2010年中国钩端螺旋体病流行病学分析[J]. 疾病监测, 2012, 27(1): 46-50.
引用本文: 2010年中国钩端螺旋体病流行病学分析[J]. 疾病监测, 2012, 27(1): 46-50.
Epidemiology of leptospirosis in China, 2006-2010[J]. Disease Surveillance, 2012, 27(1): 46-50.
Citation: Epidemiology of leptospirosis in China, 2006-2010[J]. Disease Surveillance, 2012, 27(1): 46-50.

2010年中国钩端螺旋体病流行病学分析

Epidemiology of leptospirosis in China, 2006-2010

  • 摘要: 目的 分析2006-2010年我国(未包括香港、澳门和台湾地区,以下同)钩端螺旋体病(leptospirosis,钩体病)疫情流行病学特征,为钩体病防控工作提供依据。 方法 收集2006-2010年全国疾病监测信息报告管理系统的报告数据和全国钩体病监测哨点的病例信息,利用描述性流行病学方法进行分析。 结果 2006-2010年,中国钩体病病例报告数继续减少,年均719例,合计病死率为2.47%。南方长江、珠江和澜沧江流域的四川、云南、湖南、江西、广西和广东6省病例占全国病例的74.58%。发病高峰为8、9月,占全年病例的38.96%。病例中农民占75.24%,学生占11.01%,35岁以上中老年病例占66.82%。10~15岁的儿童发病率出现小高峰,进入成年后发病率再次上升至中老年达到高峰。4年来我国共报告34起钩体病的突发公共卫生事件,共发病174例,死亡39例。2006-2010年,监测点搜集的1020例钩体病病例中62.94%发病前1个月有可疑疫水接触史,其中91.74%为田间劳动或游泳戏水史。10种常见鼠类及蛙、猪、牛、犬和小麂等检出带菌。黄疸出血群赖型、秋季群秋季型、七日热群七日热型、流感伤寒群流感临海型和澳洲群澳洲型5种菌型的抗体近年来在人群中的最为常见。 结论 近年来我国钩体病疫情维持在较低水平,但流行因素仍广泛存在,病死率较高且局部暴发仍时有发生。南方地区疫情较重、夏秋之交高发、以稻田型疫情为主的流行特点没有改变,但中老年已取代青壮年成为我国钩体病主要危害人群。局部钩体病暴发风险仍存在,医务人员培训和大众健康教育仍需加强。

     

    Abstract: Objective To understand the epidemiological characteristics of leptospirosis in China from 2006 to 2010 and provide evidence for leptospirosis prevention and control. Methods The descriptive analysis was conducted on the incidence data of leptospirosis in China from 2006 to 201 collected from national disease reporting information system and national leptospirosis sentinel surveillance system. Results From 2006 to 2010, the incidence of leptospirosis in China continued to decline, and the average annual case number was 719. The overall case fatality was 2.47%. The cases occurred in 6 provinces in southern China accounted for 74.58% of the national total. The incidence peak was during August-September and the cases during this period accounted for 38.96% of the annual total. Totally 75.24% and 11.01% of the cases were distributed in farmers and students and the cases in people aged>35 years accounted for 66.82%. The age specific sub-peak of the incidence was in children aged 10-15 years and the peak was in middle aged adults and the elderly. Totally 34 outbreaks of leptospirosis with 174 cases and 39 deaths were reported during this period in China. Among 1020 cases reported by surveillance system, 62.94% had the history of pathogen contaminated water one month before onset, in which 91.74% were infected during work in rice field and recreational activity in water. The disease pathogen was detected in rats, frogs, pigs, cattle and muntiacus, The antibodies to leptospira in serogroup Icterohaemorrhagiae, Grippotyphosa, Australis, Autumnalis and Hebdomadis were most frequently detected in the population. Conclusion The incidence of leptospirosis remained at low level in recent years in China, but the factors which could facilitate the spread of the disease still exist. The case fatality is still high and local outbreaks occur occasionally. The disease situation in southern China is serious with high incidence in summer and autumn. The disease is still mainly caused by the infection when working in rice field. Middle-aged and elder people has become the mostly affected population instead of young adults. The possibility of local leptospirosis outbreak still exists. It is necessary to strengthen the training and health education about leptospirosis prevention and control in medical care providers and general population respectively.

     

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