2016-2018年陕西省炭疽监测及基因溯源分析

目的 调查了解2016-2018年陕西省炭疽流行情况、病原学特征及分子流行病学特征。方法 对2016-2018年报告炭疽病例开展个案调查,进行流行病学三间分布分析;采集病例生物样本及环境样本,进行炭疽杆菌分离培养、炭疽ELISA抗体检测及荧光定量PCR检测,对分离到的阳性标本以canSNP及MLVA15的方法进行分子分型,与陕西省历史菌株及国内部分省份菌株基因型进行聚类分析。结果 2016-2018年陕西省共炭疽病例14例,发病到诊断平均9天,地理分布以关中及陕北地区为主,8月份发病较多,人群分布性别比为6∶1(12/2),26~59岁占85.7%(12/14),农民占71.4%(10/14)。人体标本病原培养17份,分离到炭疽杆菌1株,阳性5.9%,环境标本培养77份均为阴性,ELISA检测阳性率83.3%(10/12),荧光定量PCR阳性率21.4%(3/14);陕西省炭疽菌株canSNP基因型为A.Br.001/002型,2015年、2018年及1953年菌株MLVA分型分别为MLVA15-38、31、CHN17基因型。结论 2016-2018年陕西省炭疽疫情属较低散发水平,主要分布在关中及陕北地区,8月为发病高峰,人群以青壮年男性农民为主。炭疽杆菌canSNP基因型为A.Br.001/002,与国内主要流行株相同。存在3种不同的MLVA15基因型。陕北地区MLVA15-38型,与北部内蒙古相近;关中地区MLVA15-31型,与甘肃省及新疆类似;历史上还曾有MLVA15-CHN17型。     

贵州省织金县一起皮肤炭疽疫情的病原体分离鉴定及基因分型研究

目的对贵州省织金县一起疑似皮肤炭疽疫情来源标本进行病原体分离鉴定和基因分型,了解菌株的分子流行病学特征,为疫情判定提供病原学依据。方法对患者皮肤渗出液、血液及病死牛刨剐地土壤进行炭疽芽胞杆菌分离鉴定,采用Real-time PCR检测炭疽芽胞杆菌Pag A、Cap及rpo B基因,进一步采用基于15个串联重复序列(Variable number tandem repeat,VNTR)的多位点可变数量串联重复序列分析(Multiple locus VNTRs analysis,MLVA-15)和单核苷酸多态性(single nucleotide polymorphisms,SNP)技术对炭疽芽胞杆菌进行分子分型。结果从本次疫情中患者皮肤渗出液和血液各分离出1株疑似炭疽菌株,传统方法将2株分离菌株鉴定为炭疽芽胞杆菌,土壤标本未分离到炭疽菌。2株菌Pag A、Cap和rpo B阳性,其15个VNTR位点的重复次数谱型均为9-20-12-53-16-2-8-8-8-4-4-4-4-10-4,SNP结果显示2株菌同属A.Br.001/002簇。结论从本次疫情患者皮肤渗出液和血液检出具有致病基因的炭疽芽胞杆菌,2株菌的MLVA-15和SNP型别特征一致,提示该起疫情为感染炭疽芽胞杆菌所致。     

一起炭疽疫情中炭疽病原检测方法的应用与评价

目的分析总结一起炭疽疫情中应急检测的经验与问题,为炭疽疾病预防控制提供参考依据。方法采集报告的疑似皮肤炭疽患者皮损渗出液和静脉血标本,与病例相关的病死动物和土壤标本,渗出液采集采用载玻片直接蘸取和无菌棉签擦取2种方法,用涂片镜检、直接分离培养和肉汤增菌后分离培养细菌以及炭疽芽胞杆菌毒力基因PCR扩增方法检测病原,分析检测结果。结果共采集标本57份,病例标本占91.23%,病死牛肉及剖牛处土壤标本占8.77%。病例标本采集时间距发病时间最短1d,最长23d,平均6.62d。29例疑似皮肤炭疽患者在采样时其中16例(占55.17%)已使用抗生素类药物治疗,4例(占13.79%)未曾使用抗生素。从2例未使用抗生素的患者皮损渗出液和1份病死牛肉中分离到炭疽芽胞杆菌,分离阳性率为5.26%;其中1例患者皮损渗出液涂片镜检阳性;全部标本PCR扩增结果均为阴性。结论标本炭疽芽胞杆菌阳性检出率较低,与采样方法和采样时机关系较大,应加强部门间的沟通协作和人群的健康教育,做到疫情早报告、早确诊、早控制。     

