感染偶尔发生,也可能暴发。暴发更经常发生在鸭类或禽类养殖场以及屠宰场和加工厂的工人身上。[6]Harkinezhad T, Geens T, Vanrompay D. Chlamydia psittaci infections in birds: a review with emphasis on zoonotic consequences. Vet Microbiol. 2009 Mar 16;135(1-2):68-77.http://www.ncbi.nlm.nih.gov/pubmed/19054633?tool=bestpractice.com[7]Gaede W, Reckling KF, Dresenkamp B, et al. Chlamydia psittaci infections in humans during an outbreak of psittacosis from poultry in Germany. Zoonoses Public Health. 2008 May;55(4):184-8.http://www.ncbi.nlm.nih.gov/pubmed/18387139?tool=bestpractice.com
英格兰和威尔士每年确诊 25-50 例病例。[8]Public Health England. Guidance: psittacosis. December 2017 [internet publication].https://www.gov.uk/guidance/psittacosis 自 2010 年以来,美国每年报告的确诊病例通常不到 10 例,2017 年报告了 5 例。[9]Centers for Disease Control and Prevention. National notifiable infectious diseases: weekly tables. 2018 [internet publication].https://www.cdc.gov/nndss/infectious-tables.html据报道,2018 年 8 月至 10 月期间,弗吉尼亚州和乔治亚州的两家家禽屠宰厂内暴发了疫情(13 例确诊病例)。[10]Centers for Disease Control and Prevention. Multistate psittacosis outbreak among poultry plant workers, 2018. October 2018 [internet publication].https://www.cdc.gov/pneumonia/atypical/psittacosis/surveillance-reporting/outbreaks/2018-poultry-multistate-investigation.html
英格兰、威尔士、瑞典和美国的患病率有所增加,病因是将珍奇鸟类作为宠物饲养,但是全球尚未开展流行病学研究。一项 Meta 分析发现,大约 1% 的社区获得性肺炎病例是由鹦鹉热衣原体引起的,该比率波动于 0% 至 6.7% 之间。[11]Hogerwerf L, DE Gier B, Baan B, et al. Chlamydia psittaci (psittacosis) as a cause of community-acquired pneumonia: a systematic review and meta-analysis. Epidemiol Infect. 2017 Nov;145(15):3096-3105.http://www.ncbi.nlm.nih.gov/pubmed/28946931?tool=bestpractice.com 荷兰的一项研究通过痰液聚合酶链反应发现,鹦鹉热衣原体是 4.8% 的社区获得性肺炎病例的病因。[12]Spoorenberg SM, Bos WJ, van Hannen EJ, et al. Chlamydia psittaci: a relevant cause of community-acquired pneumonia in two Dutch hospitals. Neth J Med. 2016 Feb;74(2):75-81.http://www.ncbi.nlm.nih.gov/pubmed/26951352?tool=bestpractice.com想要从临床上鉴别鹦鹉热衣原体所致疾病和其他病原体(特别是肺炎衣原体)所致疾病比较困难,因此,对该疾病的报道可能会受到这一点的限制。
大约 5%-8% 的鸟类受鹦鹉热衣原体感染,有 465 种禽类对这种病原体易感,最常见的是鹦形目鸟类,特别是虎皮鹦鹉和鸡尾鹦鹉。[1]Schlossberg D. Chlamydophila (chlamydia) psittaci (psittacosis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases, 6th ed. Philadelphia, PA: Churchill Livingston; 2005:2256-2258.[13]Vanrompay D, Harkinezhad T, van de Walle M, et al. Chlamydia psittaci transmission from pet birds to humans. Emerg Infect Dis. 2007 Jul;13(7):1108-10.http://wwwnc.cdc.gov/eid/article/13/7/07-0074_articlehttp://www.ncbi.nlm.nih.gov/pubmed/18214194?tool=bestpractice.com可感染鹦形目鸟类和家禽的鹦鹉热衣原体菌株具有更强的致病性,它能通过空气中的悬浮颗粒或者直接接触被感染的鼻分泌物、粪便或组织感染所有年龄组的人群。[1]Schlossberg D. Chlamydophila (chlamydia) psittaci (psittacosis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases, 6th ed. Philadelphia, PA: Churchill Livingston; 2005:2256-2258.[7]Gaede W, Reckling KF, Dresenkamp B, et al. Chlamydia psittaci infections in humans during an outbreak of psittacosis from poultry in Germany. Zoonoses Public Health. 2008 May;55(4):184-8.http://www.ncbi.nlm.nih.gov/pubmed/18387139?tool=bestpractice.com