重庆口岸出入境人群登革热血清流行病学研究

[目的]了解重庆口岸出入境人群的登革热血清流行病学特征,为重庆口岸地区登革热监控工作提供科学的依据。[方法]按系统抽样抽取研究对象,进行登革热IgG抗体血清学检测和流行病学调查。[结果]检测1556份样本,其中182份登革热IgG抗体阳性,阳性率11．70％。入境人员阳性率18．87％,明显高于出境人员;外籍人员阳性率超过20％;本市人员不足10％。不同国籍人员间阳性率的差异有统计学意义,其中东南亚国籍人员阳性率62．16％,位列首位。不同职业人员间阳性率的差异有统计学意义,其中有6类人员阳性率超过10％,从高到低依次为渔民,船员、饮食服务人员、离退休人员、教师、商人、民工。曾经有国际旅行经历者阳性率（19．17％）高于没有国际旅行经历者（8．10％）;出国频次越高的,阳性率也越高;不同目的国际旅行之间的登革热抗体阳性率的差别有统计学意义,其中出国劳务人员阳性率最高（27．55％）;曾经到达不同地区人员的阳性率的差别也有统计学意义,其中有4个地区阳性率超过50％,从高到低依次为加勒比、东南亚、南美、南亚。来自,停留流行区人员的登革热阳性率（32％）明显高于未来自,停留流行区人员的登革热阳性率（9．85％）。多因素分析提示：有国际旅行经历、境外人员血清登革热IgG阳性率高,特别是有频繁出国经历、来自,停留主要流行区、有东南亚居留史是重要危险因素。[结论]重庆本地人员登革热暴露机会较少、未发生或极少发生本地传播;对重庆地区而言,重点在传染源的发现和控制。对于口岸登革热防治工作,应有所侧重地对有国际旅行经历的人员的检疫和监测,特别要重点关注出入境频繁的、有登革热流行区居留史的人员。     

河南口岸出境人员国际旅行卫生健康知识需求分析

目的 为提升出境旅行者预防境外旅行相关疾病的能力,对河南口岸出境人员的旅行卫生健康知识需求进行分析。方法 采用随机抽样方法,选择2016年5月-2017年3月间河南口岸出境人员536名,用自行设计的《国际旅行卫生保健知识调查问卷》进行现场问卷调查,对数据进行统计分析。结果 河南口岸出境人员以男性为主(75.6%),大多数为青壮年,文化程度以大专及本科居多,主要出国目的是劳务输出(52.1%),旅行目的地以亚洲和非洲国家为主,境外旅行时间超过1年的占65.1%。大多数出境者(68.5%)对于国外旅行中可能罹患疾病或者受到意外伤害的风险认知程度较高,62.1%的人担心身体检查不合格而被拒绝入境,84.5%的人希望获得国外防病知识,60.6%出境者表示会随身携带个人防病药剂或医疗器械,而74.6%的人表示需要当地国际旅行卫生保健中心提供专业的防病药剂或医疗器械服务;52.2%的出境者知晓出国预防接种能预防疾病;71.1%的人对于出国旅行可能罹患疾病有心理认知;79.7%表示愿意在归国之后做健康复查。回归分析结果显示,文化程度是国际旅行卫生保健知识需求的独立影响因素,大专及本科学历者对国际旅行卫生保健知识需求度是高中及以下者的2.179倍(95%CI:1.334~3.557)(P0.05)。结论 应重点在文化程度较低的出境旅行者群体中普及国际旅行卫生保健知识,做好相关健康教育。     

