2020-2022年陕西省人间布鲁氏菌病聚集性疫情调查处置分析

Investigation and response data analysis on clustering of human brucellosis cases in Shaanxi province, 2020−2022

  • 摘要:
    目的  分析陕西省208起布鲁氏菌病(布病)聚集性疫情流行特征,为布病防控提供依据和策略。
    方法  收集2020—2022年陕西省报告的208起布病聚集性疫情调查处置资料,采用描述性流行病学方法进行分析。
    结果 208起布病聚集性疫情涉及布病血清学阳性者596例,其中23起疫情转为暴发疫情。 7月报告疫情起数最多(17.31%);陕西省有56.67%(64/113)的县(区)报告疫情;男女性别比为1.92∶1,45~65岁人群占比最高(56.88%),职业以农民为主(86.74%)。 发生场所以牛、羊养殖户(场)为主(94.23%),养殖规模以散养户为主(59.39%),其次为规模养殖场(21.32%);病例关系以家庭成员为主(77.88%),部分病例的发病-就诊和就诊-确诊时间间隔均接近90 d;传播途径以经皮肤黏膜直接接触和呼吸道为主(72.11%)。118起疫情传染源可追溯,共检测存栏牲畜25586只(头),发现布病阳性牲畜1534只。 共采集暴露人群血清6319份,阳性率为2.83%(179/6319)。 有70起(33.65%)疫情开展了养殖环境和生活环境的终末消毒。
    结论  陕西省布病聚集性疫情分布县(区)广,疫情主要发生场所为羊只散养户,传染源追溯调查较难,病例感染后就诊意识弱,建议各级疾病预防控制机构联合同级畜牧部门做好布病疫情调查处置工作,畜间要加强可疑阳性牲畜的监管,人间要注重临床医务人员布病诊疗水平和职业人群就诊意识的提升。

     

    Abstract:
    Objective  To analyze the epidemiological characteristics of 208 clustering of human brucellosis cases in Shaanxi province, and provide evidence for the prevention and control of human brucellosis.
    Methods  Descriptive epidemiological methods was used to analyze the investigation and response data of 208 clustering of human brucellosis cases reported in Shaanxi from 2020 to 2022.
    Results  A total of 208 clustering of brucellosis cases were reported, involving 596 individuals who were positive for brucella, in which 23 were identified as outbreaks later. The case clustering were mainly reported in July (17.31%), and reported in the 64 counties (56.67%) during this period. The male to femal ratio of the cases was 1.92:1, the cases reported in people aged 45−65 years accounted for the highest proportion (56.88%), and the majority of the cases were farmers (86.74%). The epidemics mainly occurred in cattle and sheep breeders (farms), accounting for 94.23%, which were mainly free range breeders (59.39%), followed by large-scale breeding farms (21.32%). The case relationship was mainly based on family members (77.88%). The time intervals between the onset, treatment, and diagnosis of cases were close to 90 days. The transmission routes of the epidemic were mainly through direct skin and mucous membrane contact and respiratory tract (72.11%). The infection sources of 118 cases could be traced. A total of 25586 livestock on hand were detected, in which 1534 were detected to be positive. A total of 6319 serum samples were collected from the people with exposure, in which 179 were positive. Environment disinfection was conducted for 33.65% of clustering of human brucellosis cases.
    Conclusion The clustering of human brucellosis cases occurred widely in Shaanxi, sheep free range households were mainly affected, resulting in difficulty to trace and investigate the infection sources. Most cases were family members with low awareness of seeking medical treatment. So, it is necessary for disease control department at all levels animal husbandry departments in Shaanxi to carry out joint brucellosis epidemic investigation and reponse, strengthen the supervision of positive livestock, and pay attention to the improvement of clinical medical staff's brucellosis diagnosis and treatment level and professional population's awareness of seeking medical treatment.

     

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