清远市2004年钩端螺旋体病监测分析

目的 对2004年清远市钩端螺旋体病疫情、人群及宿主动物监测情况进行分析,为制定防治措施提供科学依据.方法 采取疑似病人血、鼠类、水禽类和蛙类动物肾组织分离培养病原体,用MAT法检测健康人、疑似病人、鼠类和水禽类动物血清抗体.结果 报告发生钩体病10例,发病率0.25/10万,死亡1例,病死率10.00%.从鼠肾组织中分离鉴定了5株钩体菌,分离阳性率为5.00%,均为爪哇群.流行前、后期健康人血清和流行期疑似病人血清抗体阳性率分别为13.27%、4.00%和15.79%,菌群以黄疸出血群和七日热群为主,其次为拜伦群和爪哇群.鼠血清抗体阳性率为22.00%,黄毛鼠、板齿鼠、褐家鼠和黄胸鼠的血清抗体阳性率在8.57%～50.00%之间,菌群以秋季热群为主,其次为犬热群.水禽（鸭）血清抗体阳性率为4.00%,菌群为拜伦群和致热群.结论 我市人群钩体隐性感染水平和鼠带菌率均较高,开始出现钩体病发病年龄组后移及钩体带菌优势鼠种由野栖鼠种向家栖鼠种交叉转移的动向,从水禽类动物（鸭）血清中检测出钩体带菌抗体在我市尚属首次.继续加强监测,采取综合性防治措施,可有效地控制钩体病的流行.

Surveillance of Leptospirosis in Qingyuan City in 2004

Objective To study the surveillance of leptospirosis in Qingyuan in 2004, and to provide the scientific bases for the prevention and control measures. Methods Leptospira were cultured from the serum samples of patients, and the kidney samples of mice, birds and frogs. Anti-leptospira antibodies were detected by the MAT method from the serum samples of health people, patients, mice and birds. Results There were 10 reported cases of leptospirosis in Qingyuan in 2004, with an incidence rate of 0.25/105, mortality rate of 0.03/105 and fatality rate of 10.00%. 5 Javanica serogroups leptospira were cultured from mice's kidney, with a positive rate of 5.00%. The positive rates of anti-leptospira antibody in health people before and after epidemic period were 13.27% and 4.00%, respectively. The positive rates in patients, mice and birds were 13.27%, 4.00%, 15.79%, 22.00% and 4.00%, respectively. Conclusions The positive rates of anti-leptospira antibody test in people and mice were high. People with leptospirosis were shifted to older age group. The rodent species which carried leptospira was change from vole to mouse. It was the first time that the anti-leptospira antibodies were detected in birds (duck). So surveillance of leptospirosis should be enhanced and a more comprehensive control measures should be taken to prevent and control of leptospirosis.