扑灭钩端螺旋体病：对澳大利亚悉尼一例与社会经济劣势相关的暴露性城市病例的调查

摘要(中文译文)

传统上，钩端螺旋体病在澳大利亚的报道多与旅行或职业暴露相关，而在城市环境中，该病是一种与社会经济地位较低相关的疾病，其大鼠暴露风险与居住条件成反比。尽管世界其他地区对此已有广泛报道，但在澳大利亚，城市获得性钩端螺旋体病病例较为罕见。本文报告了2003至2024年间澳大利亚悉尼第五例本地获得性病例。该病例与其社会住房街区严重的鼠患同时发生。随后开展了环境健康联合调查，参与方包括公共卫生部门和第一产业与区域发展部的人员。在病例住所1.5公里半径范围内捕获的12只大鼠均接受了钩端螺旋体病聚合酶链反应检测，结果均为阴性。这促使研究者考虑其他潜在宿主，包括本地物种。该病例揭示了悉尼大都市区持续存在的社会不平等及其对健康的影响。

Abstract

Classically reported in Australia in association with travel or occupational exposures, leptospirosis in the urban setting is a disease of lower socioeconomic status with the risk of rat exposure inversely proportional to conditions of living. Whilst this has been widely reported elsewhere in the world, urban-acquired cases of leptospirosis are rare in Australia. Here we report on the fifth locally acquired case in Sydney, Australia, during the period 2003-2024. This case coincided with a severe rat infestation in the case's social housing block. A collaborative environmental health investigation followed, involving members of the Public Health Unit and Department of Primary Industries and Regional Development. Twelve rats captured within a 1.5 km radius of the case's residence underwent polymerase chain reaction testing for leptospirosis and were all negative. This prompted consideration of other potential reservoirs, including native species. This case demonstrates persisting social inequities in metropolitan Sydney, and the consequences for health.

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