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目的分析四川省近年钩端螺旋体病高发因素,为采取针对性干预措施提供依据。方法选取近年报告钩端螺旋体病最多的四川省仪陇县作为调查县。对仪陇县2009-2012年4年中报告的临床诊断病例或实验室诊断病例进行回顾性病例对照调查研究,收集病例暴露危险行为和环境危险因素。结果病例143例,对照129例。病例调查率为60%,病例发病时间越久,调查率越低。收割水稻时田中有水、发病前1个月接触到动物粪便、发病前15 d手或脚有伤口为病例发病危险因素,接种钩体疫苗为保护因素。结论仪陇县钩端螺旋体病高发与病例居住环境、田间劳作环境及病例在钩端螺旋体流行季节的个人行为有关,注射2针钩端螺旋体疫苗可有效预防钩体病。
Objective To analyze the high incidence of leptospirosis in Sichuan Province in recent years and provide the basis for the targeted interventions. Methods In recent years, the most reported leptospirosis in Yilong County of Sichuan Province as a survey county. A retrospective case-control study was conducted on the cases of clinical diagnosis or laboratory diagnosis reported in Yilong County during the four-year period from 2009 to 2012 and the risk behaviors of exposure and environmental risk were collected. The results of 143 cases, control 129 cases. The case-finding rate was 60%. The longer the case was onset, the lower the investigation rate. There was water in the fields when rice was harvested, and animal excrement was exposed to the animals one month before the onset of the disease. Wounds on the hands or feet were the risk factors for the cases 15 days before the onset of infection. Vaccination with leptospira vaccine was the protective factor. Conclusion The high incidence of leptospirosis in Yilong County is related to the living environment, working environment in the field and the individual behavior of the cases in the season of Leptospira. Injection of 2-dose Leptospira vaccine can effectively prevent leptospirosis.