目的通过山东省沂源县人粒细胞无形体及其他立克次体病疫源地小样本试点调查,为全面深入开展立克次体病调查提供数据支持。方法对2004、2005、2006年该地区调查收集的26例可疑患者标本进行血清IgG抗体及PCR回顾性检测分析。2007年7月进一步现场流行病学调查,采集当地48名正常人、10只山羊及8只家狗的血标本以及170只蜱标本进行血清学及分子生物学检测分析。结果26例发热患者中,8例明确诊断为人粒细胞无形体感染,6例为可疑病例。当地正常人群人粒细胞无形体IgG抗体阳性率为26.7%,人单核细胞埃立克体IgG抗体阳性率为1.8%。检测的10份家养黑山羊血清标本9份阳性。8份家狗标本中,人粒细胞无形体抗体7份阳性,而人单核细胞埃立克体血清抗体全部阳性。来自发热患者、山羊及媒介蜱标本PCR扩增16S rRNA及部分序列分析结果显示高度同源性(100%)。结论沂源县农业人群普遍存在人粒细胞无形体、人单核细胞埃立克体及其他立克次体隐性感染状况。当地主要优势蜱种为长角血蜱及嗜群血蜱,两者可能是人粒细胞无形体的重要传播媒介。黑山羊可能是人粒细胞无形体的重要动物宿主,而家狗可能是人粒细胞无形体及人单核细胞埃立克体两者兼顾的重要动物宿主。
Objective To investigate infectious situation of Anaplasma phagocytophilum and other Rickettsia in Yiyuan county, Shandong province and provide data for national investigation of rickettsiosis. Methods Indirect immunofluorescence assay (IFA) for IgG antibody and PCR amplification were used to detecte and analyze the 26 blood samples of suspected febrile patients collected from 2004 to 2006. Serologic and molecular detection were made in blood samples of 48 healthy persons, 10 goats, 8 dogs and 170 ticks collected in the same areas in July 2007. Results Of 26 febrile patients, 8 were confirmed to be infected with A naplasma phagocytophilum and 6 were suspected cases. Of healthy persons, the positive rate of anti-Anaplasma phagocytophilum IgG antibody was 26.7% and that of anti- Ehrlichia chaffeensis IgG antibody was 1.8%. Anti-A naplasma phagocytophilum IgG antibody was detected in 9 goats and 7 dogs, and anti-Ehrlichia chaffeensis IgG antibody was detected in 8 dogs. PCR amplification of 16S rRNA gene and sequence analysis showed that sequencesoffebrilepatients, goatsandtickshad 100% of homology. Conclusions Infection with Anaplasma phagocytophilum and Ehrlichia chaffeensis are very common in agricultural population in Yiyuan county. It is suggested that hoemaphysdis longicornis and haemaphysalis concinna are vectors, black goats the main hosts of A naplas ma phagocytophilum, and dogs the hosts of both A naplasma phagocytophilum and Ehrlichia chaffeensis.