海南岛立克次体血清学和病原学调查报告

目的:调查海南岛立克次体的群别及其分布。方法:应用微量免疫荧光检测法(mIFA)对人群血清进行恙虫病、斑疹伤寒和斑点热3种立克次体IgM、IgC抗体检测。应用L929单层细胞进行立克次体分离培养。立克次体用特异性抗体进行mIFA鉴定。结果:恙虫病、斑疹伤寒和斑点热3种立克次体ISC抗体阳性率分别是13.55％(76/561),18.77％(101/538),30.83％(164/532)。其中IgM和IgC抗体均≥1:80者,斑疹伤寒为32.08％,斑点热为46.30％。立克次体分离培养结果,20份不明原因发热或疑似立克次体病患者血液标本分离出12株立克次体,免疫血清mIFA鉴定及聚合酶链反应(PCR)技术检测立克次体特异性DNA等方法鉴定出3株恙虫病立克次体、2株斑疹伤寒立克次体和7株斑点热群立克次体。结论:海南岛确有恙虫病、斑疹伤寒、斑点热病存在,该岛的中、西部感染率较高,南、北部较低。     

海南岛恙虫病立克次体研究

目的:阐明海南岛恙虫病立克次体的存在及其分布。方法:①恙虫病立克次体血清学调查用微量免疫荧光检测法(mIFA)。②恙虫病立克次体分离用小鼠接种法和L929细胞培养法,恙虫病立克次体鉴定用特异性抗体mIFA。③应用聚合酶链反应(PCR、NPCR)技术检测恙虫病立克次体特异性DNA。④DNA序列。结果:①35份不明原因发热患者血清中,10/35(28.57％)份血清呈IgG抗体阳性反应(滴度≥1:80)。收集自海南岛的东、西、南、北、中部地区的561份人群血清恙虫病立克次体IgG抗体阳性率为13.55％(76/561)。其中东部地区阳性率为8.69％(10/115),南部为7.22％(7/97),西部为28.83％(32/111),北部为11.76％(12/102),中部为11.03％(15/136)。②小白鼠接种分离法从疑似立克次体病患者血液中分离出3株恙虫病立克次体,L929细胞培养法从20份不明原因发热患者血液中分离出3株恙虫病立克次体。③应用PCR技术从9例疑似立克次体感染患者血液中检出4例恙虫病立克次体特异性DNA。用NPCR法从17组野鼠脾脏标本中检出3组恙虫病立克次体特异性DNA。④DNA序列已经分析清楚。结论:海南岛确有恙虫病存在,该岛的中、西部感染率较高,南、北部较低。海南岛恙虫病立克次体DNA序列已分析清楚。     

海南岛立克次体病血清学和病原学调查

作者从海南岛的东、南、西、北、中五个地区收集一般人群血清５６１份，不明热患者血液标本２０份，应用恙虫病、、斑疹伤寒、斑点热三种立克次体抗原片对血清标本同时进行ｍＩＦＡ测定。发现ＩｇＧ抗体阳性率分别为１３．５５％，１８．７７％，３０．８３％。ＩｇＧ滴度≥１∶８０的血清中，ＩｇＭ抗体也≥１∶８０者，斑疹伤寒为３２．０８％，斑点热为４６．３０％。２０份患者血液标本应用Ｌ９２９细胞进行立克次体分离培养，共分出１２株立克次体。用ｍＩＦＡ和ＰＣＲ初步鉴定出７株斑点热群立克次体。首次从血清学、病原学、遗传学上证实海南岛斑点热群立克次体病的存在。     

海南岛立克次体病血清和病原学调查

作者从海南岛的东、南、西、北、中五个地区收集一般人群血清５６１份，不明热患者血液标本２０份，应用恙虫病、斑疹伤寒、斑点热三种立克次体抗原片对血清标本同时进行ｍＩＦＡ测定。发现ＩｇＧ抗体阳性率分别为１３．５５％，１８．７％，３０．８３％。ＩｇＧ滴度≥１：８０的血清中，ＩｇＧ抗体也≥１：８０者，斑疹伤寒为２．０８％，斑点热为４６．３０％。２０份患者血液标本应用Ｌ９２９细胞进行立克次体分离培养，共分出１     