苏州口岸出入境人员乙型肝炎监测结果分析

〔目的〕了解苏州出入境人员乙型肝炎病毒(HBsAg)感染情况,为乙型肝炎的有效控制、预防及做好旅行卫生保健工作提供科学依据。〔方法〕所有出入境人员均采用酶联免疫吸附试验检测HBsAg,并对其结果进行统计分析。〔结果〕在4758名出入境人员中,共检测出HBsAg阳性263人,阳性率为5.5％。其中入境人员阳性率为8.2％,出境人员为4.8％;男性阳性率为6.6％,女性为4.2％;30～50岁年龄段阳性率最高;“大三阳”、“小三阳”共198例,占HBsAg阳性总数的75.1％。〔结论〕应加强对出入境人员HBsAg的监测,向国际旅行者提供相应的卫生保健知识,切实保护人体健康。     

传染性非典型肺炎对国际旅行人员心理影响的调查

[目的]调查传染性非典型肺炎(严重急性呼吸系统综合征，SARS)对国际旅行人员造成的心理影响，以便有针对性的开展旅行卫生保健工作。[方法]对2003年6月1—30日到东莞国际旅行卫生保健中心办理无SARS健康证明的65名中国籍出境人员，采用问卷调查的方式，了解SARS对其心理影响的程度。[结果]被调查者中71．4％的人出现过Ⅰ级心理反应；消失时间也均为Ⅰ级，未发现Ⅱ级以上的心理反应，出境前心理反应调查均为正常。[结论]产生应激障碍是一种普遍现象，国际旅行卫生保健人员应注意对国际旅行人员心理状态进行评估，帮助其解决心理存在的问题，保护国际旅行人员的身心健康。     

新冠肺炎疫情期间山西口岸出境人员健康宣教策略研究

目的 了解新冠肺炎疫情期间山西口岸出境人员对国际旅行健康教育需求及旅行医学认知的现状，为出境人员进行健康宣教策略研究提供科学依据。方法 采用整群随机抽样法，选择2022年1-6月自山西口岸出境人员600名，用自行设计的调查问卷，对其进行国际旅行健康教育需求及旅行医学认知的问卷调查。结果 近半数出境者对于国外旅行可能感染新冠肺炎或其他传染病的风险认知较高，占55.69%；有62.30%的人担心体检不合格被拒绝入境；希望从国际旅行卫生保健中心的健康咨询中了解目的地的传染病疫情动态及预防接种相关知识、相关疾病的防病知识的比例很高，分别占83.02%、70.46%；出境者对于出境接种疫苗能预防哪些疾病知晓率较低，占42.78%;76.91%的调查对象表示愿意在回国后到保健中心做复检，以筛查并判断是否在国外感染疾病。Logistic多因素回归分析显示，文化程度是国际旅行健康教育需求及旅行医学认知的独立影响因素（P<0.05）。结论 完善新冠肺炎疫情下出境旅行医学科普知识体系，提升国际旅行医学能力建设，规范国际旅行健康服务，降低跨境传染病输入风险。     

瑞丽口岸17例登革热感染者流行病学调查及疫情处理

〔目的〕了解瑞丽口岸出入境人员中登革热的流行情况。〔方法〕对出入境重点人群进行登革热监测。〔结果〕瑞丽口岸第1次检出登革热病人,检出的17例均为输入性病例。感染者以青壮年居多,职业分布以商人最多,发病地点以缅甸密支那最为集中〔。结论〕随着境外登革热疫情的日益严峻,应加强口岸登革热的预防控制工作。在做好出入境人员登革热监测及卫生检疫查验工作的同时,应注重出入境人员登革热预防控制知识的宣传教育,有效防止登革热流行和传播。     

