中国寄生虫学与寄生虫病杂志 ›› 2025, Vol. 43 ›› Issue (1): 143-146.doi: 10.12140/j.issn.1000-7423.2025.01.023

• 研究简报 • 上一篇    下一篇

2022—2023年山西省高平市5例内脏利什曼病病例流行病学调查与处置

王陆儿1(), 郑玉华2, 姬春花1, 薛淑琴1,*()   

  1. 1 高平市疾病预防控制中心,山西 高平 048400
    2 山西省疾病预防控制中心,山西 太原 030012
  • 收稿日期:2024-07-08 修回日期:2024-10-10 出版日期:2025-02-28 发布日期:2025-03-26
  • 通讯作者: 薛淑琴,女,硕士,技师,从事地方病及寄生虫病防控研究。E-mail:xsqjybs@163.com
  • 作者简介:王陆儿,男,本科,副主任医师,从事传染病预防控制研究。E-mail:xsqjybs@163.com

Epidemiological investigation and disposal of 5 visceral leishmaniasis cases in Gaoping County, Shanxi Province from 2022 to 2023

WANG Lu’er1(), ZHENG Yuhua2, JI Chunhua1, XUE Shuqin1,*()   

  1. 1 Gaoping Center for Disease Control and Prevention, Gaoping 048000, Shanxi, China
    2 Shanxi Provincial Center for Disease Control and Prevention, Taiyuan 030012, Shanxi, China
  • Received:2024-07-08 Revised:2024-10-10 Online:2025-02-28 Published:2025-03-26
  • Contact: E-mail: xsqjybs@163.com

摘要: 为确认内脏利什曼病病例的感染来源,防止疫情扩散,对全民健康保障信息系统中山西省高平市2022—2023年报告的所有内脏利什曼病病例进行个案流行病学调查,在病例所在村开展宿主及媒介情况调查,采用诱蛉灯法调查白蛉密度,采用rk39免疫层析试纸条法检测犬血清抗利什曼原虫抗体。对病例所在村开展病例搜索、传染源管理、媒介处置及健康教育等疫点处置措施。结果显示,2022—2023年山西省高平市共报告5例内脏利什曼病病例,均为本地感染病例,主要症状是发热、贫血、脾肿大。5例均为成年男性,职业为工人(3例)和农民(2例),发病时间分布在全年,均居住在农村。共采集白蛉608只,平均密度为35.81只/(灯•夜);共调查家犬244只,犬利什曼原虫抗体阳性犬24只,阳性率为9.8%。5个病例所在村均存在媒介中华白蛉及感染利什曼原虫的犬只。共采集病例邻居血样25份,检测结果均为阴性;24只阳性犬全部扑杀;采用溴氰菊酯类杀虫剂对病例住房及病例村的羊圈、犬舍、破旧窑洞等建筑内外墙壁滞留喷洒约3 000 m2;在病例所在村开展内脏利什曼病防治知识健康教育讲座10次,发放内脏利什曼病防治宣传折页5 000余份。调查结果提示高平市存在内脏利什曼病的本地流行,白蛉密度和犬利什曼原虫感染率均较高。应采取犬只管理和白蛉控制措施,防止内脏利什曼病进一步扩散。

关键词: 内脏利什曼病, 病例调查, 白蛉密度, 犬感染率, 疫情调查

Abstract:

To investigate the origin of acquiring Leishmania infections and prevent the spread of visceral leishmaniasis, all cases with visceral leishmaniasis reported in Gaoping County, Shanxi Province from 2022 to 2023 which were recorded in the National Health Information System of China were subjected to case investigations, and host and vector surveys were performed in villages where visceral leishmaniasis cases lived. The sandfly density was investigated with light traps, and the serum anti-Leishmania antibody was detected in dogs with the rk39 immunochromatographic strips. In addition, foci disposal interventions were implemented in villages where the visceral leishmaniasis cases lived, including case finding, management of sources of infection, vector disposal and health education. During the period between 2022 and 2023, a total of 5 visceral leishmaniasis cases were reported in Gaoping County, Shanxi Province, and all were local cases, with main symptoms of fever, anemia and splenomegaly. The 5 cases were all adult males, and there were 3 workers and 2 farmers. The disease occurred throughout the year, and all cases lived in rural areas. A total of 608 sandflies were captured, with a mean density of 35.81 sandflies/(light•night), and a total of 244 domestic dogs were tested, with 24 dogs tested positive for anti-Leishmania antibody (9.8%). The vector Phlebotomus chinensis and dogs infected with Leishmania were detected in all villages where 5 visceral leishmaniasis cases lived. A total of 25 blood samples were collected from 5 cases’ neighbors, and all were tested negative for anti-Leishmania antibody. Foci disposal interventions included sacrificing of all 24 Leishmania-infected dogs, residual spray with deltamethrin insecticides for interior and exterior walls of visceral leishmaniasis cases’ houses and all sheep pens, dog houses and shabby cave dwellings in villages where cases lived (covering approximately 3 000 m2), 10 health education lectures pertaining to visceral leishmaniasis control knowledge and more than 5 000 poster foldouts pertaining to visceral leishmaniasis control knowledge in villages where cases lived. These findings indicate local transmission of visceral leishmaniasis in Gaoping County, with a high sandfly density and a high prevalence rate of Leishmania infections in dogs. Dog management and vector control are recommended to prevent the further spread of visceral leishmaniasis.

Key words: Visceral leishmaniasis, Case investigation, Sandfly density, Dog infection rate, Epidemic survey

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