小兴安岭部分林区莱姆病血清流行病学调查

目的了解小兴安岭部分林区莱姆病在人群中的流行和感染状况。方法采用酶联免疫吸附试验(ELISA)法检测598例小兴安岭林区人群的菜姆病抗体水平,对血清菜姆病抗体IgG阳性者进行流行病学调查。结果血清流行病学调查显示:598例调查人群中,莱姆病抗体IgG总阳性率为33.9%,滨南林场感染率最高,达35.7%,其次为罕达汽,感染率为35.6%,七二七最低,为30.5%;男性血清262份,女性血清236份,莱姆病抗体IgG阳性率分别为34.3%与33.4%;年龄分组,莱姆病抗体IgG阳性率差异无统计学意义(P0.05),40~49岁年龄段感染率最高,为37.2%;患病人群血清119份,莱姆病抗体IgG阳性率为50.4%,明显高于调查人群莱姆病抗体IgG总阳性率。结论小兴安岭林区是莱姆病的重要自然疫源地,林区人群莱姆病的感染相当严重,应引起重视。     

新疆沙湾林场莱姆病血清流行病学调查

目的：调查新疆沙湾林区人群莱姆病感染情况。方法：采用间接免疫荧光抗体法（IFAT）和蛋白免疫印迹法（Western blot)检测沙湾林区居民血清抗莱姆病螺旋体抗体（IgG)。结果：沙湾林区是莱姆病高感染区，人群血清抗莱姆病螺旋体抗体（IgG)阳性率为16.1%(37/230)，各年龄组间、哈族与汉族间的差异无显著性。结论：新疆沙湾林区人群中存在较高的莱姆病感染。可能是莱姆病的流行区之一。     

厦门地区部分人群莱姆病感染及蜱媒调查

目的了解厦门地区莱姆病感染及其蜱类生物媒介的感染情况。方法以间接免疫荧光抗体试验(IFA)检测人群血清莱姆病IgG抗体,以PCR法检测蜱类可能携带的病原体DNA片段。结果检测239份人血清,IgG抗体阳性5份,阳性率为2.09%,检测蜱媒499只均为阴性。结论厦门地区人群血清中检测出莱姆病螺旋体抗体,证实厦门地区存在莱姆病感染者。     

北京市密云县莱姆病血清流行病学调查

目的了解北京市密云地区人群莱姆病的感染状况以及传播媒介蜱相关知识状况。方法选取549人开展莱姆病血清流行病学调查,应用酶联免疫吸附测定试验(ELISA)对血液样本进行检测,并对调查对象开展问卷调查。结果共采集人群血清标本549份,伯氏疏螺旋体Ig G抗体阳性25份,阳性率4.55%;西田各庄地区感染率最高,为9.00%;大城子最低,为1.00%。仅有0.73%的人听说过莱姆病,86.70%的人认识蜱虫,48.82%的人在周围环境中发现蜱虫;28.96%的人明显有蜱叮咬史。结论北京市密云地区人群中存在莱姆病的感染;暴露人群蜱相关知识匮乏,个人防护能力较弱,容易感染莱姆病。     

我国天津蓟县山林地区人群莱姆病调查

目的了解天津蓟县山林地区莱姆病在人群中的分布和感染状况。方法采用间接免疫荧光试验对该县3个地区10个调查点的居民进行血清流行病学调查，并用PCR方法对临床确诊的莱姆病患者进行病原检测。结果共收集人群血清标本905份，抗莱姆病螺旋体抗体（IgG）阳性率5．97％。经临床和血清学诊断为莱姆病患者25例，其主要临床表现为关节炎、慢性游走性红斑、面神经麻痹、多发性神经炎、脑膜炎和心脏损害等。收集25例患者的尿液，进行PCR检测，1例阳性。结论天津蓟县林区人群中有莱姆病的发生和流行，可能存在莱姆病的自然疫源地。     

山东省沂蒙山区莱姆病自然疫源地调查

目的 :调查山东省沂蒙山区莱姆病自然疫源地。方法 :1992～ 1999年设点 ,用间接免疫荧光抗体试验进行人群莱姆病感染调查 ;用直接免疫荧光抗体法进行蜱中肠带螺旋体率调查 ;取鼠的肾脏、膀胱分离病原。结果 :沂蒙山区人群莱姆病平均感染率为 7.50 % ,林区人群感染率明显高于非林区人群 ;该地区蜱类以长角血蜱为优势种 ,该蜱中肠携带莱姆病螺旋体率为 12 .0 % ,从86组长角血蜱培养物中获得 2株莱姆病螺旋体。结论 :从病原学上证实沂蒙山区为莱姆病自然疫源地     

