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目的调查瓮安县某村5例人炭疽发病原因,分析感染途径,评价疫源地消毒效果。方法通过访谈、查阅诊疗记录、采集患者炭疽痈组织液、病死家畜残余尸体及有关土壤标本作炭疽杆菌培养。用多位点可变数量串联重复序列分析技术(MLVA-8)判定菌株的遗传相似性。结果 66人接触死马,发生皮肤炭疽5例,罹患率7.58%。参与搬运+剖剐+洗切加工+食用者罹患率100%(3/3),搬运+剖剐+食用者罹患率100%(1/1),洗切加工+食用者发病1例,罹患率7.14%(1/14)。病人皮肤病灶渗出液的炭疽芽孢杆菌检出率25%(1/4);剖剐地消毒后土壤标本的炭疽芽孢杆菌检出率15.38%(4/26)。5株炭疽芽孢杆菌的遗传相似度100%。结论该疫情系村民搬运、剖剐、洗切加工病死马等方式感染而发病,健康教育和剖剐地消毒工作仍需加强。
Objective To investigate the causes of human anthrax in a village of Weng’an County, analyze the ways of infection, and evaluate the disinfection effects of the foci. Methods Through interviews, consulting medical records, collecting anthrax tissue fluid of patients, dead carcasses and related soil samples for Bacillus anthracis culture. The genetic similarity of the isolates was determined by MLVA-8 with a variable number of tandem repeats. RESULTS: Sixty-six people were exposed to dead horses. Five cases of skin anthrax occurred, with an attack rate of 7.58%. Participate in the handling + cut 剐 + washing and processing + the attack rate of 100% (3/3), handling + cut 剐 + 100% attack rate (1/1), wash processing + 1 case of edible disease, suffering from Rate of 7.14% (1/14). The detection rate of Bacillus anthracis was 25% (1/4) in the skin exudate of patients. The detection rate of Bacillus anthracis was 15.38% (4/26) in the soil samples after disinfection. The five strains of B. anthracis had a genetic similarity of 100%. Conclusion The epidemic is caused by the infection of the villagers such as transporting, dissecting and washing and processing dead and dead horses. The health education and the disinfection of dissection should still be strengthened.