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2023 年怀俄明州一起犬病暴发期间发生的人类钩端螺旋体病病例。

Human Case of Leptospirosis During a Canine Disease Outbreak - Wyoming, 2023.

出版信息

MMWR Morb Mortal Wkly Rep. 2024 Jul 11;73(27):602-606. doi: 10.15585/mmwr.mm7327a1.

Abstract

Leptospirosis is a zoonotic bacterial disease spread through the urine of infected animals; the typical incubation period is 5-14 days. In approximately 90% of human cases, illness is asymptomatic or mild, characterized by fever, chills, myalgia, nausea, vomiting, diarrhea, headache, calf pain, and conjunctival suffusion, but severe illness can progress to multiorgan dysfunction and death. Although Wyoming is considered a low-risk area for leptospirosis because of its cold and semiarid climate, the Wyoming Department of Health was notified of a probable human case in August 2023, the first reported in the state since 1983. The patient had occupational exposure to dogs but did not report other risk factors. The same week that the human patient's illness began, public health authorities received notification of an increase in canine leptospirosis cases. Public health authorities investigated to determine potential sources of infection, identify additional cases, and recommend control measures. After public health outreach activities were implemented, canine vaccination practices changed substantially in the affected city: a survey conducted after the outbreak revealed that all responding veterinary clinics in the affected city were recommending the vaccine more frequently to dog owners and reporting higher levels of owner compliance with vaccination recommendations. Increased vaccination coverage offers protection from leptospirosis for both dogs and persons exposed to them. Leptospirosis should be considered in the differential diagnosis of persons with occupational exposure to animals and clinically compatible signs and symptoms, including fever, chills, myalgia, nausea, vomiting, diarrhea, headache, calf pain, and conjunctival suffusion, irrespective of geographic location.

摘要

钩端螺旋体病是一种由感染动物尿液传播的人畜共患细菌性疾病;典型的潜伏期为 5-14 天。在大约 90%的人类病例中,疾病是无症状或轻度的,表现为发热、寒战、肌痛、恶心、呕吐、腹泻、头痛、小腿疼痛和结膜充血,但严重疾病可进展为多器官功能障碍和死亡。尽管怀俄明州因其寒冷和半干旱气候被认为是钩端螺旋体病的低风险地区,但怀俄明州卫生部门在 2023 年 8 月接到了一起可能的人类病例报告,这是自 1983 年以来该州首次报告。该患者有职业性接触狗的情况,但没有报告其他危险因素。在人类患者发病的同一周,公共卫生部门接到通知称,犬类钩端螺旋体病病例有所增加。公共卫生部门进行了调查,以确定潜在的感染源,识别其他病例,并建议控制措施。在实施公共卫生宣传活动后,受影响城市的犬类疫苗接种情况发生了重大变化:疫情爆发后进行的一项调查显示,受影响城市的所有回应兽医诊所都更频繁地向狗主人推荐疫苗,并报告狗主人对疫苗接种建议的遵守程度更高。增加疫苗接种覆盖率为接触动物的人和狗提供了针对钩端螺旋体病的保护。无论地理位置如何,对于有职业性接触动物和临床表现与钩端螺旋体病相符的人(包括发热、寒战、肌痛、恶心、呕吐、腹泻、头痛、小腿疼痛和结膜充血),都应考虑钩端螺旋体病作为鉴别诊断。

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