河南油田新疆石油探区莱姆病流行病学调查

目的查明河南油田所属新疆石油探区人群莱姆病感染与发病情况,为防治工作提供科学依据。方法采用普查方法进行流行病学调查,间接免疫荧光抗体法(IFAT)和酶联免疫吸附试验(ELISA)进行血清抗莱姆病螺旋体抗体检测。根据流行病学资料、临床表现和血清学检查结果进行病例诊断。统计学分析采用χ2检验。结果分别进行了5次调查,共计7956人,检测到抗莱姆病螺旋体抗体(IgG/IgM)阳性者1037份,感染率为12.07%～14.07%,平均感染率为13.03%。不同职业人群中,莱姆病感染率以野外勘探开发组最高(16.36%),野外建设施工组次之(12.63%),后勤服务组最低(7.58%),3组间感染率差异有统计学意义(χ2=101.1,P<0.01)。感染者中年龄最小6岁,最大61岁,但不同年龄组感染率差异无统计学意义(χ2=7.1,P>0.1)。诊断为莱姆病者665例,患病率为8.36%。结论河南油田新疆石油探区人群存在莱姆病感染,并有莱姆病的发生和流行,应加强莱姆病的防治,以保护其健康。     

陕西省莱姆病自然疫源地调查研究

目的调查了解陕西省莱姆病自然疫源地。方法人群莱姆病螺旋体血清抗体检查,采用间接免疫荧光法(IFA);莱姆病患者,采用个案调查;蜱样,采用拖旗法采集;莱姆病螺旋体检测,采用巢式PCR法;莱姆病螺旋体基因分型,采用RFLP法。结果通过血清流行病学调查,陕西省富县张家湾镇、南郑县碑坝、陇县八渡镇3个农林地区人群莱姆病螺旋体自然感染率分别为8.33%(6/113)、8.88%(3/36)和7.51%(4/45)(P0.05),发现莱姆病患者14例,蜱类以嗜群血蜱和达吉克斯坦革蜱为优势种,检测蜱样1 116只。检测出阳性138只,总阳性率为12.35%。物种的阳性率分别为嗜群血蜱30.06%(107/356),达吉克斯坦革蜱3.88%(29/747),日本血蜱15.38%(2/13);检测出阳性蜱样138只,其中嗜群血蜱107只,84只为伽氏疏螺旋体基因型,23只为阿弗西尼疏螺旋体基因型;达吉克斯坦革蜱29只,24只为伽氏疏螺旋体基因型,5只为阿弗西尼疏螺旋体基因型;日本血蜱2只,均为伽氏疏螺旋体基因型。结论研究提示陕西省富县张家湾镇、南郑县碑坝、陇县八渡镇3个农林地区存在莱姆病自然疫源地。     

湖南省平江县莱姆病调查研究

目的：调查湖南省平江县莱姆病的分布情况。方法：采用间接免疫荧光抗体法和直接荧光抗体染色法,于1999－2000年在平江县选点调查。结果：共查山林地区居民500人,血清抗莱姆病螺旋体抗体（IgG)阳性者32人,阳性率6.40%。38例临床和血清学确诊的莱姆病患者,其主要的临床表现有环形或慢性游走性红斑、关节炎、面神经麻痹、多发性神经炎、脑膜炎和心脏损害等。当地的蜱类以二棘血蜱为优势种,占85％,该蜱中肠携带莱姆病螺旋体率为12.0%(6/50)。结论：平江县存在莱姆病的自然疫源地,人群中有莱姆病的发生和流行。     

杭州市莱姆病血清流行病学调查

目的了解杭州市莱姆病的感染状况、流行病学特征,分析影响感染率的因素,提出杭州市莱姆病防治对策。方法选择余杭区、临安市和建德市等三地部分林场的职工和山村的居民进行血清流行病学调查。用间接免疫荧光方法(IFA)检测人血清抗莱姆病螺旋体抗体(IgG),对莱姆病抗体检测阳性血清进行钩端螺旋体和梅毒螺旋体交叉试验,以排除钩体和梅毒螺旋体的交叉感染。结果932份进行莱姆病抗体检测以及梅毒和钩体鉴别试验的血清标本中,判定为莱姆病感染的为111份,感染率为11.91%。男性的莱姆病感染率略高于女性,但经统计学检验,差异无统计学意义(P>0.05)。除10~岁组和70~岁组两个年龄组的感染率略低外,其余各年龄组间的感染率较为接近,且经统计学检验,各年龄组之间的感染率差异无统计学意义(P>0.05)。杭州市不同地区间的莱姆病感染率存在差异,经检验差异有统计学意义(P<0.05),余杭区的感染率最高,而建德市的感染率最低。山村居民的莱姆病感染率略高于林场职工,但经统计学检验,两者间的差异无统计学意义(P>0.05)。结论杭州市林场职工和山村居民中普遍存在莱姆病的感染,且感染率较高。人群对莱姆病普遍易感,不论年龄、性别、林场职工或山村居民,只要经常有接触传播媒介的机会,不做好防护而被蜱叮咬,就有可能被感染。提示在杭州市的山区和林场开展莱姆病的防治工作是非常有必要的。     

