浙江省杭州市富阳区16例鹦鹉热病例流行病学及临床特征

Epidemiological and clinical characteristics of 16 cases of psittacosis in Fuyang District of Hangzhou, Zhejiang Province

  • 摘要:
    目的 了解浙江省杭州市富阳区鹦鹉热病例的流行病学及临床特征,为该病的临床诊疗和防控提供参考依据。
    方法 收集2020年 9月—2025年2月现住址在杭州市富阳区的鹦鹉热病例的流行病学调查和临床资料,采用描述性流行病学方法分析三间分布特征、暴露史、临床表现、诊疗及实验室检测结果,并结合外环境监测和病例随访情况进行综合分析。
    结果 16例病例的男女性别比为1∶1,男性和女性发病率均为0.57/10万,平均年龄为(59.88±10.66)岁,70~岁和60~岁人群发病率最高,分别为1.41/10万和1.30/10万,14例有禽鸟暴露史(87.50%)。病例的临床症状以发热(15例,93.75%)、咳嗽(11例,68.75%)、咳痰(9例,56.25%)、畏寒(8例,50.00%)等为主。所有病例的C反应蛋白(CRP)均明显升高,胸部计算机体层成像(CT)检查均提示肺炎。87.50%(14/16)的病例中性粒细胞百分比升高,93.75%(15/16)的病例淋巴细胞百分比减少。病例发病到就诊的中位数间隔时间为4.00 d,发病到诊断的中位数间隔时间为9.50 d,住院时间中位数为9.00 d。重症组中性粒细胞百分比、CRP、发病到诊断间隔天数、发病到用药间隔天数和住院天数均高于非重症组。全部病例经治疗后均好转出院,超过50%的病例确诊后接受奥马环素治疗。
    结论 杭州市富阳区鹦鹉热病例多有明确的禽鸟接触史,早诊早治是预防重症的有效手段。

     

    Abstract:
    Objective To investigate the epidemiological and clinical characteristics of psittacosis cases in Fuyang District of Hangzhou, Zhejiang Province, and to provide evidence for clinical diagnosis, treatment, and prevention and control of this disease.
    Methods Epidemiological investigation data and clinical records of psittacosis cases residing in Fuyang District of Hangzhou from September 2020 to February 2025 were collected. Descriptive epidemiological methods were applied to analyze temporal-spatial-demographic distribution characteristics, exposure history, clinical manifestations, diagnosis, treatment and laboratory findings. Comprehensive analyses were further conducted incorporating environmental surveillance and case follow-up data.
    Results Among the 16 psittacosis cases, the male-to-female ratio was 1∶1, with an incidence rate of 0.57/100 000 for both males and females. The mean age was (59.88±10.66) years old, and the highest incidence rates were in the 70‒79 years and 60‒69 years age groups, with an incidence rate of 1.41/100 000 and 1.30/100 000, respectively. Fourteen cases (87.50%) had a history of avian exposure. The predominant clinical symptoms included fever (15 cases, 93.75%), cough (11 cases, 68.75%), expectoration (9 cases, 56.25%), and fear of cold (8 cases, 50.00%). All cases showed elevated levels of C-reactive protein (CRP), and the results of chest computed tomography (CT) indicated pneumonia in every case. Neutrophil percentage was elevated in 87.50% (14/16) of cases, while lymphocyte percentage was reduced in 93.75% (15/16) of cases. The median time from onset to first medical consultation was 4.00 days, the median time from onset to confirmed diagnosis was 9.50 days, and the median time of hospitalization was 9.00 days. Compared with non-severe cases, the severe group had significantly higher neutrophil percentage, CRP levels, and longer intervals from onset to confirmed diagnosis, onset to first antibiotic administration, and duration of hospitalization. All cases recovered and were discharged, and more than 50% were treated with omadacycline following confirmed diagnosis.
    Conclusion Most psittacosis cases reported definitive avian exposure history in Fuyang District of Hangzhou. Early diagnosis and treatment are critical for preventing disease progression to severe stages.

     

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