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目的了解襄阳市首例布鲁氏菌病病例的流行病学特点,找出发病的原因,为制订有效的防控措施提供依据。方法采用描述性流行病学方法对患者发病、就诊经过及现场流行病学调查结果进行分析。结果患者于2012年7月30日出现右肩关节疼痛,8月18日开始发热(体温37.7~38.2℃),9月11—17日,出现左腿腓肠肌疼痛症状,10月7日患者出现高热(40℃),左踝关节疼痛,双侧颈部、腋窝、腹股沟部淋巴结肿痛;期间多次到医院诊治,疼痛及发热症状无明显好转。患者于2012年5月从随州市某养殖户处购买的16只成羊中有5只母羊出现流产和死胎现象,患者经常未采取任何防护措施接生羊羔或拽出死胎盘。7月20日患者在右手有刀伤情况下直接将流产胎盘拽出,伤口接触胎盘羊水。据调查该养殖户于2011年7月曾发生畜间布病疫情。患者血液样本经检测,虎红平板试验阳性,试管凝集试验滴度为1∶400(++)。3名密切接触者血液样本经检测,虎红平板试验阴性,试管凝集试验滴度(-)。采集羊群血液样本95份,检出阳性14份,阳性率为14.74%。结论根据流行病学调查、临床表现、实验室检测结果,该病例为输入性传染源引发的布病病例。今后应加强畜牧检验检疫监管,从源头上控制布鲁氏菌病传染源的输入。
Objective To understand the epidemiological characteristics of the first case of brucellosis in Xiangyang and to find out the causes of the disease and provide evidence for effective prevention and control measures. Methods The descriptive epidemiological method was used to analyze the incidence of patients, treatment visits and field epidemiological findings. Results The patient developed right shoulder pain on July 30, 2012, and fever started on August 18 (body temperature 37.7 to 38.2 ° C). On September 11-17, he developed gastrocnemius pain in the left leg. On October 7, he developed fever (40 ℃), left ankle pain, bilateral neck, armpit, groin lymph node swelling; during the many hospital diagnosis and treatment, pain and fever symptoms no significant improvement. In May 2012, five of the 16 adult sheep purchased from a farmer in Suizhou suffered from miscarriage and stillbirth, and the patient often failed to take any precaution to deliver the lamb or to remove the dead placenta. On July 20, the patient pulled the aborted placenta directly out of the right hand with a wound and the wound touched the placental amniotic fluid. According to the survey, the breed of brucellosis occurred in July 2011. Patient blood samples were tested, tiger red plate test positive, test tube agglutination test titer of 1: 400 (++). Blood samples from 3 close contacts were tested, tiger red plate test negative, and tube agglutination test titers (-). A total of 95 blood samples were collected from flocks, 14 were positive, the positive rate was 14.74%. Conclusion According to epidemiological survey, clinical manifestations, laboratory test results, the case was caused by imported sources of brucellosis cases. In the future, supervision and inspection of livestock husbandry and quarantine should be strengthened to control the source of brucellosis from the source.