腺鼠疫患者血清抗体谱的研究

目的检测腺鼠疫患者血清抗体谱及抗体随时间变化趋势。方法利用一包含145个鼠疫耶尔森氏菌毒力相关蛋白质的蛋白芯片检测云南腺鼠疫患者血清抗体谱及抗体随时间变化趋势。结果在腺鼠疫患者体内检测到32种蛋白相应的抗体。结论FI抗体产生的速度最快、幅度最高、持续的时间最长;YopM、YopH、YopE抗体升高不明显;V抗体在患者体内未检测到;在发病后14 d才检测到pH6抗原的抗体,3个月时抗体荧光值没有下降,可持续半年。YopD的抗体在部分患者体内明显升高,但在半年后下降到正常水平。     

亚热带地区鼠疫病例的临床分析

目的：对收治的腺鼠疫疑似病例进行临床分析，探讨亚热带地区鼠疫病例的临床特点。方法：对97例鼠疫疑似病例进行临床分析，测定血清F1抗体、体液标本F1抗原和细菌分离培养，鼠疫病例分别给予链霉素、四环素、环丙沙星和头孢噻肟钠等药物治疗。结果：97例鼠疫疑似病例中确诊为腺鼠疫34例，表现为高热、烦燥，强迫体位的典型腺鼠疫表现占32．3％，不典型病例为67．7％。腺鼠疫病例在儿童组和成年组呈均匀分布，分别为42．4％和57．6％。腺鼠疫多发于腹股沟淋巴结，为69．9％。F1抗原检测为1：10240。结论：不典型的腺鼠疫病例可按（GB－15991－1995鼠疫诊断标准）鼠疫血清学间接血凝试验（IHA）检测F1抗体来确诊,F1抗原检测有早期诊断的意义。     

2004年青海省乌兰县人间鼠疫疫情隐性感染报告

鼠疫是自然疫源性疾病．以发病急、传播快、病死率高为特点。人类多因接触染疫的啮齿类动物或被媒介昆虫叮咬而感染。临床上将鼠疫分为9型，青海省人间鼠疫以肺型多见，腺型次之．败血型少见。但近年来青海省在鼠疫防治过程中发现无症状鼠疫，或称之为隐性感染鼠疫的病例。2004年10月在青海省乌兰县人间疫情处理过程中，用间接血凝实验检测发现2例隐性感染鼠疫病例．现将结果报告如下。[第一段]     

镇康县鼠疫动物病流行的调查与控制

1995年8月云南省镇康县南伞镇白岩村,鼠间鼠疫流行并波及到人间,发生人间腺鼠疫病人1例。本次鼠疫动物病流行时调查15个自然村9,605户和2个机关单位.获鼠类材料168份,疑似腺鼠疫病人腹股为淋巴腺穿刺液1份,疑似病人及密切接触者血清13份。鼠疫细菌学和血清学检验出鼠疫菌7株(人1株、鼠6株)RIHA阳性5份(疑似病人淋巴腺穿刺液1份,鼠4份),13份人血清阴性。判定鼠间鼠疫疫点1个,疫点面积约5km~2。     

2005年青海省2例人间鼠疫病例死亡报告

2005年青海省湟源县、治多县发生2起人间鼠疫疫情．发病2人．死亡2人。根据流行病学调查、临床表现、鼠疫实验室检验结果，1例死于腺鼠疫继发败血型鼠疫，1例死于腺鼠疫继发肺鼠疫，现将结果报道如下。[第一段]     

