。 结论 在 15年监测中长沙地区平均发病率为全省的 2倍左右 ,几乎每年发病率都较高 ,是湖南省的典型代表。鼠类尤其是优势鼠种黑线姬鼠、犬、猪和牛是主要传染源。病人感染菌群非常复杂 ,至少有 8个钩体菌群。用现行的四价菌苗接种易感
Objective To explore the epidemic factors and control strategies of leptospirosis. Methods Routine studies were conducted using accepted methods and etiological and serological studies were performed on patients and animals. Results The average annual incidence rate of Hunan province was 9.86 / lakh in 15 years. In Changsha, the average annual incidence rate was 19.0 6 / lakh, nearly 2 times of that in the whole province. The rat density was 6.33% , No significant difference in the late rat density; the positive rate of leptospiral culture in patients was 17.29%, at least belong to 8 serogroups, mainly influenza and typhoid fever group autumn heat; isolated kidney hook kidney body positive rate was 11.78%, at least Belong to 5 serogroups, Apodemus agrarius mainly carry jaundice hemorrhage group, followed by the rodent carrying javanica group, domestic dog carrier rate of 22.50%, no significant difference between the rat and canine carriage rate; hook body There were significant differences in the average number of antibody in six groups of patients, such as double serum antibody, jaundice hemorrhage, and canine population. There was significant difference in antibody among javanics. In the investigation of serum antibody, the detection of dogs, pigs and cattle The positive rate of a certain antibody was 60%, 5 3.33% and 84%, respectively. The difference was significant. Dog antibody belongs to 6 serotypes, mainly in Australia; pigs belong to 5 serotypes, mainly in Batavia; cattle belong to 11 serotypes, mainly in Batavia. Conclusions The average incidence rate of middle and long-term monitoring in 15 years is about 2 times that of the whole province, with a relatively high annual incidence rate. It is a typical representative of Hunan Province. Rodents, especially the dominant species of black-born Apodemus, dogs, pigs and cattle are the main source of infection. Patient infection is very complex flora, at least eight hook flora. Vaccination with the current tetravalent vaccine susceptible