He Y L, Yang H Y, Yu C X, Zhang X, Yi Q H, Ma Z L, Cha J, Xu X B, Zhang Q, Dai W J, Qian W J, Yin J, Zhu S J, Xu Z
Department of Acute Infectious Disease, Taizhou Center for Disease Prevention and Control, Taizhou 225300, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Mar 6;51(3):252-256. doi: 10.3760/cma.j.issn.0253-9624.2017.03.012.
To study the epidemiological characteristics of tsutsugamushi disease, and to confirm the existence of the disease's epidemic foci in Taizhou. From 2013 to 2014, Dongxing town hospital and Xingqiao town hospital were selected as specimen collection sites in Jingjiang city. Blood samples (5 ml) were collected from 40 patients with acute tsutsugamushi disease. A total of 59 rodents were captured with cage night method in the survey sites at 5, 7, 9, 10, and 11 months in 2013, from which, the spleen, liver, and kidney specimens were selected. Chigger mites were captured by small blackboard method and from the ears of the captured rodents. A total of 226 small blackboards were laid, 27 mites were captured, and the samples were grounded into suspension. Nested-polymerase chain reaction and cell and tissue culture techniques were used to test the specimen from the probable patients, host animals and chigger mites. Among the 40 acute tsutsugamushi disease blood samples, 29 were found to meet the test requirements, 17 were positive for orientia tsutsugamushi nucleic acid with 59% of the positive rate, and 1 stran orientia tsutsugamushi was isolated. 59 rats were captured and the density of mice was 5.5%. Among them, there were 26 Mus musculus (2.4%), 18 Rattus flavipectus (1.7%) and 15 Smelly shrew (density 1.4%). 1 Smelly shrew was tested positive for orientia tsutsugamushi nucleic acid, and the negative results were found in the other rodent specimens. 27 Chigge mites were collected by small blackboard method and the density of mites was 0.12 for each blackboard, among which 3 larvae and 24 nymphs were found. 33 Chigger mites were collected from the ears of 3 Smelly shrew, and the density of the mite was 11 per mouse. All the captured Chigger mites were identified as Leptotrombidium scutellare and 1 group of specimens of Chigger mites from the external environment were positive for orientia tsutsugamushi nucleic acid. There was a high density of mice in the epidemic area from May to November and the species of the chigger mites were Chigger mites in Taizhou. The nucleic acid of the oriental tsutsugamushi was detected in the patients with acute scrub typhus, rodents and vectors. According to the above-mentioned results, it was considered that the scrub typhus epidemic area of Taizhou city has the natural foci of scrub typhus.
为研究恙虫病的流行病学特征，证实泰州市存在该病疫源地。2013年至2014年，选取靖江市东兴镇卫生院和新桥镇卫生院作为标本采集点。采集40例急性恙虫病患者的血液样本（5毫升）。2013年5、7、9、10和11月，在调查点用鼠笼夜捕法共捕获59只啮齿动物，从中选取脾脏、肝脏和肾脏标本。用小黑板法从捕获的啮齿动物耳部采集恙螨。共放置226块小黑板，捕获27只恙螨，将样本研磨成悬液。采用巢式聚合酶链反应以及细胞和组织培养技术对疑似患者、宿主动物和恙螨的标本进行检测。40例急性恙虫病血液样本中，29份符合检测要求，17份恙虫东方体核酸阳性，阳性率为59%，分离出1株恙虫东方体。捕获59只鼠，鼠密度为5.5%。其中小家鼠26只（2.4%）、黄胸鼠18只（1.7%）、臭鼩鼱15只（密度1.4%）。1只臭鼩鼱恙虫东方体核酸检测阳性，其他啮齿动物标本检测为阴性。用小黑板法采集27只恙螨，每块黑板恙螨密度为0.12只，其中幼虫3只、若虫24只。从3只臭鼩鼱耳部采集33只恙螨，每只鼠恙螨密度为11只。所有捕获的恙螨均鉴定为地里纤恙螨，1组来自外部环境的恙螨标本恙虫东方体核酸阳性。5至11月疫区鼠密度高，恙螨种类为泰州恙螨。在急性恙虫病患者、啮齿动物和媒介中检测到恙虫东方体核酸。根据上述结果，认为泰州市恙虫病疫区存在恙虫病自然疫源地。