敦格铁路甘肃段沿线地区人间鼠疫流行病学分析

目的分析敦格铁路甘肃段沿线地区人间鼠疫流行病学特征,为今后有效防控鼠疫积累经验。方法查阅有关历史资料和文献报道,回顾性总结分析甘肃省人间鼠疫病例流行病学特征。结果敦格铁路甘肃段沿线地区人间鼠疫传染源为染疫旱獭和染疫牧羊犬,感染途径主要是人主动剥食和直接接触旱獭,其次为呼吸道传播感染;1956—2014年共发生11起人间鼠疫疫情,感染发病11例,无二代病例发生,死亡9例,治愈2例;腺鼠疫5例、占45.5%,肺鼠疫3例、占27.3%,腺鼠疫继发败血型鼠疫2例、占18.2%,败血型继发肺鼠疫1例、占9.1%;病例均为男性,8例为外来务工人员,3例为当地牧民;死亡者病程最短1 d,最长5 d。结论造成人间鼠疫疫情频发主要是外来进入河西走廊祁连山—阿尔金山喜玛拉雅旱獭疫源地内务工人员主动接触染疫动物而感染鼠疫;目前敦格铁路甘肃段开工建设,进入疫区内易感人群增加,动物间疫情随时可能波及人间,针对目前严峻的防控形式,需采取有效应对措施。     

小儿败血型鼠疫1例报道

2004年7月19日,青海省祁连县央隆乡发现1例疑似鼠疫,患者于发病后3d死亡,根据流行病学调查、临床表现、鼠疫实验室检验结果,该患者被确诊为腺鼠疫继发败血型鼠疫。1病例摘要1．1病史：死者罗××,男,5岁,藏族,青海省祁连县央隆乡人。2004年7月17     

云南勐海县一起人间鼠疫疫情的调查处置分析

目的 对2020年勐海县1起人间鼠疫疫情的调查处置进行分析,为完善家鼠鼠疫的监测和防控提供依据。方法 采用病例个案调查、宿主媒介监测等流行病学方法开展调查,对患者的血液、淋巴结穿刺液以及采集的鼠类标本进行细菌学检测、抗原检测和荧光定量PCR检测;对患者的血清进行抗体检测;采用灭鼠、灭蚤等综合措施对疫区进行处置。结果 本次疫情共确诊1例腺鼠疫病例,从黄胸鼠分离到鼠疫杆菌10株;通过采取患者隔离治疗、环境卫生整治,灭鼠、灭蚤等综合处置措施,疫情得到及时有效控制。结论 本例人间鼠疫病例感染来源是当地鼠间鼠疫,跳蚤叮咬可能为其感染途径。及时有效控制鼠间鼠疫疫情是家鼠鼠疫防控的关键。     

一例败血型鼠疫患者的治愈经过

败血型鼠疫与腺型鼠疫相比较为少见,如果得不到及时治疗,绝大多数患者将会死亡。1987年5月,在内蒙古鄂尔多斯高原腹地的鄂托克前旗境内,正值长爪沙鼠Merio-nes unguiculatus鼠疫猛烈流行时,发现1例败血型鼠疫患者,由于发现的早并得到及时的治疗,很快治愈。 一、发病经过 患者折宝山,男,64岁,牧民,汉族,未曾接种过鼠疫菌苗,固定住地是鄂前旗玛拉迪苏木(乡)苏勒德嘎查(村)阿勒台牧业社。1987年5月21日上午,患者折宝山在后来证实为鼠疫动物病流行区的苏勒德牧业     

鼠疫菌感染兔血清抗体谱分析

目的分析鼠疫耶尔森菌感染的兔血清(鼠疫菌感染兔血清)中抗体产生的种类与规律,为了解鼠疫菌的致病机制及筛选新的疫苗亚单位提供实验依据。方法利用含有145个鼠疫菌毒力相关蛋白的蛋白质芯片检测鼠疫菌感染兔血清抗体谱,并与鼠疫菌活疫苗EV76株免疫兔血清(免疫兔血清)抗体谱比较。结果在鼠疫菌感染兔血清中共检测到41个蛋白相应的抗体,其中28个抗体在免疫兔血清中也检测到,有6个蛋白抗体只在鼠疫菌感染兔血清中检测到。结论鼠疫菌感染兔血清的抗体谱与免疫兔血清的抗体谱不完全一致,通过对鼠疫菌感染兔血清抗体谱的研究,可为深入了解细菌的致病机制及筛选新的疫苗亚单位奠定基础。     

Role of the Yersinia pestis plasminogen activator in the incidence of distinct septicemic and bubonic forms of flea-borne plague

