李旦, 寇增强, 陈秋兰, 崔步云, 张丽杰, 冯自河, 彭孝旺, 赖圣杰, 李俊梅, 朱银田, 杨传欣, 刘兆山, 黄伟, 陈保立, 刘维量, 郑建东, 殷文武, 冯录召, 毕振旺. 2016年山东省一起活羊交易市场导致的人间布鲁氏菌病暴发疫情调查[J]. 疾病监测, 2017, 32(7): 539-543. DOI: 10.3784/j.issn.1003-9961.2017.07.004
引用本文: 李旦, 寇增强, 陈秋兰, 崔步云, 张丽杰, 冯自河, 彭孝旺, 赖圣杰, 李俊梅, 朱银田, 杨传欣, 刘兆山, 黄伟, 陈保立, 刘维量, 郑建东, 殷文武, 冯录召, 毕振旺. 2016年山东省一起活羊交易市场导致的人间布鲁氏菌病暴发疫情调查[J]. 疾病监测, 2017, 32(7): 539-543. DOI: 10.3784/j.issn.1003-9961.2017.07.004
LI Dan, KOU Zeng-qiang, CHEN Qiu-lan, CUI Bu-yun, ZHANG Li-jie, FENG Zi-he, PENG Xiao-wang, LAI Sheng-jie, LI Jun-mei, ZHU Yin-tian, YANG Chuan-xin, LIU Zhao-shan, HUANG Wei, CHEN Bao-li, LIU Wei-liang, ZHENG Jian-dong, YIN Wen-wu, FENG Lu-zhao, BI Zhen-wang. Investigation of an outbreak of human brucellosis due to live sheep trade in Shandong,2016[J]. Disease Surveillance, 2017, 32(7): 539-543. DOI: 10.3784/j.issn.1003-9961.2017.07.004
Citation: LI Dan, KOU Zeng-qiang, CHEN Qiu-lan, CUI Bu-yun, ZHANG Li-jie, FENG Zi-he, PENG Xiao-wang, LAI Sheng-jie, LI Jun-mei, ZHU Yin-tian, YANG Chuan-xin, LIU Zhao-shan, HUANG Wei, CHEN Bao-li, LIU Wei-liang, ZHENG Jian-dong, YIN Wen-wu, FENG Lu-zhao, BI Zhen-wang. Investigation of an outbreak of human brucellosis due to live sheep trade in Shandong,2016[J]. Disease Surveillance, 2017, 32(7): 539-543. DOI: 10.3784/j.issn.1003-9961.2017.07.004

2016年山东省一起活羊交易市场导致的人间布鲁氏菌病暴发疫情调查

Investigation of an outbreak of human brucellosis due to live sheep trade in Shandong,2016

  • 摘要: 目的 了解2016年山东省菏泽市牡丹区人间布鲁氏菌病(布病)发病数异常升高的原因、感染来源、危险因素,及时采取针对性控制措施。方法 通过对医院、重点村庄进行主动搜索,检索医疗机构上报的传染病报告信息管理系统等方式获得该区的人间布病病例,采取重点村庄现场查看,当面访谈或电话调查的方式开展病例个案调查,同时完成病例标本实验室检测。结果 2016年共搜索到170例人间布病病例,58.24%(99/170)的病例集中发生在10-12月。76.47%(130/170)的病例居住在回民聚居地A镇Ⅰ村和B镇Ⅱ村。Ⅰ村和Ⅱ村之间有一个日交易量约1 000只的活羊交易市场,80.00%的羊购自布病高发省份。9月宰牲节期间,两村村民购买的羊数量为平时2倍,其间参与家庭内羊肉处理过程者罹患率和未参与者的罹患率分别是34.82%(122/3 504)和0.02%(1/3 608),差异有统计学意义(2=124.782,P=0.001)。14岁以上村民中,从事与羊接触工作(贩卖、屠宰、皮毛加工、养殖)的村民布病患病率为17.28%(108/625),未从事接触羊工作的14岁以上村民患病率为0.30%(15/5 065)(RR=58.349,95%CI:34.220~99.492)。从事活羊贩卖、屠宰活动、皮毛加工和羊养殖的布病发病风险RR值(95%CI)分别为84.417(45.925~155.172)、80.604(45.209~143.713)、43.414(23.450~80.374)和 40.098(20.757~77.459)。在接触羊时,5.13%(8/156)的病例戴口罩,21.15%(33/156)戴毛线手套。结论 本次事件可能为一起因活羊交易市场输入染疫羊而接触者缺乏有效防护而引起的人间布病疫情。建议多省份和多部门联防联控,保证羊的输出、输入和交易均在动物卫生检疫指导下进行。此外,需要加强布病防治知识的宣传教育。

     

    Abstract: Objective To understand the reason for sudden increase of human brucellosis cases, infection source and related risk factors in Mudan district of Heze, Shandong province in 2016, and provide evidence for the targeted prevention and control. Methods Active case finding were conducted in local hospitals and affected villages, the incidence data of human brucellosis reported by local medical facilities were collected through communicable disease reporting system, field survey and face to face or telephone survey were conducted, and case sample detection was completed. Results A total of 170 human brucellosis cases were identified in the district, in which 99 (58.24%) occurred during October-December. And 130 (76.47%) cases were the villagers of two Hui ethnic villages. For these two villages, there was a live sheep market with daily trading volume of 1 000 sheep. The sheep sold in the market were mainly from the provinces with high incidence of brucellosis (80.00%). In September, the sheep trading volume increased by 2 times due to Dasain festival. The attack rates were 34.82% (122/3 504) and 0.02% (1/3 608) respectively in those with or without contact with raw mutton, the difference was significant(2=124.782,P=0.001). In the villagers aged 14 years, the attack rate was 17.28% (108/625) in those with contact with sheep (trading, slaughtering, fur processing and raising) and 0.30% (15/5 065) in those without contact with sheep (RR=58.349, 95%CI: 34.220-99.492). The relative risks (RR) for brucellosis in those engaged in sheep trading, slaughtering, fur processing and raising were 84.417(45.925-155.172),80.604(45.209-143.713),43.414(23.450-80.374) and 40.098(20.757-77.459) respectively. When contacting sheep, only 5.13% (8/156) of the cases worn face masks and 21.15%(33/156) of cases worn woolen gloves. Conclusion Contact with sheep from enzootic areas and lacking of effective personal protections were the risk factors for this outbreak. It is suggested that the sheep of endemic area should be vaccinated and the sheep unvaccinated should not be sold in markets. The sheep quarantine and self-protection should be strengthened.

     

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