安徽省怀远县2005年钩端螺旋体病监测分析

目的研究怀远县人群钩端螺旋体感染及宿主动物带菌情况,为控制该病提供依据。方法采用血清学、病原学、流行病学方法对钩体病进行监测。结果自然人群感染率流行季节高于非流行季节（9.00∶0.96）,均为黄疸出血群。宿主动物鼠种构成较以往发生明显改变,黑线姬鼠占84.02%,鼠密度秋季高于春季（10.54∶8.63）,鼠带菌率秋季高于春季（24.53∶4.54）,感染菌群与人一致。结论怀远县钩体病流行菌群由1970年代波摩那群更迭为黄疸出血群。主要带菌宿主动物由猪改变为黑线姬鼠,鼠感染菌群更迭与人感染情况吻合。今后应加强宿主动物调查和人群钩体病疫情调查研究,掌握流行动态,及时采用有效的防治对策,防止黄疸出血群钩体病暴发流行。     

四川省1993-2001年钩端螺旋体病传染源监测分析

目的 调查研究四川省1993-2001年钩端螺旋体（简称钩体）病传染源情况。为防治该病提供科学依据。方法 按全国钩体病监测方案全省选择10个监测点，进行钩体病主要传染源调查。结果 黑线姬鼠带菌率占第1位。主要携带黄疸出血群钩体，首次从牛尿中检出七日热群钩体。结论 鼠密度，鼠带菌率，带菌鼠密度分别与钩体发病率呈正相关。黑线姬鼠是四川省稻田型钩体主要传染源，耕牛作为七日热群钩体宿主和重要传染源应继续调查。     

四川省江油市钩端螺旋体病传染源调查

目的：研究近年来江油市钩端螺旋体（简称钩体）病流行的传染源情况。为防治该病提供科学依据。方法 调查钩体主要宿主动物鼠，猪，牛带菌情况及鼠密度，种群构成等。结果：该市平均鼠带菌率为11.34%，黑线姬鼠占其鼠种构成的63.64%，平均带菌率为17.52%，从钩体患者和动物中分离出的钩体，黄疸出血群占98.56%。结论：黑线姬鼠是江油市稻田型钩体流行的主要传染源，流行菌群的变化是造成流行重要因素之一。     

在重庆黑线姬鼠中发现巴达维亚群钩端螺旋体

据资料统计,１９９７年重庆市未直辖前的四川省已从２６种动物中检出钩端螺旋体（钩体）,分属１７群３１型。其啮齿目鼠科姬鼠属中的黑线姬鼠系四川主要带菌动物,又是大部份地区优势鼠种,且携带钩体血清群达１０群,主要为黄疽出血群,占９７．刀％,是四川稻田型钩体病主要传染源。１９９８年,我站钩端螺旋体病实验室对重庆市卫生防疫站送检的钩体（１９９７年秋从黑线姬鼠中分获）进行血清群鉴定（１５群１５型参考株诊断血清由中国药品生物制品检定所提供）,结果显示：该株钩体与巴达维亚群诊断血清发生正：３２００ｏ的凝集反应,…     

贵州省2015～2019年钩端螺旋体病流行特征及监测分析

目的:分析贵州省2015～2019年人钩端螺旋体病(简称钩体病)流行病学特征与鼠类宿主动物带菌情况,为钩体病的防控提供科学依据。方法:收集2015～2019年钩体病例个案,进行描述性流行病学分析。在钩体病高发地区对宿主动物的带菌情况进行监测,并分析与人间疫情的相关性。结果:2015～2019年,贵州省共报告钩体病118例,死亡2例。年发病率在0.0142/10万～0.0770/10万之间波动。病例的职业主要为农民,共96例(81.36%),其中男女性别比为3.72∶1。贵州省钩体病有明显季节性,每年集中于9～10月发病。以黔东南州报告病例为主,共102例,占全省的86.44%。疑似病例经血清学检测阳性56例,阳性率为52.83%,有11个血清群,以黄疸出血群为主(34例,占60.71%)。黑线姬鼠密度较2010～2014年上升,是钩体病的主要动物宿主,携带黄疸出血群钩体,分离阳性率为14.7%。结论:贵州省钩体病高发地区仍以黑线姬鼠为主要传染源,建议在黑线姬鼠密度高的地区开展灭鼠,同时做好健康宣教,做好秋季田间劳动防护,减少农民接触疫水的机会。     