内蒙古西部地区人兽血清斑疹伤寒和恙虫病抗体检测

我们于１９８８～１９８９年内蒙古西部地区收集职业人群（皮、毛、乳、肉加工人员）血清１３８７份，家畜血请１２０份，野生动物血清１００份。用斑点酶标染色法进行斑疹伤寒和恙虫病血清抗体检测，结果人群血清阳性率斑疹伤寒为６０／１３８７（４．３３％），恙虫病为９／１３８７（０．６５％），家畜血清阳性率斑疹伤寒为５／１２０（４．７７％），恙虫病为４／１２０（３．３３％），野生动物血清阳性率斑疹伤寒为２／１００     

立克次体病实验室诊断现状

立克次体是一类严格细胞内寄生的原核细胞型微生物，天然寄生在各种吸血节肢动物和昆虫体内。立克次体病是一类人兽共患自然疫源性疾病，人通过被感染立克次体的媒介昆虫叮咬或接触其粪便感染，该病多发生在热带与亚热带国家和地区，在历史上曾严重威胁人类健康，目前立克次体病已成为世界性关注的疾病。同发达国家一样，我国斑疹伤寒基本得到控制，然而地方性斑疹伤寒仍在持续流行，恙虫病疫区几乎漫延全国，世界范围包括我国在内的斑点热新种不断出现，一些非致病性的立克次体病原体不断被证实，尤其我国埃立克体及巴尔通体等新发传染病的各种流行病学资料、实验室数据足以提示我们提高实验室诊断能力是传染病预防控制中刻不容缓的任务。     

海南岛恙虫病流行概况及临床分析(综合资料)

恙虫病是地方性斑疹伤寒的一种,病原体称为东方立克次体(R.tus—gamushi)。寄生在鼠类(田鼠或家鼠),借幼恙虫的媒介造成鼠与鼠间互相传染,人若被带有本病病原体的幼恙虫叮咬时,便能感染本病。恙虫病最早于1879年由Palm氏在日本发现,一向流行于日本秋田、新泻及山杉等县。我国古代医学书籍中在一千多年前,晋     

海南岛恙虫病流行概况及临床分析

恙虫病是地方性斑疹伤寒的一种,病原体称为东方立克次体(R. orientalis)。笔者之一自1956年首次报告2例以来,此病在海南岛屡有报告,(正式报告者已达1,711例),本文仅就手头现有资料在国内报道过的海南岛恙虫病1,711例进行综合分析下,供同道参考。     

应用L929细胞从患者血液中分离立克次体

目的:从不明原因发热患者血液中分离立克次体。方法:应用L929细胞培养法分离立克次体,并用微量免疫荧光检测法(mIFA)、聚合酶链反应(PCR)技术进行鉴定。结果:从20份不明原因发热患者血液标本中分离出12株立克次体,鉴定结果,3株为恙虫病立克次体,2株为斑疹伤寒立克次体,7株为斑点热群立克次体。结论:应用L929细胞培养法可以直接从立克次体病患者血液中分离立克次体。     

恙虫病的诊断与治疗

恙虫病(tsutsugamishi disease)亦称丛林斑疹伤寒(scrub typhus),是由恙虫病立克次体(Richettsia tsutsugamushi)亦称东方立克次体(R.orientalis)所致的急性自然疫源性传染病,鼠类为其主要传染源,以恙虫幼虫为媒介将疾病传染给人.临床上有发热、焦痂(或溃疡)、淋巴结肿大及皮疹等为特征.     

Molecular epidemic survey on co-prevalence of scrub typhus and marine typhus in Yuxi city, Yunnan province of China