公主岭市1起人间皮肤炭疽疫情调查

[目的]总结经验教训,为今后做好炭疽防控工作提供科学依据。[方法]对2010年公主岭市1起炭疽暴发疫情进行现场流行病学调查和实验室检查。[结果]2010年6月15~30日先后有5人出现典型的炭疽样皮肤病变,患者血炭疽杆菌抗原均为阳性,均确诊为皮肤炭疽病人。[结论]这是1起因私自屠宰病死牛和接触病死牛肉引发的人间皮肤炭疽暴发疫情。     

乌兰浩特市1998～2001年炭疽疫区监控效果评价

为了解和掌握炭疽疫区疫情的消长规律和流行动态 ,及时预防和控制炭疽的发生和流行 ,对 1 998～ 2 0 0 1年两炭疽疫区监控结果进行全面分析评价。为今后控制人畜间炭疽发生流行提供科学依据。1 .监控内容及方法 :①对疫区病原学监控 ,重点对因炭疽造成的死畜埋葬地、畜尸污染的草地、井、田、屠剥病死畜的场所、病死畜的厩圈进行长期的监测。在该病流行季节前 ,对污染区的土壤、植被、水源等根据污染区面积范围定期采样 ,每 2个月采样 1次 ,每年不少于 6次 ,每次土壤分深浅各采样 1 0份做炭疽杆菌病原分离检验。②疫区畜间的监控 ,对疫区内…     

一起突发炭疽疫情中炭疽芽胞杆菌的分离及鉴定

目的：2007年8月在辽宁省北部某市JG镇两名村民在屠宰病死牛后怀疑感染了炭疽,采集了相应的样品分离炭疽芽胞杆菌。方法：对采集的一块牛肉及土壤标本分离培养炭疽芽胞杆菌,以生化试验,炭疽血清凝集试验,PCR试验鉴定。结果：从牛肉中分离出一株炭疽芽孢杆菌,经鉴定该分离菌株为炭疽芽胞杆菌。使用了三对引物包括两对质粒PXO1和PXO2上的基因片段及菌体基因进行PCR实验。结论：经PCR试验证实在923、1242、618 bp出现特征条带,为有毒性菌株。     

一起由炭疽杆菌引起皮肤炭疽病例调查分析报告

7月24日我中心接到某县防疫站送检的疑似皮肤炭疽4份牲畜样本、患者病灶渗出物和痰液。经流行病学调查、临床表现及实验室检验确认为患者是由炭疽杆菌引起皮肤炭疽,现将结果报道如下。     

一起农民家庭屠宰病死羊引发皮肤炭疽疫情的调查和处置

目的 通过对一起家庭屠宰病死羊引发的皮肤炭疽疫情进行流行病学调查，分析其发病原因、病例诊断及报告情况，为炭疽疫情防控提供依据。方法 采用现场流行病学的方法对病例进行调查，对疫情发生后采取的措施进行分析，对疫情防控中存在的问题进行研究。结果 本次疫情为一起散发性人间皮肤炭疽疫情。病例于8月23日在自己家中没有采取任何防护措施的情况下宰杀病死羊，且在4天前左手大拇指关节处有约1～2 mm的小伤口，炭疽杆菌经过伤口感染发病。暴露后第3天伤口出现黑点，无痛感，黑点逐渐增大，第7天直径增至15 mm，颜色炭黑，第8天黑痂周围出现水肿，有痛感，先后就诊于村诊所和县医院骨外科，第9天（9月1日）就诊于乡镇卫生院并以“手指外伤”收治入院，入院后第3天卫生院院长怀疑炭疽并进行了报告。密切接触者和共同暴露者28人，均未感染。病例焦痂期2份黑痂周围水肿渗出液标本炭疽杆菌PCR检测阳性，病例急性期和恢复期双份血清抗炭疽特异性抗体出现阳转，采集27份外环境标本，进行炭疽杆菌PCR检测，其中7份阳性。结论 屠宰羊时应加强个人防护，以防感染；提高广大群众尤其是养殖户等重点人群对病、死畜危害的知晓率。应建立炭疽诊疗知...     

2021年山东省菏泽市曹县一起皮肤炭疽疫情调查报告

目的分析山东省菏泽市曹县一起皮肤炭疽疫情的暴发原因与流行病学特征, 为炭疽防控提供科学依据。方法采用现场流行病学调查方法, 使用《炭疽流行病学个案调查表》, 根据全民健保系统报告的炭疽疑似病例流行病学接触史及密切接触者进行个案调查(n = 83)。采集病例皮肤焦痂涂抹物、病牛组织、屠宰场地土壤样本及屠宰器具涂抹物, 分别进行Real-time PCR检测、病原菌分离培养。炭疽判定标准参照《炭疽诊断》(WS 283-2020)进行。结果本次疫情共发现皮肤炭疽病例13例, 其中临床诊断病例12例, 确诊1例(Real-time PCR检测阳性且分离出1株炭疽芽孢杆菌)。经流行病学调查确定, 本次疫情传染源为病牛, 传播途径为屠宰病牛、接触被污染的用具及相关牛产品, 患者主要是从事牛屠宰或牛产品收售相关职业。实验室共收集样本84份, 其中皮肤焦痂涂抹物13份、环境样本64份、牛肉样本7份。PCR检测结果阳性36份, 阳性率为42.86%(36/84)。其中皮肤焦痂涂抹物标本阳性率为100.00%(13/13), 环境样本阳性率为29.69%(19/64), 牛肉样本阳性率为4/7。共分离到8...     

