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目的掌握人感染猪链球菌病疫情的流行病学特点,为制订防制对策提供科学依据。方法对广西报告的人感染猪链球菌病病例进行个案调查,采集标本进行细菌培养和基因检测,对所收集的资料进行数据录入和流行病学分析。结果病例呈散发性分布,发病时间集中在夏秋季,病例多为中老年男性,职业以农民和屠商为主,传播途径为直接接触病死猪肉及内脏,手上有伤口占76.19%。脑膜脑炎型、中毒休克型和普通型病例分别占52.38%、38.10%和9.52%。中毒休克型和脑膜脑炎型病人在克氏征阳性、皮肤瘀点瘀斑、休克和多脏器衰竭等症状体征方面有统计学差异。病死率33.33%,治愈率66.67%,后遗症发生率35.71%。平均潜伏期中位数为42小时;从发病至到县级以上医院就诊的时间间隔中位数为2天;病程在死亡病例中位数为3天、存活病例中位数为20天。结论没有发现人传人现象;直接接触病死猪肉及内脏是感染猪链球菌的重要途径,应告诫群众严禁剖杀食用病死猪;中毒休克型病例病情进展快、病程短、病死率高,脑膜脑炎型后遗症发生率高,应及早采取措施预防休克和致残。
Objective To understand the epidemiological characteristics of human infection with Streptococcus suis and provide a scientific basis for the development of control strategies. Methods A case-by-case survey of human cases of Streptococcus suis infection in Guangxi was conducted. Specimens were collected for bacterial culture and genetic testing. Data were collected and epidemiological analysis was performed on the collected data. Results The cases were distributed sporadically. The onset time was concentrated in summer and autumn. The cases were mainly middle-aged and elderly men. The main occupation were peasants and butcher shops. The route of transmission was direct contact with diseased pork and offal with 76.19% of the wounds on hand. Meningoencephalitis type, poisoning shock type and common type accounted for 52.38%, 38.10% and 9.52% respectively. Toxic shock and meningoencephalitis type patients were positive in Kirschner, skin petechia ecchymosis, shock and multiple organ failure and other symptoms and signs were statistically different. The case fatality rate was 33.33%, the cure rate was 66.67% and the sequelae rate was 35.71%. The median incubation period was 42 hours. The median time between onset and arrival at county hospitals was 2 days. The median duration of death was 3 days and the median survival time was 20 days. Conclusions No human transmission phenomenon was found. Direct contact with diseased pork and offal was an important route of infection of Streptococcus suis. It should be warned to the public that it is forbidden to kill the sick pigs. The condition of poisoning and shocking type is characterized by rapid progression, short course, high case fatality rate, meningoencephalitis Sequelae of the high incidence, should take early measures to prevent shock and disability.