新型冠状病毒肺炎聚集性疫情中无症状感染者与确诊患者的流行差异

 目的 探讨无症状新型冠状病毒感染者(无症状感染者)流行特征。方法 通过中国疾病预防控制系统,收集、汇总河南省含有无症状感染者的聚集性疫情,描述其流行特征,分析与新型冠状病毒肺炎确诊病例流行特征的差异。结果 共报告聚集性疫情257起,其中41起有无症状感染者,包含84例无症状感染者,占全省无症状感染者的74.34％(84/113)。无症状感染者聚集性疫情分布在11个地市,涉及新型冠状病毒感染者208例,平均每起波及新型冠状病毒感染者5.07(2~19)例,16起(39.02%)新型冠状病毒感染者≥5例。无症状感染者的发现以聚集性疫情调查为主,确诊时间晚于新型冠状病毒肺炎确诊病例。河南省各地市无症状感染者占新型冠状病毒感染者的比率,以商丘市最高,为26.02%。无症状感染者与新型冠状病毒肺炎确诊病例比较,性别分布流行病学史方面,差异均无统计学意义(均P>0.05);年龄及职业的分布构成比较,差异均有统计学意义(均P<0.05),无症状感染者≤40岁者占58.33%,学生、儿童占28.57%,确认者分别占21.77%、4.03%。结论 无症状感染者在年龄和职业分布上与新型冠状病毒肺炎确诊病例存在差异。聚集性疫情调查是发现无症状感染者的主要途径,对密切接触者进行有效的隔离管理是正确有效的防控措施。     

新冠肺炎疫情时期妇科病房管理策略及思考

 

新型冠状病毒感染疫情给社会和经济带来极大影响,也严重影响抗击疫情非一线科室的日常医疗运行。本文总结了新型冠状病毒疫情暴发以来中南大学湘雅医院妇科病房运行的相关经验,针对妇科病房收治患者过程中的各个环节所需的医务防护措施,以及如何应用网络平台对患者进行全病程管理的讨论和建议,以期做到在工作人员安全防护前提下患者的精准管理。

     

2010年登封市肠道传染病监测分析

目的了解并掌握登封市肠道传染病的发生、流行特征、变化趋势及细菌病原分布特点,为制定预防措施和临床治疗提供参考依据。方法采集腹泻病人大便,收集外环境(家畜、家禽粪便)标本,送实验室检验。利用SPSS软件对检测数据进行统计、分析。结果采集腹泻病人标本256份,外环境标本431份。63份阳性腹泻病人粪便标本中,志贺菌有6株(8.45%),OX+有50株(70.42%),O157有5株(7.04%),沙门氏菌有4株(5.63%),耶尔森氏菌有6株(8.45%)。121份阳性外环境粪便标本中,O157有22份(18.18%),耶尔森氏菌有51份(42.15%),OX+有34份(28.10%)。结论初步揭示了登封市肠道传染病的流行病原谱。     

Small risk of developing Lyme borreliosis following a tick bite on Ameland: research in a general practice

OBJECTIVE: To investigate the percentage of ticks infected with Borrelia burgdorferi on the Dutch North Sea island of Ameland, and the risk of developing Lyme disease following tick bite on the island. DESIGN: Prospective, observational. METHOD: Ticks were collected from patients who visited a general practitioner and were tested for the DNA of B. burgdorferi. After 6 months the patients were interviewed by phone using a standardised questionnaire. RESULTS: From 2004-2006, 216 ticks were collected from 167 persons. Most ticks were removed within 24 hours. In 44 ticks (20.4%) B. burgdorferi DNA was detected. Follow up information was available on 146 persons, 41 (28.1%) of whom had been bitten by a Borrelia-positive tick. None of the persons developed a typical erythema migrans. From the 13 persons (9%) reporting a non-specific redness of the skin (diameter less than 5 cm) at the site of the tick bite, 5 had been bitten by a positive tick and 8 by a negative tick. One patient bitten by a positive tick reported systemic symptoms related to Lyme borreliosis, namely fatigue, perspiration and joint ache, without local redness. CONCLUSION: The probability of developing Lyme borreliosis was low even though a relatively large percentage of the ticks collected were positive for B. burgdorferi. This is probably connected to the fact that in the majority of cases the tick had been removed within 24 hours.     