四川省2005～2008年钩端螺旋体病监测结果分析

[目的]通过对2005～2008年四川省钩端螺旋体病监测资料的分析,了解人群和宿主动物钩体菌群分布和变动情况,研究钩体病流行规律,为制定预防和控制措施提供依据. [方法]用显微镜凝集试验,对临床诊断病例、自然人群和宿主动物进行抗体测定.采集临床诊断病例血液和鼠、蛙、猪肾、牛中段尿,进行病原体分离培养. [结果]2005～2008年全省累计发生钩体病1316例,死亡11例,除攀枝花市、德阳市、甘孜州和阿坝州外,各市州均有病例报告.病人血清群以黄疸出血群为主,自然人群血清群以黄疸出血群和澳州群为主,宿主动物主要携带黄疸出血群钩体. [结论]近几年我省钩体病处于最低发病水平,主要宿主动物携带钩体菌群与病人感染主要菌群基本一致,主要流行菌群稳定.但培养分离出钩体的宿主动物主要为高山姬鼠,而不是黑线姬鼠.因此,钩体病监测仍不能放松,需密切注意主要传染源的变化.     

仙居县钩端螺旋体病地理流行病学研究

本文对仙居县钩体病地理流行病学进行了研究,从蛙和鼠类中检出钩体菌株,携带菌群以黄疸出血群为主。蛙类带菌率1.27%,室外鼠7、8月带菌率最高(30.91%、36.51%),流行区(22.25%)和非流行区(19.14%)无显著性差异,黑线姬鼠和黄毛鼠为主要带菌鼠种。病人血培养和健康人群隐性感染检测表明;人间流行菌群以黄疸出血群、七日热群为主。提示:鼠和蛙类为本县钩体病的主要宿主动物,目前的山区非流行区为潜在疫区。     

江油地区首次发现黄疸出血群赖型钩端螺旋体

本文报告了四川省江油市１９９５年９月，钩端螺旋体病（以下简称钩体病）暴发流行期间，首次从３３例病人血液标本检出钩体７株，阳性率为２１．２１％，分属二个血清群三个血清型、黄疸出血群黄疸出血型５株，赖型１株，七日热群棉兰型１株。培养鼠肾２２５份，检出钩体３１株（待定１株，失传１株），阳性率为１３．７８％，以黄疸出血群赖型为主要血清型，病原体带菌宿主以黑线姬鼠为主，为我市稻田型钩体病的主要传染源，携带钩体与本次钩体病暴发流行人间主要流行菌群和型一致。     

贵州省不明原因发热病例钩端螺旋体病原体分离鉴定研究

目的 对贵州省钩端螺旋体（钩体）病疫区不明原因发热病例进行钩体分离鉴定和分子分型，了解其病原学特征，为当地钩体病的防治提供病原学依据。方法 采集贵州省钩体病疫区黔东南州黎平县不明原因发热病例血液和尿液标本进行钩体分离培养，对分离的钩体疑似菌株通过致病性钩体G1/G2-PCR方法进行初步鉴定，进一步采用钩体血清群特异PCR进行分群鉴定，然后采用多位点序列分型（MLST）技术对其进行分子分型，并与国内常见血清群参考菌株进行聚类分析。结果 从35例发热病例血液中分离得到3株钩体疑似菌株，分离率为8.6%，分别命名为17BX002、17BX003和17AJX008；3株菌株经钩体特异性G1/G2-PCR鉴定为致病性钩体；钩体血清群PCR鉴定显示，17BX002株为流感伤寒群钩体，其余2株菌为阴性（排除其为黄疸出血群、赛罗群、犬型、秋季群、流感伤寒群和七日热群）；进一步的MLST显示，17BX002株为ST106型，与流感伤寒群聚类最近，而其余2株为ST96型，与巴达维亚群菌株一致。结论 高发季节贵州省疫区不明原因发热病例中存在钩体感染病例，流感伤寒群和巴达维亚群为贵州省新发现钩体菌群。     

