北京市平谷区208例恙虫病流行特征及临床症状分析

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目的分析2010-2013年北京市平谷区恙虫病流行特征和病例临床特点,为调整防控措施提供依据。方法通过中国疾病监测信息报告管理系统获取病例资料数据,由北京市疾病预防控制中心进行恙虫病东方体核酸检测,由平谷区疾病预防控制中心进行病例个案调查,应用描述流行病学的方法进行统计分析。结果平谷区恙虫病流行于秋收季节,属于秋冬型,多以田间作业农民发病为主,东方体核酸检测均为Kawasaki型。208例病例中,男女比例为1.06∶1,年龄17~87岁,平均年龄(54.93±12.83)岁,发病职业以农民(77.88%,162/208)为主,发病集中在每年10月份。61.54%(128/208)的病例有田间作业史,田间作业地点主要以玉米地(57.03%,73/128)及果园(28.13%,36/128)为主。临床表现以发热(95.67%,199/208)、皮疹(74.04%,154/208)为主,56.73%(118/208)出现特异性焦痂或溃疡。结论针对40岁以上从事田间作业的农民,在秋收季节进行恙虫病知识的宣教;应加强恙虫病临床特点的研究,总结出适合平谷区恙虫病的诊断标准,降低误诊率,为北京市恙虫病诊断及防控提供依据。 Objective To analyze the epidemiological features of tsutsugamushi disease in Pinggu District of Beijing from 2010 to 2013 and the clinical features of the cases so as to provide basis for the adjustment of prevention and control measures. Methods The data of case data were obtained through China Disease Surveillance Information Reporting Management System. The nucleic acid of Orientia tsutsugamushi was detected by Beijing Center for Disease Control and Prevention. The case was investigated by Pinggu District Center for Disease Control and Prevention, and the epidemiological method was used for statistics analysis. Results The epidemic of tsutsugamushi in Pinggu was in fall and autumn, belonging to the autumn and winter type. Most of the cases were mainly farmland farmers, and the Kawasaki type nucleic acids were detected in oriental plants. Among 208 cases, the male-female ratio was 1.06:1, with a mean age of (54.93 ± 12.83) years old ranging from 17 to 87 years. The incidence of occupational diseases was mainly peasant (77.88%, 162/208), and the incidence was concentrated in October of each year. 61.54% (128/208) of the cases had field work history. The main field operations were cornfields (57.03%, 73/128) and orchards (28.13%, 36/128). The clinical manifestations were fever (95.67%, 199/208), skin rashes (74.04%, 154/208) and 56.73% (118/208) with specific eschar or ulcer. Conclusions Aiming at the peasants who are engaged in field work over the age of 40, they carry out the missionary education of scrub typhus in the autumn harvest season. The clinical characteristics of scrub typhus should be strengthened, the diagnostic criteria for scrub typhus should be summarized, the rate of misdiagnosis should be reduced, Diagnosis and prevention provide the basis.
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