Liu R Y, Zeng Y X, Yang C H, Wang L P
Department of Public Health Information, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China.
Institute for Acute Communicable Disease Control and Prevention, Sichuan Provincial Center for Disease Control and Prevention, Chengdu 610041, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 May 10;41(5):695-699. doi: 10.3760/cma.j.cn112338-20190703-00491.
To explore the epidemiological characteristics of leptospirosis in Sichuan province from 2004 to 2018, and provide evidence for the prevention and control of leptospirosis. The descriptive epidemiology analysis was conducted based on the epidemic data of leptospirosis collected from the national notifiable infectious disease reporting information system (NNIDRIS) and sentinel surveillance system in 11 areas in Sichuan from 2004 to 2018. The ArcGIS 10.2 software was used for mapping. The SaTScan 9.1.1 software was used to analyze spatiotemporal scanning and characteristics of temporal-spatial clusters of leptospirosis. A total of 2 834 cases of leptospirosis, including 41 deaths, were reported in Sichuan from 2004 to 2018, and the reported morbidity rate was 0.23/100 000 and the mortality rate was 0.003/100 000. It revealed that leptospirosis had an overall downward fluctuated trend. The incidence of leptospirosis had obvious seasonality, mainly from the last ten-day of August to the end of September, 1-2 weeks later after rice harvesting time. The reported cases were mainly males, the male to female ratio of the cases was 2.05∶1. The incidence was higher in age group 50-65 years. The majority of reported cases were farmers, accounting for 82.75% (2 345/2 834), followed by students, accounting for 12.74% (361/2 834). However, rare cases in students had been reported since 2011. In recent years, the high-incidence areas were alternating between Mabian, Muchuan counties along the Yangtze River and Yilong county located in the Jialing River basin. According to the spatial-temporal descriptive analyses by SaTScan, there were two clustering areas in the province where most cases occurred (<0.001). The average density of field rats in 11 sentinel surveillance areas was 5.44%(14 351/263 767), and the predominant field rats included (69.07%), (12.73%). Whatmore, the density of the ranged from 4.60% to 0.19%, showing downward trend with the lowest level in 2018. The annual culture rate of from rat kidney samples declined. During 2007-2018, the average positive rate of antibodies in healthy people was 24.52%(3 271/13 339), and the predominant serogroup was Icterohaemorrhagiae. There was no replacement of serogroup in recent years. The incidence of leptospirosis in Sichuan was extremely low during 2004-2018, and the incidence peak of leptospirosis occurred in rice harvesting period. The cases were mainly old farmers, and the high-risk areas were constantly alternating between the Yangtzi River and the Jialing River basin. Both the density and the carriage rate of of were low, and the predominant serogroup was Icterohaemorrhagiae. The average positive rate of leptospira antibodies in healthy people was very low.
为探讨2004 - 2018年四川省钩端螺旋体病的流行病学特征，为钩端螺旋体病的防控提供依据。基于2004 - 2018年从国家法定传染病报告信息系统（NNIDRIS）及四川省11个地区的哨点监测系统收集的钩端螺旋体病疫情数据进行描述性流行病学分析。采用ArcGIS 10.2软件绘制地图，运用SaTScan 9.1.1软件分析钩端螺旋体病的时空扫描及时空聚集特征。2004 - 2018年四川省共报告钩端螺旋体病病例2834例，其中死亡41例，报告发病率为0.23/10万，死亡率为0.003/10万。结果显示钩端螺旋体病总体呈下降波动趋势。钩端螺旋体病发病具有明显季节性，主要集中在8月下旬至9月底，即水稻收割后1 - 2周。报告病例以男性为主，病例男女比为2.05∶1。50 - 65岁年龄组发病率较高。报告病例中大部分为农民，占82.75%（2345/2834），其次为学生，占12.74%（361/2834）。但自2011年以来学生中罕见病例报告。近年来，高发区在长江沿线的马边、沐川县与嘉陵江流域的仪陇县之间交替。根据SaTScan的时空描述分析，该省存在两个病例聚集区（<0.001）。11个哨点监测地区的野鼠平均密度为5.44%（14351/263767），优势鼠种包括（69.07%）、（12.73%）。此外，的密度在4.60%至0.19%之间，呈下降趋势，2018年处于最低水平。鼠肾样本的年培养率下降。2007 - 2018年，健康人群钩体抗体平均阳性率为24.52%（3271/13339），优势血清群为出血性黄疸型。近年来血清群无更替。2004 - 2018年四川省钩端螺旋体病发病率极低，发病高峰出现在水稻收割期。病例主要为老年农民，高危地区在长江和嘉陵江流域之间不断交替。野鼠的密度和带菌率均较低，优势血清群为出血性黄疸型。健康人群钩端螺旋体抗体平均阳性率很低。
