黑龙江口岸蜱携带斑点热群立克次体及嗜吞噬细胞无形体复合感染调查

目的为了研究黑龙江地区密山、绥芬河、嘉荫、东宁、虎林、同江、逊克、萝北、牡丹江、黑河、饶河11口岸蜱类分布、携带及复合感染新发蜱传病原体的情况。方法 2014年4月到2015年10月,利用布旗法采集蜱类样本,通过建立斑点热群立克次体(spotted fever group Rickettsia,SFGR)及嗜吞噬细胞无形体(Anaplasma phagocytophilum,A.P.)特异性引物,利用PCR方法对所有样本进行特异性片段扩增,通过基因测序对五种新发蜱传疾病作进一步鉴定并分型。结果共采集1306只蜱标本,经分类鉴定分属于革蜱属的森林革蜱、硬蜱属的全沟硬蜱和血蜱属的嗜群血蜱和日本血蜱。共检测出528例(40.43%)斑点热群立克次体阳性样本和31例(2.37%)嗜吞噬细胞无形体阳性样本。并证实存在三种斑点热群立克次体,分别为劳氏立克次体Rickettsia raoultii、新塔拉塞维奇立克次体Candidatus Rickettsia tarasevichiae、黑龙江立克次体Rickettsia heilongjiangensis。共检测到复合感染12例,复合感染率为0.92%(12/1306)。结论黑龙江口岸媒介蜱类存在斑点热群立克次体及嗜吞噬细胞无形体的复合感染现象,提示黑龙江地区蜱媒疾病的危险程度很高,急需加强黑龙江口岸地区蜱媒传染病及其复合感染的监测与防控技术研究,进而建立科学合理的新发蜱媒疾病预警监测和防控技术体系。     

安徽地区流行蜱媒传染病临床特征观察分析

目的：探讨安徽地区蜱媒传染病的临床诊断及治疗的特点和对策。方法：对49例蜱媒传染病患者的临床数据进行回顾性分析。结果：49例患者的临床表现复杂多样,绝大多数患者表现为发热、乏力,实验室检查可见嗜酸性粒细胞明显减少。随着确诊时间的延长,发生器官损害的数量增多,确诊时间越长,治疗效果越差。蜱媒传染性疾病可导致中枢神经、血液、呼吸、消化、肾脏、心脏多个重要脏器的功能损害。结论：蜱媒传染病的早期诊断在患者救治中起着重要作用;确诊后应关注多脏器功能受损情况,尽早识别和合理治疗并发症是治愈蜱媒传染病的重要环节。     

金华地区部分蜱媒传染病感染状况调查研究

目的为了解金华地区蜱与部分蜱媒传染病的种类、分布以及危害状况，建立适合于当地的蜱媒病预警和防制技术体系。方法采用夹线法，在金华某地区林区采集鼠形动物和体外寄生蜱，采用PCR和序列测定方法对该地区的蜱媒病原的感染情况进行了初步流行病学调查研究。结果在体外寄生的中华硬蜱中检出艾氏螺旋体Borreliaafzelii和普氏立克次体Rickettsia prowazekii，并发现这两种病原体的复合感染现象。结论金华地区有莱姆病和普氏立克次体存在，可能引起一些蜱媒传染病的发生，应引起公共卫生部门的重视。     

浙江省建德市蜱媒传染病综合监测研究

目的 了解建德地区蜱媒传染病主要宿主和媒介的种群密度、季节消长、染带关系和病原体携带状况,为蜱媒传染病预防控制提供科学依据。方法 采用布旗法、宿主动物体表检蜱法采集蜱,用鼠笼捕捉鼠形动物,采用PCR方法检测其蜱媒传染病感染情况。结果 建德地区主要蜱种有长角血蜱、中华硬蜱和镰形扇头蜱,长角血蜱为优势种,布旗法6月蜱密度最高,体表检蜱法6月带蜱率最高。在蜱及宿主动物中检出嗜吞噬细胞无形体、巴贝西原虫、查菲埃立克体、立克次体、巴尔通体、肾综合征出血热病毒6种蜱媒传染病病原体,并存在病原体复合感染。结论 建德地区蜱媒传染病的宿主和媒介广泛分布,而且携带多种病原体,需要采取措施进行防制。     

绥芬河地区三种蜱媒疾病的血清学调查

１９９６年４～６月，对黑龙江省绥芬河、东宁地区驻军及部分林业工人进行了蜱传斑点热、Ｑ热、莱姆病的血清学调查。应用Ｍｉｃｒｏ－ＩＦ共调查２２１人，三种蜱媒疾病的总感染率为２２．２％，其中斑点热感染率为最高（１１．８％），同莱姆疾病（５．９％）、Ｑ热（４．５％）相比差异显著（Ｐ＜０．０５）。部队战士的感染率略低于林业工人，分别是斑点热：９．５％和２１．４％，莱姆病：５．６％和７．１％，Ｑ热：４．５％和４．８％。结果表明，上述三种蜱媒疾病在该地区存在程度不同的感染。     