昆明市东川区突发皮肤炭疽的实验室检测分析

目的通过对2015年昆明市东川区突发皮肤炭疽疫情的处理和实验室检测,提供处置此类事件的一种科学准确的方法和依据,以提供借鉴。方法用WS 283—2008炭疽诊断标准进行病原菌分离培养,用real-time PCR方法进行炭疽芽胞杆菌染色体编码的rpo B基因及质粒pXO1上pag A基因、pXO2上cap基因的检测及单核苷酸多态性(SNP)测定,用毛细管电泳进行多位点可变数目串联重复序列分析(MLVA)。结果从4例疑似皮肤炭疽患者的疱疹液中分离得到2株炭疽芽胞杆菌,且此2株菌的rpo B基因、pagA基因和cap基因均为阳性,对照分类表为A.Br.001/002亚群。结论此次皮肤炭疽疫情是由当地村民宰杀携带炭疽芽胞杆菌强毒株的病牛引起,与云南地区曾经存在的炭疽芽胞杆菌类型一致。     

铁岭市一起皮肤炭疽疫情中炭疽芽胞杆菌的快速检测与分析

目的 对2015年7月铁岭市发生一起皮肤炭疽疫情中运用UPT上转发光免疫分析仪联合荧光定量PCR技术进行描述与分析,探讨可以快速现场检测炭疽芽胞杆菌的方法。方法 采集疑似皮肤炭疽患者的焦痂下涂抹样本10份和炭疽疫区外环境样本19份,运用上转发光免疫层析技术联合荧光定量PCR技术对标本进行检测,与此同时进行细菌分离培养。结果 10份患者的痂下涂抹物样本和2份病死牛血污染土壤样本在上转发光免疫层析技术和荧光定量PCR技术检测结果均呈现阳性。细菌分离培养技术仅分离到1株炭疽芽胞杆菌。结论 实验室检测结果充分证明此次疫情的病原体为炭疽芽胞杆菌的感染。上转发光免疫层析技术和荧光定量PCR方法的联合应用,能快速、特异、灵敏检测出炭疽芽胞杆菌,具有推广应用价值。     

Isolated case of bioterrorism-related inhalational anthrax,New York City, 2001

On October 31, 2001, in New York City, a 61-year-old female hospital employee who had acquired inhalational anthrax died after a 6-day illness. To determine sources of exposure and identify additional persons at risk, the New York City Department of Health, Centers for Disease Control and Prevention, and law enforcement authorities conducted an extensive investigation, which included interviewing contacts, examining personal effects, summarizing patient's use of mass transit, conducting active case finding and surveillance near her residence and at her workplace, and collecting samples from co-workers and the environment. We cultured all specimens for Bacillus anthracis. We found no additional cases of cutaneous or inhalational anthrax. The route of exposure remains unknown. All environmental samples were negative for B. anthracis. This first case of inhalational anthrax during the 2001 outbreak with no apparent direct link to contaminated mail emphasizes the need for close coordination between public health and law enforcement agencies during bioterrorism-related investigations.     

利用串联重复序列研究炭疽芽胞杆菌的基因分型

目的 应用基因组中多位点串联重复序列遗传标记对不同地区88株炭疽芽胞杆菌进行基因分型。方法炭疽芽胞杆菌染色体DNA基因组中存在着串联重复序列。在串联重复序列两侧设计引物，PCR扩增，琼脂糖和聚丙烯酰胺凝胶电泳，凝胶影像分析软件对PCR扩增产物碱基含量进行测算，并与测序结果进行比较，计算出串联重复拷贝数，对拷贝数进行聚类分析。结果 （1）聚类分析发现，88株菌株可分为三大群，45个基因型，基因型与生态环境存在一定的关系。就某一地区炭疽暴发而言，其可变数目串联重复序列遗传标记具有相似性。（2）研究发现，A16R疫苗株作为中国的疫苗株具有代表性。结论 炭疽芽胞杆菌基因组中的串联重复序列具有遗传稳定性和特异性，可作为炭疽芽胞杆菌基因分型的指标，在炭疽暴发和生物恐怖事件中的病原体溯源上具有重要的意义。     

