2023 年怀俄明州犬科疾病爆发期间的钩端螺旋体病人类病例。

IF 25.4 1区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH MMWR. Morbidity and mortality weekly report Pub Date : 2024-07-11 DOI:10.15585/mmwr.mm7327a1
Brittney Waranius, Courtney Tillman, Clay Van Houten, Alexia Harrist, Rose Digianantonio, Hallie Hasel, Christine Atherstone, Emily Curren
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引用次数: 0

摘要

钩端螺旋体病是一种通过受感染动物的尿液传播的人畜共患细菌性疾病;潜伏期一般为 5-14 天。约 90% 的人类病例无症状或症状轻微,表现为发热、寒战、肌痛、恶心、呕吐、腹泻、头痛、小腿疼痛和结膜充血,但重症病例可发展为多器官功能障碍和死亡。尽管怀俄明州因其寒冷和半干旱的气候而被认为是钩端螺旋体病的低风险地区,但怀俄明州卫生部还是在 2023 年 8 月接到了一例疑似人类病例的通知,这是自 1983 年以来该州报告的首例人类病例。该患者曾在工作中接触过狗,但没有报告其他风险因素。就在人类患者发病的同一周,公共卫生部门收到了犬类钩端螺旋体病病例增加的通知。公共卫生部门进行了调查,以确定潜在的感染源、发现新增病例并提出控制措施建议。公共卫生宣传活动开展后,受影响城市的犬类疫苗接种方法发生了重大改变:疫情爆发后进行的一项调查显示,受影响城市的所有兽医诊所都更频繁地向狗主人推荐接种疫苗,狗主人对疫苗接种建议的遵从度也更高。疫苗接种覆盖率的提高为狗和接触狗的人提供了预防钩端螺旋体病的保护。对于因职业原因接触动物并出现发热、寒战、肌痛、恶心、呕吐、腹泻、头痛、小腿疼痛和结膜充血等临床症状和体征的人,无论其身处何地,在鉴别诊断时都应考虑钩端螺旋体病。
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Human Case of Leptospirosis During a Canine Disease Outbreak - Wyoming, 2023.

Leptospirosis is a zoonotic bacterial disease spread through the urine of infected animals; the typical incubation period is 5-14 days. In approximately 90% of human cases, illness is asymptomatic or mild, characterized by fever, chills, myalgia, nausea, vomiting, diarrhea, headache, calf pain, and conjunctival suffusion, but severe illness can progress to multiorgan dysfunction and death. Although Wyoming is considered a low-risk area for leptospirosis because of its cold and semiarid climate, the Wyoming Department of Health was notified of a probable human case in August 2023, the first reported in the state since 1983. The patient had occupational exposure to dogs but did not report other risk factors. The same week that the human patient's illness began, public health authorities received notification of an increase in canine leptospirosis cases. Public health authorities investigated to determine potential sources of infection, identify additional cases, and recommend control measures. After public health outreach activities were implemented, canine vaccination practices changed substantially in the affected city: a survey conducted after the outbreak revealed that all responding veterinary clinics in the affected city were recommending the vaccine more frequently to dog owners and reporting higher levels of owner compliance with vaccination recommendations. Increased vaccination coverage offers protection from leptospirosis for both dogs and persons exposed to them. Leptospirosis should be considered in the differential diagnosis of persons with occupational exposure to animals and clinically compatible signs and symptoms, including fever, chills, myalgia, nausea, vomiting, diarrhea, headache, calf pain, and conjunctival suffusion, irrespective of geographic location.

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来源期刊
MMWR. Morbidity and mortality weekly report
MMWR. Morbidity and mortality weekly report PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
65.40
自引率
0.90%
发文量
309
期刊介绍: The Morbidity and Mortality Weekly Report (MMWR ) series is prepared by the Centers for Disease Control and Prevention (CDC). Often called “the voice of CDC,” the MMWR series is the agency’s primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations. MMWR readership predominantly consists of physicians, nurses, public health practitioners, epidemiologists and other scientists, researchers, educators, and laboratorians.
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