Pediatric Lyme Disease Biobank,United States, 2015–2020

In 2015, we founded Pedi Lyme Net, a pediatric Lyme disease research network comprising 8 emergency departments in the United States. Of 2,497 children evaluated at 1 of these sites for Lyme disease, 515 (20.6%) were infected. This network is a unique resource for evaluating new approaches for diagnosing Lyme disease in children.     

A focus of Lyme disease in Monmouth County, New Jersey

An endemic focus of Lyme disease is present in Colt's Neck, Howell, Freehold, and Wall Townships in Monmouth County, New Jersey. Cases of Lyme disease have occurred in this area from 1978 to 1982. Fifty-seven of the 117 persons (49%) who acquired their infection in New Jersey from 1978 to 1982 live or work in these four townships, whose population of 82,491 is only 1.1% of the population of the entire state. Thirty persons who contracted Lyme disease were exposed to ticks at the Naval Weapons Station, Earle, which is located within Colt's Neck and Howell Townships. The annual incidence rate for persons stationed at or working on this military facility in 1981 and 1982 was about 1%. At Naval Weapons Station, Earle, persons working outdoors in 1981-1982 were at higher risk than those working indoors.     

Relapsing fever-like spirochetes infecting European vector tick of Lyme disease agent

To determine whether relapsing fever-like spirochetes associated with hard ticks may infect Ixodes ricinus ticks in central Europe, we screened questing ticks for 16S rDNA similar to that of Asian and American relapsing fever-like spirochetes. We compared the prevalence of these spirochetes to that of Lyme disease spirochetes transmitted by the same vector. Relapsing fever-like spirochetes infect 3.5% of questing vector ticks in our three central European sites near the Rhein Valley. These spirochetes differ genetically from their American and Asian analogs while being relatively homogeneous in the region we sampled. The Lyme disease genospecies most commonly detected in central Europe are distributed broadly, whereas those that are less frequently found appear to be place-specific. The absence of co-infected ticks suggests that relapsing fever-like and Lyme disease spirochetes may not share hosts. Exposure risk for relapsing fever-like spirochetes is similar to that of certain Lyme disease genospecies. Although many persons may be bitten by ticks infected by relapsing fever-like spirochetes, health implications remain unknown.     

福建省莱姆病的发现

血清学调查证实福建省8个县(市)林区人群存在莱姆病感染。根据流行病学、临床学和血清学确诊莱姆病典型病例6例,疑似病例9例。从蜱类中肠涂片见到典型的莱姆病螺旋体。     

Inapparent infection of hepatitis A virus

To detect inapparent infection with hepatitis A virus, serial sera were collected from patients with hepatitis A and their contacts in two waterborne epidemics in China. Epidemic 1 occurred in a rural village near Hangzhou during August 1978-January 1979, and epidemic 2 took place in a rural primary school in Pinghu County in Zhejiang in April-May 1985. These sera were tested for antibodies against hepatitis A virus (anti-HAV), serum glutamic pyruvic transaminase (SGPT) activity, and icteric index. Feces also were collected in epidemic 1 to test for hepatitis A virus antigen. Both anti-HAV immunoglobulin M (IgM) and total anti-HAV were assayed in sera from "healthy persons" (symptomless persons without icterus and with normal SGPT level) who were in close contact with hepatitis A patients. In epidemic 1, among 18 "healthy persons", 12 were anti-HAV IgM positive, two were immune, and four susceptibles escaped infection. In epidemic 2, among 32 "healthy children", three were anti-HAV IgM positive, five had been infected by hepatitis A virus in the past, and 24 were not infected. These results demonstrate that inapparent infections occur along with overt and subclinical infections during epidemics of hepatitis A. The proportions of inapparent, subclinical, and overt infections were, respectively, 34.3%, 45.7%, and 20% in epidemic 1, and 25%, 50%, and 25% in epidemic 2. In addition, hepatitis A virus particles were demonstrated in the feces of all infected subjects who were examined and who included all levels of clinical response. These particles were identified with immuno-electron microscopy and enzyme-linked immunoassay.