Background Human rickettsioses are worldwide zoonoses and it is not easy to differentiate them from other infectious diseases because of their atypical manifestation. In recent years the number of patients with fever of unknown causes from Hongta District CDC, Yuxi city of Yunnan Province has been increasing significantly in the summer. Diagnosis of scrub typhus was made by local clinicians. In order to ascertain the disease, we undertook a laboratory investigation for such patients from August 18 to 26, 2005.Methods Active surveillance was conducted by Hongta District CDC Yuxi city of Yunnan Province from 2002 to 2004 and basic data were obtained from cases confirmed according to clinical definitions. Average incidences and town-level incidences were calculated during the study periods. Blood samples were analyzed by PCR and serological test. Based on the groEL gene sequences a paired general outer primers (Gro-1 and Gro-2) targeting typhus, spotted fever as well as scrub typhus and two paired inner primers (SF1, SR2 and TF1, TR2) for typhus together with spotted fever and scrub typhus, respectively, were designed to perform a multiplex-nested PCR. Serological assay was carried out by indirect immunofluorescence assay with 7 different rickettsial antigens, i.e., R.mossori, R.sibirica, R.conorii, O.tsutsugamushi, B.quintana, B.henselae and Coxilella burnetii phase II Ag.Results Epidemiological surveillance showed that from 2002 to 2004, the average incidences of the scrub typhus or scrub typhus with murine typhus were 222.1/10(5), 204.3/10(5) and 109.6/10(5), respectively. Of 13 blood samples taken during acute stage of illness, 6 showed the amplified products for scrub typhus and the sequenced products showed 100%, 99%, 99%, 99%, 99%, 99% similarity to O.tsutsugamushi Karp but they shared the same deduced amino acid sequences, which indicated 100% identity with the heat shock protein of the O.tsutsugamushi Karp strain. Five yielded PCR products for murine typhus and their corresponding nucleotide sequences exhibited 100%, 100%, 99%, 99% and 99% similarity to R. mossori Wilmington and the analyses of predicted amino acid sequences indicated 100%, 100%, 98%, 98% and 98% identity with the heat shock protein of R. mossori Wilmington strain. Of the 8 PCR positive patients, 3 showed a co-infection of scrub typhus with murine typhus. All the 13 serum samples from febrile patients were positive against O. tsutsugamushi and 8 of them were positive against R. mossori. All of the 8 paired specimens had four-fold elevation of antibody against O. tsutsugamushi, and seroconversion for typhus was demonstrated in 3 paired serum samples. Another finding in the study was that a high seropositive prevalence (76.9%) of Q fever was detected.Conclusion It’s confirmed that co-prevalence of scrub typhus with murine typhus are occurring in Yuxi city of Yunnan province, China. Other rickettsial diseases also need to be investigated in these areas.     

Flinders Island spotted fever: a newly recognised endemic focus of tick typhus in Bass Strait. Part 2. Serological investigations

Twenty-six cases of a spotted-fever-like illness have been identified on Flinders Island, Tasmania, over a 17 year period. These patients and 335 healthy persons from the island were investigated serologically using the Weil-Felix agglutination test (Proteus sp. antigens OX2, OX19, OXK) and rickettsia-specific microimmunofluorescence. The antigens used in these latter tests comprised one member of the typhus group (Rickettsia typhi) and three members of the spotted fever group (Rickettsia rickettsii, Rickettsia australis and Rickettsia conorii). Patients with Flinders Island spotted fever showed a higher prevalence of positive reactions to the Weil-Felix tests (with OX2 and OX19 antigens) and a higher prevalence of positive results to rickettsia-specific serological tests (with the exception of antibodies to Rickettsia typhi) than did healthy persons; OX2 (36% v. less than 1%); OX19 (36% v. less than 1%); Rickettsia rickettsii (42% v. 1%); Rickettsia australis (46% v. 1%); Rickettsia conorii (42% v. 1%); Rickettsia typhi (4% v. 4%). In seven of the 26 patients (27%) seroconversion was demonstrated by means of Weil-Felix tests, confirming recent infection. In six of these patients seroconversion was also demonstrated in rickettsia-specific tests. Although these results support the clinical evidence that the illness on Flinders Island is caused by a rickettsia of the spotted fever group, the aetiological agent remains to be isolated.     

海南省琼中黎族苗族自治县2019年恙虫病东方体分子流行病学及遗传进化分析

目的 通过分析海南省琼中黎族苗族自治县（简称“琼中”）98例不明原因发热患者的恙虫病流行特点,了解该地区恙虫病东方体菌株流行的情况,为该地区制定恙虫病防治策略和控制措施提供科学依据。方法 收集2019年 1月1日至2019年12月31日琼中黎族苗族自治县人民医院诊断为疑似恙虫病和不明原因发热患者血液样本,利用胶体金免疫层析法和巢式PCR方法对样本进行恙虫病东方体特异性IgM、IgG抗体和恙虫病东方体56kD型特异性抗原基因检测,同时使用预先设计的样本信息表收集患者的临床表现及流行病学信息。针对巢式PCR检测结果为阳性的样本,进行克隆及Sanger测序。对获得的患者临床信息及检测结果进行流行病学分析,将测序得到的序列进行基因遗传进化分析。结果 98例样本中,恙虫病IgM抗体阳性率为24.49%（24/98）,恙虫病IgG抗体阳性率为46.94%（46/98）,恙虫病PCR阳性率26.53%（26/98）,焦痂或皮疹13.27%（13/98）。根据诊断标准,最终诊断为恙虫病的患者为33例。感染人群主要以31~50岁的青壮年为主,职业主要为农民。该地区恙虫病的流行以营根镇、长征镇和红毛镇为主并涉及9个乡镇。流行时间有明细的季节性,以7月和11月为主要高发期。流行的基因型主要为Karp型和Gilliam型。结论 琼中为恙虫病的自然疫源地,该地区流行的恙虫病东方体基因型主要为Karp和Gilliam型,具有基因多态性。     