1997～2000年浙江省钩端螺旋体病监测分析

目的 探讨钩端螺旋体病（钩体病）流行规律。分析存在问题。方法 用MAT法检测病人、水鸭和蛙血清抗体；同时分离培养病原体。用夹夜法捕鼠，采集鼠肾，猪肾，牛中段尿，蛙肾、水鸭肾和蚂蝗血分离培养病原体。结果 1997-2000年全省共发生钩体病789例，平均发病率为0.44/10万，死亡12人，平均病死率为1.52%。衢州、丽水和台州市的发病数占全省发病总数的93.28%。病例主要分布在7-10月，占95.06%，病人血清抗体阳性率为65.43%，菌群主要为黄疸出血群和七日热群。病人血培养阳性率为1.20%。鼠密度为5.08%，以黑线姬鼠为优势种，占47.34%，鼠带菌率为6.90%，黑线姬鼠带菌率为13.19%，蛙肾阳性率为0.17%。水鸭血清抗体阳性率为50%，菌株主要为秋季群；蛙血抗体阳性率为13.64%，菌株为秋季群。结论 钩体病防制工作不能放松。要加强对该病的监测和防治工作。     

福建省2015-2020年钩端螺旋体病流行状况分析

目的:分析2015-2020年福建省钩端螺旋体（钩体）病流行状况,为钩体病风险评估和防控策略提供依据。方法:钩体病数据来源于中国疾病预防控制信息系统的传染病监测系统和2015-2020年17个监测点,采用描述性流行病学和空间自相关方法进行分析,对捕获的鼠脏器进行钩体培养,鼠血清、健康人血清和医院送检的患者血清进行血清抗...     

A survey of leptospirosis in febrile patients mainly from hospitals and clinics in Trinidad

Acute and convalescent sera were obtained from 202 febrile patients, most of whom were admitted to or attended hospitals or clinics in northern Trinidad during the 12 months from mid-February 1977 to mid-February 1978. Laboratory tests confirmed that 10 of the patients were suffering from current leptospirosis while another 54 had serological evidence of previous leptospiral infections.Antibodies to strains of the Icterohaemorrhagiae serogroup were most commonly found, followed by those to the Hebdomadis and Autumnalis serogroups.Isolates were obtained from the blood of two and the urine of three of the 10 current cases. Four of these strains were identified as belonging to copenhageni serovar of the Icterohaemorrhagiae serogroup and one to serovar brasiliensis of the Bataviae serogroup.Seven of the patients suffering from leptospirosis were males, all rural dwellers, and all except one under 20 years of age. Two of the three female patients were over 60 years old and were urban dwellers. It was not possible to identify the sources of infection with certainty, although dogs may have been responsible for three of the Icterohaemorrhagiae and one of the Canicola infections.Of the 192 patients who were not currently infected, serological evidence of previous infection was obtained in 31 (40%) males and 23 (21%) females and was most common among farmers and rural workers.     

Reassessment of MLST schemes for Leptospira spp. typing worldwide

Leptospirosis is a neglected zoonosis of global importance. Several multilocus sequence typing (MLST) methods have been developed for Leptospira spp., the causative agent of leptospirosis.In this study we reassessed the most commonly used MLST schemes in a set of worldwide isolates, in order to select the loci that achieve the maximum power of discrimination for typing Leptospira spp. Global eBURST algorithm was used to detect clonal complexes among STs and phylogenetic relationships among concatenated and individual sequences were inferred through maximum likelihood (ML) analysis. The evaluation of 12 loci combined to type a subset of strains rendered 57 different STs. Seven of these loci were selected into a final scheme upon studying the number of alleles and polymorphisms, the typing efficiency, the discriminatory power and the ratio dN/dS per nucleotide site for each locus. This new 7-locus scheme was applied to a wider collection of worldwide strains. The ML tree constructed from concatenated sequences of the 7 loci identified 6 major clusters corresponding to 6 Leptospira species. Global eBURST established 8 CCs, which showed that genotypes were clearly related by geographic origin and host. ST52 and ST47, represented mostly by Argentinian isolates, grouped the higher number of isolates. These isolates were serotyped as serogroups Pomona and Icterohaemorrhagiae, showing a unidirectional correlation in which the isolates with the same ST belong to the same serogroup.In summary, this scheme combines the best loci from the most widely used MLST schemes for Leptospira spp. and supports worldwide strains classification. The Argentinian isolates exhibited congruence between allelic profile and serogroup, providing an alternative to serological methods.     