2018年四川省红原县1起炭疽暴发疫情调查分析

目的分析炭疽疫情调查和处置过程,为今后炭疽疫情处置提供经验和参考。方法对疫情数据、现场调查信息及处置措施进行流行病学分析和统计描述。结果此次疫情共报告7例炭疽病例,其中肠炭疽5例,皮肤炭疽2例,死亡2例。所有病例均为炭疽疫区常住居民,其中3例肠炭疽有病死牛(马)肉类食用史,2例肠炭疽感染途径不详,2例皮肤炭疽有病死牛(马)畜接触史。2例死亡病例在基层医疗机构未被及时正确诊断。经采取流行病学调查、疫点处置、病例治疗、健康教育等措施,疫情得到及时控制。结论牧民接触、食用病死牛(马)是感染炭疽的主要途径,牧区基层医疗机构对该类疾病的诊断意识较弱。建议加大牧民炭疽健康教育力度,提高牧民健康防病意识;加大基层医疗机构炭疽病例的诊断治疗技术的培训力度,提高基层医疗机构炭疽病例早期识别能力。     

Anthrax in Wabessa village in the Dessie Zuria district of Ethiopia

In 2002 an investigation of sudden death in a goat in Wabessa village in the Dessie Zuria district of Ethiopia was undertaken using fresh blood brought to the Kombolcha Regional Veterinary Laboratory. The sample was examined using standard bacteriological techniques and animal pathogenicity tests were also performed. The laboratory investigation revealed Bacillus anthracis as the cause of sudden death. Information gathered from stockowners in the same village revealed other similar recent cases and deaths, both in animals and humans, with farmers clearly describing the clinical signs and necropsy findings of anthrax. The disease occurs annually in this area in May and June, and in the 2002 outbreak mortality rates of 7.7%, 32.7% and 47.1% were observed in cattle, goats and donkeys, respectively. This study indicates that the community of this particular village neither knows of, nor practises, any of the conventional methods for anthrax control. The cutaneous form of the disease in humans and the environmental contamination associated with the practise of opening cadavers are briefly described and the findings are discussed with reference to the epidemiology of anthrax in both Ethiopia and elsewhere. Control strategies are also recommended.     

Suspected cutaneous anthrax in a laboratory worker--Texas, 2002

On March 6, 2002, CDC's National Institute for Occupational Safety and Health (NIOSH) received a request for a health hazard evaluation from the director of Laboratory A to assist in the evaluation of a worker who had been diagnosed with cutaneous anthrax. Laboratory A, a provisionally approved Laboratory Response Network level B laboratory, had been processing environmental samples for Bacillus anthracis in support of CDC investigations of the bioterrorist attacks in the United States during fall 2001. Since March 7, CDC has interviewed the ill laboratory worker and other workers at the laboratory and conducted environmental assessments of the workplace. This report summarizes the epidemiologic and environmental investigation of this case, which indicates that the likely source of exposure was the surface of vials containing B. anthracis isolates that the worker placed in a freezer on March 1. Laboratory workers handling specimens of B. anthracis should follow recommended procedures to minimize the risk of B. anthracis transmission and anthrax.     

Environmental sampling for spores of Bacillus anthracis

On November 11, 2001, following the bioterrorism-related anthrax attacks, the U.S. Postal Service collected samples at the Southern Connecticut Processing and Distribution Center; all samples were negative for Bacillus anthracis. After a patient in Connecticut died from inhalational anthrax on November 19, the center was sampled again on November 21 and 25 by using dry and wet swabs. All samples were again negative for B. anthracis. On November 28, guided by information from epidemiologic investigation, we sampled the site extensively with wet wipes and surface vacuum sock samples (using HEPA vacuum). Of 212 samples, 6 (3%) were positive, including one from a highly contaminated sorter. Subsequently B. anthracis was also detected in mail-sorting bins used for the patient's carrier route. These results suggest cross-contaminated mail as a possible source of anthrax for the inhalational anthrax patient in Connecticut. In future such investigations, extensive sampling guided by epidemiologic data is imperative.     

Update: Cutaneous anthrax in a laboratory worker--Texas, 2002

On April 5, 2002, CDC reported a case of suspected cutaneous anthrax in a worker at laboratory A who had been processing environmental samples for Bacillus anthracis in support of CDC investigations of the 2001 bioterrorist attacks in the United States. Since the initial report, the worker had serial serology performed at the CDC laboratory. A greater than fourfold rise from baseline in the concentration of immunoglobulin G to protective antigen was demonstrated. The peak antibody level was observed 7-8 weeks after the onset of symptoms, and the time course and levels of detectable antibodies were consistent with those seen in other cases of cutaneous anthrax. On the basis of case definitions developed during the recent investigation, these additional findings confirm this as a case of cutaneous anthrax. This case brings the number of anthrax cases identified in the United States since October 3, 2001, to 23, including 11 inhalation and 12 cutaneous (eight confirmed and four suspected). This is the first laboratory-acquired case of anthrax associated with the recent investigation.