湖南省人间布鲁氏菌病流行特征及布鲁氏菌溯源调查

刘志国; 王妙; 湛志飞; 崔步云; 李振军

Abstract

刘志国,王妙,湛志飞,崔步云,李振军.湖南省人间布鲁氏菌病流行特征及布鲁氏菌溯源调查[J].Chinese journal of Epidemiology,2019,40(9):1150-1154

湖南省人间布鲁氏菌病流行特征及布鲁氏菌溯源调查

Epidemiology of human brucellosis and source of Brucella isolates in Hunan province

Received:March 03, 2019

DOI：10.3760/cma.j.issn.0254-6450.2019.09.025

KeyWord: 布病流行病学溯源调查

English Key Word: Brucellosis Epidemiology Trace-back investigation

FundProject:国家重点研发计划（2017YFC1200303）；国家科技重大专项（2017ZX10303401，2018ZX10734401，2018ZX10734404）；内蒙古自治区自然科学基金（2018MS08004）

Author Name	Affiliation	E-mail
Liu Zhiguo	State Key Laboratory for Infectious Diseases Prevetion and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China Inner Mongolia Autonomous Region Center for Comprehensive Disease Control and Prevention, Huhhot 010031, China
Wang Miao	Ulanqab Prefectural Center for Endemic Disease Control and Prevention, Ulanqab 012000, China
Zhan Zhifei	Hunan Provincial Center for Disease Control and Prevention, Changsha 410000, China
Cui Buyun	State Key Laboratory for Infectious Diseases Prevetion and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China Engineering Technology Research Center for Brucellosis Control and Prevention of Inner Mongolia Autonomous Region, Tongliao 028000, China
Li Zhenjun	State Key Laboratory for Infectious Diseases Prevetion and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China	lizhenjun@icdc.cn

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Abstract:

目的分析2010－2018年湖南省人间布鲁氏菌病（布病）的流行特征，并追溯该地区布病的感染来源，为该地区人间布病防控提供参考。方法采用Excel 2016和ArcGIS 10.5等软件对湖南省2010－2018年人间布病监测数据进行流行病学分析，采用例数、构成比和率描述疫情特征。采用常规分型方法对临床分离的2株布鲁氏菌的种型进行鉴定，采用UTS-PCR复核种型鉴定结果，并对菌株的6个毒力基因进行检测。采用多位点可变数目串联重复序列分析（MLVA）方法对临床分离布鲁氏菌进行聚类分析。结果 2010－2018年湖南省共报告人间布病728例，年均发病率为0.12/10万，郴州市和永州市发病率居前，发病率分别为2.50/10万和1.90/10万。发病县（市、区）从2010年的5个增加到2018年的69个。45～54岁年龄组病例最多（279例），占38.32%（279/728），农民占59.07%（430/728），男女性别比为2.75 ∶ 1。5－7月报告病例最多，占45.33%（330/728），发病呈明显的夏秋季高发特征，发病高峰在5月。常规鉴定表明临床分离的2株布鲁氏菌是羊种1型布鲁氏菌，UTS-PCR鉴定显示菌株为羊种布鲁氏菌。6个毒力基因均被检出，菌株为强毒株。MLVA分析表明2株菌与来自内蒙古自治区从绵羊和骆驼分离的菌株具有完全相同的基因型。结论湖南省人间布病趋于严峻，疫情向非疫区和普通人群蔓延。湖南省分离的2株羊种布鲁氏菌起源于内蒙古地区。应加强动物转运的检疫检测，防止布病暴发流行。

English Abstract:

Objective To analyze the epidemiological characteristics of human brucellosis and trace back source of infection of human brucellosis in Hunan province during 2010-2018, and provide evidence for the prevention and control of human brucellosis. Methods The surveillance data of human brucellosis in Hunan during 2010-2018 were analyzed with software Excel 2016 and ArcGIS 10.5, the epidemic characteristics were described using cases number, constituent ratio and rate. The conventional biotype methods were used for the identification of Brucella species, UTS-PCR was applied to further confirm the results from conventional biotype detections, then six virulence genes of two clinical Brucella strains were detected by PCR assay. Cluster analysis of two Brucella strains were performed with Multiple locus variable-number tandem repeat analysis (MLVA) for the investigation of the infection source of human brucellosis. Results From 2010 to 2018, a total of 728 human brucellosis cases were reported in Hunan with the annual incidence rate of 0.12/100 000. The incidence rate was 2.50/100 000 in Chenzhou and 1.90/100 000 in Yongzhou, higher than those in other areas. The number of counties reporting cases increased from 5 in 2010 to 69 in 2018. Most cases were reported in age group 45-54 years, accounting for 38.32% (279/728). The cases in farmers accounted for 59.07% (430/728) of the total. The male to female ratio of the cases was 2.75:1. The reported case number was highest during May-July, accounting for 45.33% (330/728). The incidence was high in summer and autumn, and the peak was in May. The conventional identification showed that two strains were all Brucella melitensis biovar 1, consistent with UTS-PCR amplification results. Six virulence genes were found in two isolated strains, suggesting that the Brucella melitensis strains in this study had strong virulence. MLVA results confirmed that two strains detected in Hunan had complete identical MLVA-16 genotype with strains isolated from goat and camel in Inner Mongolia Autonomous Region, indicating that there was molecular epidemiology relationship between these strains and the source of infection were originated from Inner Mongolia. Conclusions The epidemic of human brucellosis in Hunan is becoming serious, and disease has spread to general population and non-epidemic areas. Two Brucella melitensis strains detected in Hunan were originated from Inner Mongolia. The quarantine and inspection in animal transportation should be strengthened to prevent human outbreaks of brucellosis.

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