河南口岸出境人员旅行医学认知及健康教育需求分析

目的对河南口岸出境人员的旅行医学认知及旅行防病知识需求进行量化分析。方法按随机抽样,选择2016年5月—2017年3月间自河南口岸出境人员536名。基于德尔菲法设计《国际旅行医学知识问卷》对选取样本现场问卷调查;采用Epi Data 3.1软件录入数据,以SPSS 22.0软件分析。结果问卷调查:68.5%出境者对于国外旅行罹患疾病或受意外伤害风险认知较高;62.1%人担心身体检查不合格被目的国拒绝入境;84.5%的人渴望从国际旅行卫生保健中心了解国外防病知识;70.1%的人表示懂得旅行医学卫生;60.6%出境者表示会随身携带个人防病药剂或医疗器械,而74.6%的人表示需要当地国际旅行卫生保健机构提供专业防病药剂或医疗器械服务;52.2%出境者知晓"出国预防接种"能预防疾病;71.1%人对于国际旅行可能罹患疾病有心理认知;79.7%应答者愿意在归国之际再来保健中心做健康复查。单因素和多因素回归分析显示:文化程度为旅行医学认知和旅行医学知识需求的独立影响因素,大专及本科学历者对旅行医学认知程度和旅行医学知识需求度是高中及以下应答者的2.179倍(95%CI:1.334~3.557)(P0.05)。结论文化程度较低的旅行群体是普及健康教育重点人群。     

2021年重庆口岸出入境人员乙肝病毒感染情况及HBV分型检测分析

目的 了解2021年重庆口岸出入境人员乙型肝炎病毒感染情况和基因分型情况。方法采集2021年在重庆国际旅行卫生保健中心进行健康监测的出入境人员血清样本，使用电化学发光法进行HBsAg检测，采用荧光PCR的方法对100份HBsAg阳性血清标本进行HBV基因检测和分型检测。结果 2021年在重庆国际旅行卫生保健中心进行健康监测的出入境人员11431名，其中HBsAg阳性485例；100例HBsAg阳性血清标本中，B型47例，C型19例，D型2例，BCD以外的其他基因型3例，样本HBV DNA含量低于最低检测限29例。结论 2021年重庆口岸出入境人员中HBV感染者以青壮年居多，职业以劳务为主；出境人员HBV基因型以B型为主，应加强对劳务人员健康宣传。     

出境劳务人员艾滋病相关知识的现状调查及多因素分析

〔目的〕了解出境劳务人员艾滋病相关知识掌握情况和影响因素,为今后口岸改善艾滋病健康教育提供一定的理论依据。〔方法〕在江苏国际旅行卫生保健中心的各分中心采取整群抽样法,随机抽取出境的劳务人员为调查对象,对其进行艾滋病相关知识及有关情况的问卷调查,并对影响因素进行分析。〔结果〕51.82%的出境劳务人员已经掌握了大部分的艾滋病相关知识,但总的认知水平在性别、年龄、学历和既往是否获得过相关知识方面均没有显著性差异(P0.01),但镇江、南京、南通的出境劳务人员明显高于连云港和扬州在地区上则存在显著性差异。在一些具体问题上,不同的年龄和学历出境劳务人员对艾滋病的认识存在显著差异(P0.01),表现为年龄小和学历高的劳务人员回答正确率高。艾滋病相关知识的多因素分析显示,地区是影响艾滋病相关知识水平的主要因素(P0.01)。〔结论〕出境劳务人员已经掌握了一定的艾滋病相关知识,地区是艾滋病相关知识水平掌握的主要影响因素,提示"出入境人员HIV感染检验检疫监督控制系统"是有效的,艾滋病健康教育应该建立一种新的教育理论和实践模式。     

一例HIV感染者的调查报告

2000年6月5日,珠海国际旅行保健中心对出入境人员实施传染病监测体检时,从1名首次申请出境人员的血清样本中检出HIV抗体阳性,此为珠海国际旅行保健中心开展传染病监测以来首次从出境人员中检出的HIV感染者。     