Yersinia pestis is transmitted by fleas and causes bubonic plague, characterized by severe local lymphadenitis that progresses rapidly to systemic infection and life-threatening septicemia. Here, we show that although flea-borne transmission usually leads to bubonic plague in mice, it can also lead to primary septicemic plague. However, intradermal injection of Y. pestis, commonly used to mimic transmission by fleabite, leads only to bubonic plague. A Y. pestis strain lacking the plasmid-encoded cell-surface plasminogen activator, which is avirulent by intradermal or s.c. injection, was able to cause fatal primary septicemic plague at low incidence, but not bubonic plague, when transmitted by fleas. The results clarify a long-standing uncertainty about the etiology of primary septicemic plague and support an evolutionary scenario in which plague first emerged as a flea-borne septicemic disease of limited transmissibility. Subsequent acquisition of the plasminogen activator gene by horizontal transfer enabled the bubonic form of disease and increased the potential for epidemic spread.     

Plague. A clinical review of 27 cases.

We reviewed the medical records of 27 patients with plague seen at the Gallup (NM) Indian Medical Center between 1965 and 1989. Nineteen patients had bubonic plague and eight had septicemic plague. Three patients with septicemic plague and three with bubonic plague died. The patients presented with five different clinical pictures. Ten patients presented with classic signs of plague, five with the appearance of an upper respiratory tract infection, five with a nonspecific febrile syndrome, four with the appearance of a gastrointestinal or urinary tract infection, and three with the appearance of meningitis. Blood cultures were positive in 24 of 25 cases, and bubo aspirate cultures were positive in 10 of 13 cases. All six patients who died were under 30 years old, and all the deaths were related to a failure to treat initially with an antibiotic appropriate for plague. Plague is a treatable disease, but clinicians must have a high index of suspicion and give appropriate antibiotics at the earliest possible time to patients whose presentation suggests plague.     

30例鼠疫患者间接血凝试验的结果分析

本文报告了30例鼠疫患者的间接血凝反应及3例腺鼠疫患者的血凝抗体动态,探讨了间接血凝试验对鼠疫患者诊断的价值。 30例患者于病后5～10天均可出现血凝抗体(1:80～1:81920),其血凝滴度比EV活菌苗接种者为高。一些病例的血凝抗体可维持4～6年。但细菌学检查仅2例为鼠疫菌阳性。可以认为间接血凝试验比细菌学检查更为敏感,它可用于鼠疫患者的诊断。若患者曾有预防接种史或血凝滴度较低时,可采用双份(急性和恢复期)血凝试验,其滴度升高4倍以上亦可作出诊断。     

Cases of cat-associated human plague in the Western US, 1977-1998.

Exposure to cats infected with Yersinia pestis is a recently recognized risk for human plague in the US. Twenty-three cases of cat-associated human plague (5 of which were fatal) occurred in 8 western states from 1977 through 1998, which represent 7.7% of the total 297 cases reported in that period. Bites, scratches, or other contact with infectious materials while handling infected cats resulted in 17 cases of bubonic plague, 1 case of primary septicemic plague, and 5 cases of primary pneumonic plague. The 5 fatal cases were associated with misdiagnosis or delays in seeking treatment, which resulted in overwhelming infection and various manifestations of the systemic inflammatory response syndrome. Unlike infections acquired by flea bites, the occurrence of cat-associated human plague did not increase significantly during summer months. Plague epizootics in rodents also were observed less frequently at exposure sites for cases of cat-associated human plague than at exposure sites for other cases. The risk of cat-associated human plague is likely to increase as residential development continues in areas where plague foci exist in the western US. Enhanced awareness is needed for prompt diagnosis and treatment.     

