Gray Erana, Atatoa-Carr Polly, Bell Anita, Roberts Sally, Al Mudallal Daud, Mills Graham D
Dept of Medicine, Rotorua Hospital, Private Bag 3023, Rotorua 3046.
N Z Med J. 2007 Aug 10;120(1259):U2661.
To characterise and investigate patients diagnosed with murine typhus in the Waikato District Health Board (DHB) region during 2006.
We reviewed the hospital and general practitioner records of all patients presenting with clinical and serological evidence of murine typhus. All patients were interviewed by telephone using a semi-structured questionnaire to identify environmental risk factors for infection. A limited, retrospective serosurvey was undertaken and surveillance was enhanced.
12 patients were identified, all had either lived, or spent considerable time, in rural areas; 7 patients had seen rats on their properties 'regularly' and 3 remembered fleabites within the incubation period of the illness. The classic triad of symptoms is fever, headache, and rash--these symptoms were seen in 12, 11, and 8 patients respectively; lethargy, myalgias, nausea, and vomiting were also common. 11 patients had abnormal liver function tests at presentation, and 7 had low platelets. Treatment with doxycycline was associated with a shorter hospital stay.
Murine typhus has now been confirmed in rural areas throughout the Waikato DHB region. Rats are likely associated with disease in rural communities and rat control is a complex issue. However, a greater awareness of the disease should lead to earlier diagnosis and treatment.
对2006年怀卡托地区卫生局（DHB）区域内被诊断为地方性斑疹伤寒的患者进行特征描述和调查。
我们查阅了所有出现地方性斑疹伤寒临床和血清学证据的患者的医院及全科医生记录。通过电话使用半结构化问卷对所有患者进行访谈，以确定感染的环境风险因素。进行了一项有限的回顾性血清学调查并加强了监测。
共确定了12名患者，他们均居住在农村地区或在农村地区度过了相当长的时间；7名患者“经常”在其住所看到老鼠，3名患者记得在疾病潜伏期内被跳蚤叮咬过。典型的三联征症状为发热、头痛和皮疹——分别有12、11和8名患者出现这些症状；嗜睡、肌痛、恶心和呕吐也很常见。11名患者就诊时肝功能检查异常，7名患者血小板计数低。使用强力霉素治疗可缩短住院时间。
现已在整个怀卡托DHB区域的农村地区确诊了地方性斑疹伤寒。老鼠可能与农村社区的疾病有关，灭鼠是一个复杂的问题。然而，对该疾病的更多认识应能导致更早的诊断和治疗。