Dengue fever in travelers to the tropics, 1998 and 1999

Dengue fever (DF) has become common in western travelers to the tropics. To improve the basis for travel advice, risk factors and dengue manifestations were assessed in 107 Swedish patients for whom DF was diagnosed after return from travel in 1998 and 1999. Patient data were compared with data on a sample of all Swedish travelers to dengue-endemic countries in the same years. Only three of the patients had received pretravel advice concerning DF from their physicians. Hemorrhagic manifestations were common (21 of 74 patients) but caused no deaths. Risk factors for a DF diagnosis were travel to the Malay Peninsula (odds ratio [OR] 4.95; confidence interval [CI] 2.92 to 8.46), age 15-29 years (OR 3.03; CI 1.87 to 4.92), and travel duration >25 days (OR 8.75; CI 4.79 to 16.06). Pretravel advice should be given to all travelers to DF-endemic areas, but young persons traveling to southern and Southeast Asia for >3 weeks (who constituted 31% of the patients in our study) may be more likely to benefit by adhering to it.     

Travel-associated Illness Trends and Clusters, 2000–2010

Longitudinal data examining travel-associated illness patterns are lacking. To address this need and determine trends and clusters in travel-related illness, we examined data for 2000–2010, prospectively collected for 42,223 ill travelers by 18 GeoSentinel sites. The most common destinations from which ill travelers returned were sub-Saharan Africa (26%), Southeast Asia (17%), south-central Asia (15%), and South America (10%). The proportion who traveled for tourism decreased significantly, and the proportion who traveled to visit friends and relatives increased. Among travelers returning from malaria-endemic regions, the proportionate morbidity (PM) for malaria decreased; in contrast, the PM trends for enteric fever and dengue (excluding a 2002 peak) increased. Case clustering was detected for malaria (Africa 2000, 2007), dengue (Thailand 2002, India 2003), and enteric fever (Nepal 2009). This multisite longitudinal analysis highlights the utility of sentinel surveillance of travelers for contributing information on disease activity trends and an evidence base for travel medicine recommendations.     

Travel-related dengue virus infection, The Netherlands, 2006-2007

To assess the incidence of and risk factors for clinical and subclinical dengue virus (DENV) infection, we prospectively studied 1,207 adult short-term travelers from the Netherlands to dengue-endemic areas. Participants donated blood samples for serologic testing before and after travel. Blood samples were tested for antibodies against DENV. Seroconversion occurred in 14 (1.2%) travelers at risk. The incidence rate was 14.6 per 1,000 person-months. The incidence rate was significantly higher for travel during the rainy months. Dengue-like illness occurred in 5 of the 14 travelers who seroconverted. Seroconversion was significantly related to fever, retro-orbital pain, myalgia, arthralgia, and skin rash. The risk for DENV infection for short-term travelers to dengue-endemic areas is substantial. The incidence rate for this study is comparable with that in 2 other serology-based prospective studies conducted in the 1990s.     

Dengue virus infections among travelers returning from Haiti--Georgia and Nebraska, October 2010

In October 2010, a Nebraska clinician notified the state's Central District Health Department (CDHD) of a cluster of dengue-like illnesses in six of 28 missionary workers from Nebraska and Georgia who recently had returned after 7-11 days in Haiti. Infection with the mosquito-transmitted dengue virus (DENV) later was confirmed by laboratory testing in seven persons, five of whom were hospitalized. CDHD, the Nebraska Department of Health and Human Services (NDHHS), the Georgia Department of Public Health (GDPH), and CDC conducted a retrospective cohort study to assess the pretravel dengue knowledge and mosquito-avoidance practices of those with and without laboratory-confirmed infection. This report describes the results of that study, which indicated that 90% of those in the study had a pretravel health-care appointment, 57% sought travel advice on the Internet, and 24% used mosquito repellent several times a day; neither pretravel knowledge nor mosquito-avoidance practices were significantly associated with absence of DENV infection. Clinicians should be vigilant for dengue among travelers returning from Haiti and other areas where DENV is endemic or likely to be endemic and should report suspected cases of dengue to public health authorities.     