A cluster of leptospirosis cases in canoeists following a competition on the River Liffey

On 6 November 2001, a possible case of leptospirosis was notified in a canoeist following a white-water event on the River Liffey. It emerged that a second race participant was also a possible case. An outbreak control team coordinated the epidemiological investigation, laboratory investigation, environmental assessment, communication and control measures. A cluster of six laboratory-confirmed cases of leptospirosis, serologically Leptospira interrogans serogroup Icterohaemorrhagiae was found. The attack rate was 9.2% (6/65). Fever, chills, red eyes and shortness of breath were significantly associated with being a confirmed case. Five cases were hospitalized. Swallowing more than one mouthful of water was associated with an increased risk of developing leptospirosis. Increased rainfall and release of hydroelectric water may have contributed to this outbreak. A multidisciplinary approach and use of the Internet and e-mail facilitated rapid and effective communication.     

Multiple-locus variable-number tandem repeat analysis of Leptospira interrogans and Leptospira borgpetersenii isolated from small feral and wild mammals in East Asia

Leptospira spp. are the causative agents of a worldwide zoonosis, leptospirosis, maintained by various mammals. Each Leptospira serovar is frequently associated with a particular maintenance host, and recently, Leptospira genotype–host association has also been suggested to limit serovars to restricted areas. We investigated the molecular characteristics of L. interrogans and L. borgpetersenii which were isolated from small feral and wild animals in four East Asian states using multiple-locus variable-number tandem repeat analysis (MLVA).MLVA using 11 loci was performed on 110 L. interrogans serogroups from Japan (79 strains of 5 serogroups from 3 animal species), Philippines (21; 3; 2), Taiwan (7; 2; 3), and Vietnam (3; 1; 1). A MLVA method using 4 loci for L. borgpetersenii was established and performed on 52 isolates from Japan (26; 3; 7), Philippines (13; 1; 2), and Taiwan (13; 1; 3). In L. interrogans, serogroups Autumnalis and Hebdomadis appeared more genetically diverse than serogroups Bataviae, Grippotyphosa, Icterohaemorrhagiae, Pomona, or Pyrogenes. The former serogroup strains with the exception of one Hebdomadis strain were isolated from Apodemus speciosus while all the latter serogroup strains with the exception of Grippotyphosa were isolated from Rattus norvegicus. L. borgpetersenii was isolated from at least 11 animal species while L. interrogans was isolated from five species, which might suggest a wider host range for L. borgpetersenii. Broad host preference in a single genotype was also observed, which colonized not only different species of the same genera but also multiple animal genera.This study demonstrates that there may be variability in the range of genetic diversity among different Leptospira serogroups, which may be attributed to maintenance host animals and environmental factors.     

甘肃省2004-2018年甲型肝炎时空聚集性分析

目的 分析2004-2018年甘肃省甲型肝炎（甲肝）时空分布与聚集性特征,为甲肝防控工作提供依据。方法 利用中国疾病预防控制信息系统传染病报告信息管理系统收集2004-2018年甘肃省各县（区）甲肝病例报告数据,描述甲肝疫情流行特征,采用SaTScan 9.1软件进行时空扫描分析、ArcGIS 10.3软件实现扫描结果可视化。结果 2004-2018年甘肃省甲肝年均报告发病率为10.91/10万,报告发病率呈现下降趋势,周期性和季节性均不明显;实施扩大国家免疫规划（EPI）后,年均报告发病率异常高值的7个县（区）位于临夏回族自治州和甘南藏族自治州;2004-2012年各年龄组发病RR值均低于0～9岁组（P=0.000）。除2015年0～9岁组外,2013-2018年各年龄组发病RR值低于≥60岁组（P=0.000）;年均报告发病率的趋势由北向南逐渐升高,由西向东逐渐升高;时空扫描结果显示：2004-2018年甘肃省甲肝发病存在时空聚集性。2004-2008年探测出1个一级聚集区,聚集半径为91.95 km,时间为2004-2005年,主要分布在临夏回族自治州和陇南市。2009-2018年探测出1个一级聚集区,聚集半径为183.26 km,时间为2009-2012年,主要分布在甘南藏族自治州、临夏回族自治州、定西市和陇南市。结论 2004-2018年甘肃省甲肝发病呈现显著的下降趋势,流行模式有了很大的变化,周期性和季节性均不明显。0～9岁组儿童甲肝报告发病率显著下降且低于其他年龄组,≥60岁人群发病率最高应被重点关注。甲肝存在时空聚集性,重点防控区域在甘肃省西南部地区。     