海南省发热患者血标本中恙虫病东方体groEL基因检测

目的了解海南省发热病人中感染恙虫病东方体的状况,并确定其基因分型。方法利用巢氏PCR方法,检测海南省各家医院2009~2010年送检的117份不明原因发热病人血标本的groEL基因的特异性片段,对所检测到的部分目的片段进行基因测序,从基因水平进一步证实阳性结果,并对序列同源性及进化分析。结果从117份发热病人血标本中发现有恙虫病东方体阳性15份,检出率为12.8%。取10份PCR阳性产物进行测序,核酸序列基本一致,彼此间仅存在3个核苷酸的差异,构建进化树进行聚类分析,结果示海南省恙虫病东方体序列与R.tsutsugamushi(M31887)恙虫病东方体在同一分支上,同源性高。结论海南省发热病人中存在恙虫病东方体感染的状况,应加强相关监测和防控措施,为给海南省制定恙虫病防治策略提供科学依据。     

A case of murine typhus in Queensland.

OBJECTIVE: To present a case of murine (endemic) typhus, the first to be reported within the last 30 years in Australia. CLINICAL FEATURES: A 17-year-old pregnant woman presented with a viral-like illness and later developed a spotted rash, fever and headache. INVESTIGATION AND OUTCOME: Sera taken on Day 7 and Day 30 of the illness showed seroconversion to Proteus OX19 (Weil-Felix) and to Rickettsia typhi (by immunofluorescence), indicating recent infection with Rickettsia of the typhus group. Her illness was clinically compatible with murine typhus. She responded well to erythromycin and delivered a normal infant at term. CONCLUSION: Infection with Rickettsia typhi (murine typhus) still occurs in Australia. It can be diagnosed by means of specific serological tests for rickettsial disease, which are superior to the non-specific Weil-Felix test.     

恙虫病流行病学研究新进展

恙虫病又称丛林斑疹伤寒,是一种由恙虫病立克次体引起的急性自然疫源性传染病,是我国法定报告传染病之一.现要求医疗机构一旦确诊恙虫病病例,应在24h内向国家监测系统报告.世界卫生组织曾指出恙虫病可能是世界上最流行、被严重忽视但容易治疗的一种发热性疾病之一.据我国CDC疫情报告显示,随着我国绿化工程的不断实施,恙虫病病例数持...     

海南省680例不明原因发热患者恙虫病东方体感染调查

目的 了解海南省不明原因发热患者的恙虫病东方体检感染情况,为不明原因发热患者恙虫病防治提供指导。方法 收集2018—2021年海南医学院第一附属医院、海南医学院第二附属医院、海口市人民医院和琼中黎族苗族自治县人民医院临床诊断为不明原因发热患者血液样本,利用胶体金免疫层析法和PCR方法分别对样本进行恙虫病东方体特异性IgM、IgG抗体和恙虫病东方体56kD型特异性抗原基因检测,同时收集样本的临床及流行病学信息,并进行流行病学分析。结果 共收集临床不明原因发热患者血样680份,恙虫病东方体IgM、IgG抗体和56kD型特异性抗原PCR阳性率分别为23.97%(163/680)、36.62%(249/680)和20.88%(142/680),焦痂或皮疹率为12.06%(82/680)。根据诊断标准,最终诊断为恙虫病的患者为223例,其中男性111例（49.78%）,女性109例（48.88%）,平均年龄（53.14±15.12）岁,其中40～<60岁98例（占43.95%）,感染人群民族中汉族136例（占60.99%）,农民93例（41.70%）,秋季发病114例（51.12%）。临床...