Seasonality, annual trends, and characteristics of dengue among ill returned travelers, 1997-2006

We examined seasonality and annual trends for dengue cases among 522 returned travelers reported to the international GeoSentinel Surveillance Network. Dengue cases showed region-specific peaks for Southeast Asia (June, September), South Central Asia (October), South America (March), and the Caribbean (August, October). Travel-related dengue exhibited annual oscillations with several epidemics occurring during the study period. In Southeast Asia, annual proportionate morbidity increased from 50 dengue cases per 1,000 ill returned travelers in nonepidemic years to an average of 159 cases per 1,000 travelers during epidemic years. Dengue can thus be added to the list of diseases for which pretravel advice should include information on relative risk according to season. Also, dengue cases detected at atypical times in sentinel travelers may inform the international community of the onset of epidemic activity in specific areas.     

Dengue antibody prevalence in German travelers

We studied 2,259 German citizens after they returned from dengue-endemic countries from 1996 to 2004. Serotype-specific dengue antibodies indicated acute infections in 51 (4.7%) travelers with recent fever and 13 (1.1%) travelers with no recent fever, depending largely on destination and epidemic activity in the countries visited.     

Who brings dengue into North Queensland? A descriptive,exploratory study

Objective: To describe the demographics, patterns of assessment and treatment of people visiting a regional emergency department with potential diagnoses of malaria or dengue fever. Design: To identify potential dengue fever cases, we used an indicator of recent overseas travel and fever that is a request for malaria testing. A chart audit of 301 medical records of people between 2008 and 2010 was conducted to describe patient characteristics, diagnostic tests performed and treatment. Setting: A regional hospital located in the wet tropics. Results: Malaria testing was most often performed on Australian citizens (64.1%), medical evacuees (20.3%) and tourists (18.6%). Overall, 49.8% of patients tested for malaria did not also have a dengue test, despite being indicated in 54% of this group. People tested for malaria usually lived in a residential house or unit (69.7%). Only 9% were staying in hotels and hostels . Oceania was the most commonly visited region in the two weeks prior to presentation. Malaria was diagnosed in 17.3% and dengue fever in 12% of patients tested. Patients with dengue fever were more likely than patients with malaria to self‐refer to hospital, be staying in commercial accommodation and to have recently travelled to Southeast Asia. Conclusion: Both dengue fever and malaria occur predominantly in residents who reside in non‐commercial accommodation. Efforts to identify imported dengue fever cases should focus on both tourists and local residents returning from overseas countries.     

Use of an accelerated immunization schedule for combined hepatitis A and B protection in the corporate traveler

Increased international business travel to moderate or high endemic areas of hepatitis A and B may leave many business travelers at risk for infection if not vaccinated. Many international business travelers depart for hepatitis A and B endemic areas within 2 months of the decision to travel. Many of these travelers do not seek pretravel medical advice and are unaware of the risks and modes of acquiring hepatitis A and B. Monovalent vaccines and a combined hepatitis A and B vaccine are available and can be administered on an accelerated schedule. Because many areas endemic for hepatitis A are also endemic for hepatitis B, accelerated administration of the combined vaccine can offer protection for many international business travelers destined for areas endemic for both diseases and should be part of corporate travel immunization programs.     

Imported dengue--United States, 1999 and 2000

Dengue is a mosquito-transmitted acute viral illness caused by any of the four dengue virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4). Dengue is endemic in most tropical and subtropical areas of the world and has occurred among U.S. residents returning from travel to such areas. CDC maintains a laboratory-based passive surveillance system for imported dengue among U.S. residents (laboratory-diagnosed dengue in a U.S. resident living in an area without known authochthonous dengue transmission, with travel history outside the United States in the 14 days before symptom onset). The system relies on reports by clinicians to state health departments, which forward patient specimens to CDC for diagnostic testing. This report summarizes information about imported dengue cases among U.S. residents during 1999-2000. The findings indicate that dengue continues to cause disease in U.S. travelers abroad. Travelers to tropical areas should protect themselves from mosquito bites, and health-care providers should consider dengue in the differential diagnosis of illness for patients who have returned recently from such areas.