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目的掌握云南省不明原因发热病人钩体病的感染状况,为制定有效的预防控制措施提供科学依据。方法选择4个钩体病重疫区县,开展基本情况调查,不明原因发热病人和对照人群血清抗体水平测定,以及不明原因发热病人全血钩体分离培养等。结果 4个疫区县为年平均气温高、雨量充沛的亚热带、热带季风气候区。共检测不明原因发热病人全血/血清690份,对照人群血清400份。不明原因发热病人血清抗体阳性率2.46%、抗体几何平均滴度1:173.01,从全血中分离出钩体菌株3株,检出率0.44%,三个指标均明显高于对照人群。结论不明原因发热病人中有一定比率的人是因为感染钩体而引起的发热,并非原因不明。在钩体病流行地区的不明原因发热病人中开展钩体病筛查,有利于疾病的诊治和减少患者的病痛。做好钩体病常规疫情监测的同时,也应加强对不明原因发热病人的主动监测。
Objective To understand the infection status of leptospirosis in patients with unexplained fever in Yunnan Province and provide a scientific basis for making effective prevention and control measures. Methods Four leptospirosis-endemic counties were selected to carry out the investigation of the basic conditions, the determination of serum antibody levels in patients with fever of unknown reason and control subjects, and the isolation and culture of whole blood leptospira from patients with unexplained fever. Results The four affected counties were subtropical and tropical monsoon climate zones with high annual mean temperature and abundant rainfall. A total of 690 whole blood / serum samples of patients with unexplained fever and 400 serum samples of control subjects were detected. The positive rate of serum antibody in patients with unexplained fever was 2.46%. The geometric mean antibody titer was 1: 173.01. Three strains of leptospira were isolated from whole blood, the detection rate was 0.44%. All the three indexes were significantly higher than that of the control group. Conclusion It is not the cause of unknown fever that is caused by infection of the leptospirosis in a proportion of people with unexplained fever. Leptospirosis screening among patients with unexplained fever who are endemic to the leptospirosis endeavors to facilitate the diagnosis and treatment of the disease and reduce the patient’s pain. While doing routine monitoring of leptospirosis, we should also take the initiative to monitor patients with unexplained fever.