Liu Y, Li S J, Yao G H, Huang H, Ma Q, Zhou J Z, Tang G P, Wang D M
Institute for Communicable Disease Control and Prevention, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Mar 6;51(3):243-247. doi: 10.3760/cma.j.issn.0253-9624.2017.03.010.
To conduct an epidemiological investigation of two leptospirosis death cases reported in Guizhou Province in 2014. The information of the patients were investigated and analyzed. The serological detection, samples of the two patients was detected using ELISA and microscopic agglutination test (MAT). carrier status of murine host animal in the living environment of the two patients was investigated in October and November of 2014. in the kidney were cultured and isolated, the isolates were identified using specific PCR and further identified with serogroup specific PCR and the conventional MAT. The relativity between the carrier status of murine and the death cases of human leptospirosis was analyzed. The two death cases of human leptospirosis came from Liping County and the clinical symptoms were consistent with the diagnosis criteria for Leptospirosis. The results of ELISA detection showed that the anti- antibody was positive for one of the death cases, MAT identified the serum reacted with sera-group icterohaemorrhagiae , while the serum sample of the other case was failed to perform antibody detection due to hemolysis. 1 600 traps were placed in the living environment of the two death cases and 183 murine rodents were trapped. The murine density was 11.44% (183/1 600); 40 suspected strains were isolated and all of them were isolated from Apodemus agrarius. The positive rate was 21.86% (40/183); 95 Apodemus agrarius were trapped and the murine density was 5.93% (95/1 600). Species specific PCR identified all the 40 strains as . Serogroup specific PCR further identification showed that they were iterohaemorrahgiae serogroup . interrogans. Anti-iterohaemorrahgiae antibody was detected from one of the two patients. 40 strains of iterohaemorrahgiae serogroup interrogans were isolated and all of them were isolated from Apodemus agrarius in the living environment and the serogroup of the matched with the serological detection results from patients, which indicated that the two death cases were caused by the infection of iterohaemorrahgiae serogroup interrogans, and Apodemus agrarius were the potential source of infection.
对2014年贵州省报告的2例钩端螺旋体病死亡病例进行流行病学调查。对患者信息进行调查分析。采用酶联免疫吸附试验(ELISA)和显微镜凝集试验(MAT)对2例患者血清样本进行血清学检测。于2014年10月和11月对2例患者生活环境中的鼠类宿主动物带菌状况进行调查。对肾脏进行培养分离,采用特异性PCR进行鉴定,再用血清群特异性PCR和传统MAT进一步鉴定。分析鼠类带菌状况与人类钩端螺旋体病死亡病例之间的相关性。2例人类钩端螺旋体病死亡病例均来自黎平县,临床症状符合钩端螺旋体病诊断标准。ELISA检测结果显示,1例死亡病例抗抗体呈阳性,MAT鉴定血清与出血性黄疸型血清群发生反应,而另1例病例血清样本因溶血未能进行抗体检测。在2例死亡病例生活环境中布放1600个鼠夹,捕获鼠类183只,鼠密度为11.44%(183/1600);分离出可疑菌株40株,均分离自黑线姬鼠,阳性率为21.86%(40/183);捕获黑线姬鼠95只,鼠密度为5.93%(95/1600)。种特异性PCR鉴定40株菌株均为问号钩端螺旋体。血清群特异性PCR进一步鉴定显示均为出血性黄疸型血清群问号钩端螺旋体。2例患者中1例检测到抗出血性黄疸型抗体。从生活环境中的黑线姬鼠分离出40株出血性黄疸型血清群问号钩端螺旋体,血清群与患者血清学检测结果相符,表明2例死亡病例系由出血性黄疸型血清群问号钩端螺旋体感染所致,黑线姬鼠为潜在传染源。