2006-2017年江西省恙虫病流行病学分析
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摘要
目的探讨2006-2017年江西省恙虫病流行特点,为防控提供依据。方法对2006-2017年江西省恙虫病疫情资料进行分析,运用实时荧光PCR方法检测恙虫病东方体56 kD外膜蛋白基因。结果 2006-2017年江西省共报告恙虫病病例4 253例,年均报告发病率为0.79/10万,发病呈上升趋势。流行期为6-11月,占总发病数的90.22%;地区主要以赣州市和抚州市为主,占总发病数的96.59%,发病排前八位的南丰县、寻乌县、安远县、龙南县、信丰县、南康区、崇义县和宜黄县,发病率均超过3.00/10万;35～岁至75～岁年龄组病例占总发病数的90.88%,男性发病率为0.54/10万,女性为1.06/10万,农民占92.73%。检测107例病例血清标本,恙虫病东方体56 kD外膜蛋白基因阳性72例,阳性率为67.29%。从发病至诊断为恙虫病所需时间中位数为8天,以综合性医院占绝大多数(92.69%)。结论江西省恙虫病呈上升趋势,赣州市和抚州市为高发地区,夏秋季流行,以35～岁以上年龄组农民高发,发病至诊断为恙虫病时间略长,建议加强重点地区重点人群健康宣传教育,强化恙虫病的鉴别诊断。
Objective To explore the epidemic characteristics of scrub typhus in Jiangxi province from 2006 to 2017,so as to provide a basis for prevention and control.Methods The data of scrub typhus in Jiangxi province from 2006 to 2017 was analyzed.The 56 kD peripheral membrane protein gene of scrub typhus was detected by Real-time Fluorescent PCR.Results From 2006 to 2017,a total of 4 253 cases of scrub typhus were reported in Jiangxi province,with an average annual incidence of 0.79/100 000.The incidence was on the rise.The epidemic period was from June to November,accounting for 90.22% of the total cases.Ganzhou and Fuzhou were main areas,accounted for 96.59%.The top eight reported incidence counties(cities and districts)were Nanfeng County,Xunwu County,Anyuan County,Longnan County,Xinfeng County,Nankang District,Chongyi County and Yihuang County,and the incidences of above each area were all over 3.00/100 000.Cases in the 35 to 75 age group accounted for 90.88% of the total number of cases.The incidence of male cases was 0.54/100 000,and that of female cases was 1.06/100 000,and farmers accounted for 92.73%.A total of 107 serum samples were tested,and 72 cases were positive for 56 KD epigastric protein gene eastern body scrub typhus,with a positive rate of 67.29%.The median time from the onset to the diagnosis of scrub was 8 days.The majority of hospital were comprehensive hospitals(92.69%).Conclusion The incidence of scrub typhus in Jiangxi province is on the rise,and Ganzhou and Fuzhou are high-risk areas.It is prevalent in summer and autumn.The incidence of over 35 age group is high in farmers,and the time from onset to diagnosis is slightly longer.Health publicity and education for key groups in key areas should be promoted,and the differential diagnosis of scrub typhus should be strengthened.
Objective To explore the epidemic characteristics of scrub typhus in Jiangxi province from 2006 to 2017,so as to provide a basis for prevention and control.Methods The data of scrub typhus in Jiangxi province from 2006 to 2017 was analyzed.The 56 kD peripheral membrane protein gene of scrub typhus was detected by Real-time Fluorescent PCR.Results From 2006 to 2017,a total of 4 253 cases of scrub typhus were reported in Jiangxi province,with an average annual incidence of 0.79/100 000.The incidence was on the rise.The epidemic period was from June to November,accounting for 90.22% of the total cases.Ganzhou and Fuzhou were main areas,accounted for 96.59%.The top eight reported incidence counties(cities and districts)were Nanfeng County,Xunwu County,Anyuan County,Longnan County,Xinfeng County,Nankang District,Chongyi County and Yihuang County,and the incidences of above each area were all over 3.00/100 000.Cases in the 35 to 75 age group accounted for 90.88% of the total number of cases.The incidence of male cases was 0.54/100 000,and that of female cases was 1.06/100 000,and farmers accounted for 92.73%.A total of 107 serum samples were tested,and 72 cases were positive for 56 KD epigastric protein gene eastern body scrub typhus,with a positive rate of 67.29%.The median time from the onset to the diagnosis of scrub was 8 days.The majority of hospital were comprehensive hospitals(92.69%).Conclusion The incidence of scrub typhus in Jiangxi province is on the rise,and Ganzhou and Fuzhou are high-risk areas.It is prevalent in summer and autumn.The incidence of over 35 age group is high in farmers,and the time from onset to diagnosis is slightly longer.Health publicity and education for key groups in key areas should be promoted,and the differential diagnosis of scrub typhus should be strengthened.
引文
[1] 中国疾病预防控制中心.恙虫病预防控制技术指南(试行)[EB/OL].(2009-01-05)[2019-02-18].http://www.chinacdc.cn/tzgg/200901/t20090105_40316.htm.
[2] 吴光华.我国恙虫病流行病学研究现状与展望[J].中华传染病杂志,2000,18(2):69-71.
[3] 廖如桂,何似,谢党根,等.江西省恙虫病首例报告[J].中国人兽共患病杂志,1999(2):32.