三种蜱媒传染病在媒介蜱和鼠类中复合感染的研究

目的 了解中国部分地区埃立克体病和其他蜱媒传染病病原体的复合感染情况。方法 运用聚合酶链反应方法对内蒙古自治区、黑龙江省、北京市的蜱和鼠类标本粒细胞埃立克体、莱姆病螺旋体、斑点热群立克次体的感染进行检测，对福建省的蜱和鼠脾脏标本中查菲埃立克体、斑点热立克次体及莱姆病螺旋体的感染情况进行检测。结果 内蒙古采集的全沟硬蜱408只，人粒细胞埃立克体感染率68％，莱姆病螺旋体感染率7．8％，斑点热群立克次体感染率45．6％，其中粒细胞埃立克体与莱姆病螺旋体复合感染标本5份(5／408)，粒细胞埃立克体与斑点热群立克次体复合感染标本1份(1／408)。黑龙江采集的46只全沟硬蜱中人粒细胞埃立克体感染率6．5％，莱姆病螺旋体感染率10．8％，斑点热群立克次体感染率34．8％，其中粒细胞埃立克体与莱姆病螺旋体复合感染标本1份(1／46)。北京市采集的蜱类标本922只，有2只检测到莱姆病螺旋体的DNA片段。福建省宁化地区采集的优势蜱种越原血蜱283组(659只)中，查菲埃立克体最小阳性率为3．8％(25组阳性)，38份野鼠脾脏的阳性率为564％(21只阳性)，检测出有2只(2／659)蜱同时感染了粒细胞埃立克体和斑点热群立克次体，野鼠的脾脏标本中，也发现有一只同时感染了查菲埃立克体和斑点热立克次体。结论 人粒细胞埃立克体和莱姆病螺旋体复合感染以及查菲埃立克体和斑点热群立克次体复合感染可能在特定地区发生；其地区的蜱类、鼠类存在着极低的复合感染。     

内蒙古地区2015—2019年不同寄生蜱的种群分布及病原体多样性分析

目的 了解内蒙古地区2015—2019年不同寄生宿主蜱的蜱种分布、病原体感染及复合感染状况。方法 在每年蜱活跃高峰期采集蜱标本,经体视显微镜和特异性18S rRNA基因分型法进行蜱种鉴定。提取蜱基因组DNA,并对斑点热立克次体gltA和rOmpA基因、无形体msp2基因、埃立克体omp1基因、莱姆病螺旋体flaB基因和新型回归热螺旋体glpQ基因等病原体进行PCR检测。结果 本次共采集蜱虫6 465只,隶属于1科5属8种。游离蜱多为全沟硬蜱（79.0%）;羊和牛寄生蜱多为草原革蜱（68.2%,52.0%）;马和骆驼寄生蜱均为亚洲璃眼蜱;犬寄生蜱均为图兰扇头蜱。立克次体gltA阳性率为39.4%,其中羊、骆驼、马、牛等家畜寄生蜱阳性率均超过平均值;其他4种病原体多为游离蜱携带,其阳性率分别为12.3%、10.1%、11.0%、17.0%。内蒙古地区蜱媒疾病复合感染率为12.6%,其中,游离蜱复合感染率高于寄生蜱。结论 家畜感染立克次体较严重。游离蜱的复合感染情况较严重,因此要重点加强东部大兴安岭一带蜱媒传染病的监测工作。     

黑龙江口岸蜱类及其携带病原体状况研究初报

〔目的〕根据目前蜱媒病原的危害情况,从分子流行病学角度探讨可能存在的新发蜱媒传染病及复合感染情况。〔方法〕采集黑龙江11个口岸的蜱,通过病原培养分离,动物试验后进行分子生物学检测。〔结果〕检出5种病原微生物,全沟硬蜱可同时携带这5种病原体,发现了复合感染蜱。〔结论〕黑龙江口岸蜱类及蜱携带病原体情况复杂,引起蜱传疾病的风险巨大。     

绥芬河、东宁口岸地区鼠类感染新发蜱媒病原的检测

目的了解黑龙江省绥芬河、东宁口岸地区鼠类感染新发蜱媒病原的情况。方法采用现场调查与分子流行病学调查手段,监测分析两地鼠类感染新发蜱媒病原的情况。结果对102只鼠类进行检测,发现有9种蜱媒病原,主要感染的鼠类为黑线姬鼠和东方田鼠;病原感染率高的是微小巴贝西原虫,分别为25．0％－27．3％和33．0％－42．9％;其次是莱姆病螺旋体,感染率分别达21．2％－30．0％和28．6％－33．0％;病原感染率较低的是病毒类森林脑炎,仅在东宁林区的2只黑线姬鼠中发现,感染率为5．00％。结论两地蜱媒病原的感染均以黑线姬鼠和东方田鼠为主。该检测结果为下一步深入了解这些疾病的性质及其流行病学特征提供了基础。     

我国新发蜱媒病原体研究概述

蜱是许多重大传染病的重要传播媒介,持续危害全球健康,我国蜱种丰富、分布广泛,蜱媒传染病暴发流行较多,且新的蜱媒疾病及其病原体不断被发现。近年来,我国共陆续报道33种新发蜱媒病原体,包括8种新发斑点热群立克次体,该病原体主要分布在北方地区;7种无形体,其中嗜吞噬细胞无形体分布地区最广、感染蜱种最多;6种伯氏疏螺旋体,该病原体被证实在我国25个省份的26种蜱中广泛分布;11种巴贝西虫,其中3种病原体可引起人群感染;发热伴血小板减少综合征布尼亚病毒,病例高度散发,蜱是主要传播媒介,也可人与人接触传播,目前缺乏有效的疫苗和药物进行防控和治疗。因此,对新发蜱媒病原体及其传播媒介进行研究具有重要意义。本文对我国近年来广泛流行的新发蜱媒病原体进行了概述,总结新发病原体发生、分布、媒介蜱类等目前的研究进展,以期为我国蜱传疾病的系统研究提供理论基础。     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.