Isolation and clinical sample typing of human leptospirosis cases in Argentina

Leptospira typing is carried out using isolated strains. Because of difficulties in obtaining them, direct identification of infective Leptospira in clinical samples is a high priority. Multilocus sequence typing (MLST) proved highly discriminatory for seven pathogenic species of Leptospira, allowing isolate characterization and robust assignment to species, in addition to phylogenetic evidence for the relatedness between species. In this study we characterized Leptospira strains circulating in Argentina, using typing methods applied to human clinical samples and isolates. Phylogenetic studies based on 16S ribosomal RNA gene sequences enabled typing of 8 isolates (6 Leptospira interrogans, one Leptospira wolffii and one Leptospira broomii) and 58 out of 85 (68.2%) clinical samples (55 L. interrogans, 2 Leptospira meyeri, and one Leptospira kirschneri). MLST results for the L. interrogans isolates indicated that five were probably Canicola serogroup (ST37) and one was probably Icterohaemorrhagiae serogroup (ST17). Eleven clinical samples (21.6%), provided MLST interpretable data: five were probably Pyrogenes serogroup (ST13), four Sejroe (ST20), one Autumnalis (ST22) and one Canicola (ST37). To the best of our knowledge this study is the first report of the use of an MLST typing scheme with seven loci to identify Leptospira directly from clinical samples in Argentina. The use of clinical samples presents the advantage of the possibility of knowing the infecting strain without resorting to isolates. This study also allowed, for the first time, the characterization of isolates of intermediate pathogenicity species (L. wolffii and L. broomii) from symptomatic patients.     

Rodents and Leptospira transmission risk in Terceira island (Azores)

The role of rodents as Leptospira renal carriers in Terceira island was evaluated (1993–1995) through kidney culture and serology [microscopic aglutination test (MAT)] of 94 mice and rats. Fifty-nine animals were positive (n = 41 by serology + culturing; n = 11 serology; n = 7 culturing), presenting a wide distribution in man-made and natural areas. House mice had the highest bacteriological (82.9%) and serological (90.9%) rates, being strictly related to serovar arborea. Black rats were involved in the dispersion of all isolated L. interrogans sensu lato serovars (arborea,copenhageni and icterohaemorrhagiae). Logistic regression analysis and non-metric multi-dimensional scaling, relating Leptospira infection with biological and environmental variables, expressed that adult males Mus domesticus, sexually active and living in humid biotopes, mainly above 500 m, are the most likely reservoirs. This study emphasizes the role of house-mice in the epidemiology of leptospirosis in Terceira and the need of reducing the risk of Leptospira transmission through integrated control programmes, primarily focusing on adult house-mice in peri-domestic environments, before the breeding season.     

A twelve-year study of leptospirosis on Barbados

Between November 1979 and December 1991, 398 cases of severe leptospirosis were confirmed on Barbados (range for 1980–1991 23–56; mean 32.7; incidence 13.3/100,000/year). For the six-year periods 1980–1985 and 1986–1991 there was no significant change in incidence with time. Incidence is unlikely to change significantly in the next decade. Monthly average case numbers ranged from 1.4 (July) to 4.3 (November). The average (2.8) for June to December (the 7 wetter months) was not significantly higher than that (2.5) for January to May (the 5 drier months). The age range was 7–86. There were three times as many male cases (302) as female (96), and nearly 10 times as many in those <35. Although the highest number of cases (69) was in males aged 15–24, the highest incidence was in the older age groups, particularly the male 65–74 year-olds, and the female 55–64 year-olds. Leptospirosis was the proven cause of death in 55 (13.8%) hospital patients (annual range 0–13, mean 4.5). Some of a further 39 fatalities might have been cases. Death from leptospirosis was nearly twice as common among the women as among the men. Only one patient under 20 years of age died.Leptospira were isolated and identified from 117 (29.4%) of the 398 sick patients. The infecting organisms werebim (serogroup Autumnalis — 75),copenhageni (Icterohaemorrhagiae — 26),arborea (Ballum — 14) andbajan (Australis — 2). These infecting serovars could not be distinguished clinically, but infection was milder in children than in adults. Despite its predominance in surveyed children, serogroup Panama was virtually absent in this study. Rainfall is the major factor affecting the distribution of cases; not surprisingly, sanitation workers and agricultural workers appear to be the groups at highest risk. The general lack of clear-cut risk factors reflects the ubiquity of leptospires in the environment and the fact that the disease is not entirely occupational.