[4] 吴中发,邓海智,苏子林,等.赣州市发现恙虫病5例[J].中国寄生虫学与寄生虫病杂志,2006,24(5):398-399.
[5] 余平,程慧健,魏雄杰.江西省2006-2012年恙虫病流行特征分析[J].中华疾病控制杂志,2014,18(11):1124.
[6] 张萌,王显军,赵仲堂.中国恙虫病流行态势及预防控制[J].中华流行病学杂志,2011,32(4):419-423.
[7] 李贵昌,栗冬梅,李焱,等.2006-2016年我国恙虫病流行特征分析[J].疾病监测,2018,33(2):139-143.
[8] 廖勇,李如,杨健平,等.赣州市2008-2012年恙虫病流行病学分析[J].中华疾病控制杂志,2014,18(1):86-88.
[9] 张桂娟.赣州市恙虫病分子流行病学及临床特征的研究[M].南昌大学,2016.
[10] 上官致洋,吴斐琳,严秀英,等.2011-2015年抚州市恙虫病流行特征分析[J].中华疾病控制杂志,2018,22(2):153-156.
[11] 吴中发,邓海智,朱丰秀,等.江西省赣州市恙虫病的调查研究[J].新医学,2008,39(6):390-391.
[12] 彭志强,钟豪杰,梁文佳.广东省2006-2011年恙虫病流行病学分析[J].华南预防医学,2013,39(1):51-52,55.
[13] 韩腾伟,刘菁,洪荣涛,等.福建省2010-2013年恙虫病流行特征分析[J].海峡预防医学杂志,2015,21(6):8-10.
[14] 辛化雷,李晓静,徐士林,等.2006-2015年江苏省盐城市恙虫病流行病学特征分析[J].现代预防医学,2017,44(19):3475-3478.
[15] 高丽芬,胡海梅,胡秋凌,等.2006-2014年云南省楚雄州恙虫病流行特征分析[J].现代预防医学,2016,43(2):207-210.
[16] Kelly DJ,Fuerst PA,Ching WM,et al.Scrub typhus:the geographic distribution of phenotypic and genotypic variants of orientia tsutsugamushi[J].Clinical Infectious Diseases,2009,48(3):S203-S230.
[17] 展海燕,徐贞,何义林.江苏省靖江市2011-2015年恙虫病流行特征及影响因素[J].中华疾病控制杂志,2017,21(11):1119-1122.
[18] 韩雪玲,景莉,张莹,等.我国恙虫病临床流行病学研究进展[J].现代医学,2018,46(3):340-345.
[2] 吴光华.我国恙虫病流行病学研究现状与展望[J].中华传染病杂志,2000,18(2):69-71.
[3] 廖如桂,何似,谢党根,等.江西省恙虫病首例报告[J].中国人兽共患病杂志,1999(2):32.
[4] 吴中发,邓海智,苏子林,等.赣州市发现恙虫病5例[J].中国寄生虫学与寄生虫病杂志,2006,24(5):398-399.
[5] 余平,程慧健,魏雄杰.江西省2006-2012年恙虫病流行特征分析[J].中华疾病控制杂志,2014,18(11):1124.
[6] 张萌,王显军,赵仲堂.中国恙虫病流行态势及预防控制[J].中华流行病学杂志,2011,32(4):419-423.
[7] 李贵昌,栗冬梅,李焱,等.2006-2016年我国恙虫病流行特征分析[J].疾病监测,2018,33(2):139-143.
[8] 廖勇,李如,杨健平,等.赣州市2008-2012年恙虫病流行病学分析[J].中华疾病控制杂志,2014,18(1):86-88.
[9] 张桂娟.赣州市恙虫病分子流行病学及临床特征的研究[M].南昌大学,2016.
[10] 上官致洋,吴斐琳,严秀英,等.2011-2015年抚州市恙虫病流行特征分析[J].中华疾病控制杂志,2018,22(2):153-156.
[11] 吴中发,邓海智,朱丰秀,等.江西省赣州市恙虫病的调查研究[J].新医学,2008,39(6):390-391.
[12] 彭志强,钟豪杰,梁文佳.广东省2006-2011年恙虫病流行病学分析[J].华南预防医学,2013,39(1):51-52,55.
[13] 韩腾伟,刘菁,洪荣涛,等.福建省2010-2013年恙虫病流行特征分析[J].海峡预防医学杂志,2015,21(6):8-10.
[14] 辛化雷,李晓静,徐士林,等.2006-2015年江苏省盐城市恙虫病流行病学特征分析[J].现代预防医学,2017,44(19):3475-3478.
[15] 高丽芬,胡海梅,胡秋凌,等.2006-2014年云南省楚雄州恙虫病流行特征分析[J].现代预防医学,2016,43(2):207-210.
[16] Kelly DJ,Fuerst PA,Ching WM,et al.Scrub typhus:the geographic distribution of phenotypic and genotypic variants of orientia tsutsugamushi[J].Clinical Infectious Diseases,2009,48(3):S203-S230.
[17] 展海燕,徐贞,何义林.江苏省靖江市2011-2015年恙虫病流行特征及影响因素[J].中华疾病控制杂志,2017,21(11):1119-1122.
[18] 韩雪玲,景莉,张莹,等.我国恙虫病临床流行病学研究进展[J].现代医学,2018,46(3):340-345.