胶体金标法快速检测鼠疫F1抗体的现场应用

目的了解胶体金标快速检测试剂盒检测鼠疫FI抗体的现场应用。方法按鼠疫快速诊断盒(胶体金标法)的使用说明进行,并与间接血凝微量法(IHA)进行比较。结果检测了来自云南家鼠鼠疫流行区和非流行区血清共335份,检出腺鼠疫病人血清阳性32份,与IHA法结果一致。结论胶体金标鼠疫FI抗体快诊盒诊断鼠疫简便、快速、特异、敏感,便于现场鼠疫监测应用。     

云南德宏1982～2010年鼠疫流行特征及防治效果分析

目的分析德宏州鼠疫流行特征及防治效果,为制定防治策略提供科学依据。方法收集德宏州动物和人间鼠疫疫情及防治工作资料,进行描述流行病学分析和防治效果评价。结果1982～2010年德宏州有25年次发生鼠疫流行,判定动物鼠疫疫点497个,疫情波及5县（市）41个乡（镇）319个自然村或单位。有9年次发生人问鼠疫,病例数39例,其中腺鼠疫38例,败血型鼠疫1例,病人全部治愈。2004年人间鼠疫得到控制,2008年动物鼠疫得到控制。结论德宏州属家鼠鼠疫自然疫源地,辖区内鼠疫宿主和媒介均不冬眠,家野兼栖,活动范围大,动物鼠疫常年均可发生,人群凶接触疫鼠、疫蚤感染发病。应继续抓好鼠疫“疫情三报”,认真开展鼠疫监测,对鼠疫好发和鼠蚤密度超标地区实施预防性灭鼠灭蚤,完善各项防治措施,才能有效预防和控制鼠疫的发生和流行。     

Plague

In the United States, plague poses a threat to humans from the infected animals in the endemic areas of the Western states. Plague may also be used in the near future as an agent of warfare or terrorism. Although the presentation of bubonic plague may be less of a problem, the septicemic and pneumonic forms present challenges to early diagnosis and prompt treatment. The major threat of plague as an agent of terrorism will probably be through the inhalational route. which could result in many cases of the pneumonic form, requiring early recognition and initiation of appropriate therapy. In a mass-casualty scenario, the clinician should be aware of the potential agents of biowarfare and be familiar with the treatment and prophylaxis recommendations outlined by the CDC. It is also prudent to employ universal precautions and respiratory isolation when treating patients with any unknown exposure. In endemic areas, personal protective measures such as use of insecticides, insect repellants, and prompt prophylaxis in cases of exposure to plague are recommended for reducing the incidence of infection. The author also recommends review of CDC website on bioterrorism (http://www.bt.cdc.gov) to keep informed of plague updates.     

隆林县鼠疫暴发的流行病学特征及防治效果分析

目的 分析隆林县2000年鼠疫疫情的流行病学特征。方法 对疫区鼠疫病例进行个案调查和描述性分析，用IHA法检测指示动物、鼠和人血清中鼠疫FI抗体。结果 鼠疫疫情波及2个乡(镇)7个村13个自然屯及1个水泥厂，共发生腺鼠疫病人42例，发病率达1．06％。7月份为发病高峰，病人多为天生桥水库库区后靠移民，以0-29岁青少年儿童为主。从53只自毙鼠和11份病人淋巴液中分别分离出鼠疫菌11株和4株。119份鼠血清、71份犬血清、13份猫血清中分别检出FI抗体阳性l份、8份和6份。结论 2000年隆林鼠疫疫情流行特征与云南省相似。静息多年的鼠疫自然疫源地遭到人为破坏后，生态环境发生巨大变化可能是导致本次动物鼠疫流行并波及人间的重要原因。     

新疆41例鼠疫患者流行病学分析

根据流行病学、临床症状及实验室检查,证实1949年以后,新疆共发生人间鼠疫11起,确诊鼠疫患者41例。在北天山发生鼠疫10起,确诊鼠疫患者14例;洛浦县农业区发生鼠疫1起,确诊鼠疫患者27例。在41例患者中,腺型25例,肺型9例,败血症型7例。其中3名患者治疗情况不详,12名患者因误诊或未经治疗而死亡。接受鼠疫治疗的26名患者中,19名治愈,治愈率为73％。首发病例中,除1起是由于剥食自毙狍鹿染疫外,其余10起的首发患者皆与接触、捕猎或剥食旱獭有关。