摘要目的 分析山东省济南市人间布鲁杆菌病流行特征、疫情变化趋势及原因.方法 自国家疾病监测信息报告管理系统收集济南市2004-2007年人间布鲁杆菌病疫情资料;对济南市近3年曾发生布鲁杆菌病疫情的疫点内从事家畜养殖、贩卖和屠宰等职业的布鲁杆菌病高危人群,采用虎红平板凝集试验(RBPT)和试管凝集试验(SAT)进行血清学检测;对2007年确诊病例进行流行病学调查.结果 2004-2007年济南市发生布鲁杆菌病共32例,其中2007年发生15例,发病人数为2004年的3.75倍(15/4).采集高危人群血液样品共178份,血清阳性检出率为11.24%(20/178).2007年发生的病例主要集中在济南市的章丘市,占93.33%(14/15),3-9月份发病占93.33%(14/15),农民发病占93.33%(14/15),50岁以上年龄段发病占66.67%(10/15),男女发病比为2.75:1(11:4);发病具有一定的家庭聚集性,有3个家庭分别发生2或3例;全部病例均有病牛、病羊接触史;病人从发病到确诊所需时间为17～529 d,中位数为70 d.由疾病预防控制机构在监测中发现的病例占86.67%(13/15).结论 济南市布鲁杆菌病疫情呈上升趋势,章丘市是济南市布鲁杆菌病主要疫区,春夏季是济南市布鲁杆菌病的高发季节,患者以老年男性农民为主.传染源没有彻底清除,外来家畜未得到有效检疫,从业人员自我防护意识淡薄是疫情上升的主要原因.

abstractsObjective To evaluate the epidemiological characteristics of brucellosis in Jinan, Shandong Province, and to analyze epidemic trend and its cause. Methods Epidemic data of human brucellosis from 2004 to 2007 in Jinan were collected from National Disease Supervision Information Management System. The rose bengal plate agglutination test(RBPT) and standard tube agglutination test(SAT) were employed to detect brucellosis in the serum samples of high-risk exposure groups involved in livestock transaction, slaughter and raising where brucellosis had been outbreak in the last three years, and epidemiological survey was conducted on the confirmed patients in 2007. Results A total of 32 brucellosis cases occurred in 2004-2007 in Jinan, among which 15 cases in 2007, 3.75 times(15/4) of those in 2004. One hundred and seventy-eight blood samples were collected from high risk population, and positive detective rate was 11.24%(20/178). Most of the patients were found in Zhangqiu and in the months from March to September, accounting for 93.33% (14/15). Farmers accounted for 93.33% (14/15) in all cases. Sixty-six point six seven percent(10/15) of the patients were over 50 years old. Male to female was 2.75: 1(11: 4) in ratio. There was a tendency of family aggregation. Two or three cases occurred in each of 3 families. All cases had a contact history with cattle and sheep, and the diagnosis were confirmed between 17-529 days(median being 70 days), in which 86.67%(13/15) of the cases were confirmed by The Centers for Disease Control and Prevention. Conclusions Brucellosis epidemic of Jinan is in an upward trend. Zhangqiu is the main epidemic region. Spring and summer are the prevailing periods, most of the patients are old male farmers were the majority of the patients. It is believed that the epidemic is primarily due to potential infection sources, incompetent quarantine of imported livestock and poor awareness of self-protection among high-risk occupational groups.