Research On Epidemiological Characteristics And Type Of Tsutsugamushi Disease In Zhuhai

Objective: To investigate epidemiological characteristics, clinical characteristics,pathogen separation and classification of tsutsugamushi disease in Zhuhai city, and forproviding theoretical basis of clinical treatment, effective prevention, and local vaccine andrapid detection reagent preparation.Methods: A descriptive analysis on the epidemiological and clinical data was made byadopted100tsutsugamushi disease patients in Zhuhai city. Among them, sixty cases wereadopted by both Weil-Felix test and colloidal gold antibody test to investigate positive rate.Five cases were antibody positive adopted by intraperitoneal inoculation of mice withpathogen separation. Ten cases were antibody positive adopted by nPCR for DNA testing,sequencing and expansion of tsutsugamushi disease Oriental using whole bloodspecimens，and the results were analyzed in Homology-Tree.Results: As the survey results shows:1. Epidemiological characteristics: Tsutsugamushi disease mainly was sending out;The number of tsutsugamushi disease was mainly spread from April to December,primarily.summer and autumn two seasons. There was no significant difference in genders.The disease appeared in every age and stage, and the high morbidity age was from41to70years old (75%). Most sufferers were farmers (73%).2. As the results of analysis in clinical data displayed:(1)Clinical characteristics: Therewere67cases of contacting with grass and brushwood (67%),93cases of fever (93%),83cases of eschar(83%),9cases of ulcer(9%);18cases of skin rash(18%),63cases of lymphnode enlargement(63%),3cases of spleen enlargement(3%).(2)Auxiliary examination inthe laboratory:①Blood routine examination:66cases within normal reference value inwhite blood cell(66%),18cases up to normal reference value in white blood cell(18%) and16cases down to normal reference value in white blood cell(16%).②Biochemical routine examination:69cases increased in alanine aminotransferase (69%) and74cases increasedin aspartate aminotransferase (74%).③83cases increased in different levels in CRP（83%）；(3)Treatment and outcome: The100tsutsugamushi disease patients were curedby antiviral therapy with tetracycline and chloramphenicol, and the cure rate was100%.3. There existed capable difference in positive rate both adopted Weil-Felix test(10%)and Rapid Tsutsugamushi Test(81.6%),(p<0.01).4.Pathogen separation: Dissect the abdomen of the ill mice of intraperitonealinoculation, and then by Scraping fluid smear, GIMSA dying assay and Microscopedetection observes several of particles in purple circular，oval and short rod of Orientaltsutsugamushi.5. Classification results: The Homology-Tree results showed that its homology wasmore than95%as same as the type of Yonchon.Conclusion:1. Zhuhai city is the tsutsugamushi disease epidemics focus; In morbidity seasondistribution: summer and autumn two seasons primarily.2. There was Oriental tsutsugamushi in type of Yonchon in Zhuhai.3. The positive rate of antibody detection was higher, thereby it is suggested to beapplied to each laboratory of hospital as the auxiliary examination in Zhuhai.