1988～2002年柳城县伤寒、副伤寒疫情处理与分析

目的分析我县15年来发生3起较大伤寒、副伤寒疫情的病原检测结果、流行菌株的变迁及疫情的发生和处理情况，以利于今后采取相应防治措施。方法收集和整理柳城县1988～2002年发生的3起较大伤寒、副伤寒疫情及相关资料。结果伤寒病原菌血培养阳性率为17．99％，有12．oo％血培养阳性患者血清肥达反应呈阴性；副伤寒病原菌血培养阳性率为46．58％，有19．12％血培养阳性患者血清肥达反应呈阴性。伤寒、副伤寒病原菌粪便培养及肥达氏反应阳性率均较低。结论肥达氏反应对诊断伤寒、副伤寒只起辅助作用。我县伤寒、副伤寒由原来以伤寒杆菌流行为主转为以副伤寒为主导菌型，应采取综合性措施控制副伤寒。     

卢龙县潘庄镇上新庄村伤寒流行的调查分析

70年代以来，我县伤寒处于散在性发病状况．而在1995年6～8月我县潘庄镇上新村发生伤寒流行，我站得知疫情后立即深入疫区进行流行病学调查，并开展防治工作，现将结果报告如下．1材料与方法1．1由流行病学医师对伤寒病人进行个案调查，填入统一的流行病调查表．1．2采取病人血和粪便按常规方法分离培养伤寒杆菌．并用常规试管法进行肥达氏反应．对分离出的伤寒杆菌采用Kirby-baner法进行药敏试验，药敏试纸由中国药品生物制品检定所提供，参考菌株为金黄色葡萄球菌（ATCC25923）、大肠杆菌（ATCC25922）、绿脓杆茵（ATCC27853）；按…     

关于甲型副伤寒患者肥达氏试验中的几个问题探讨

随着医学检验技术的发展,对伤寒副伤寒的诊断从病原 学诊断,肥达氏反应逐渐发展有对流免疫电泳法、杀菌抗体试 验法、炭凝集试验法、酶联免疫吸咐试验法、胶孔凝集试验法 和ＳＰＡ协同凝集法等多种诊断方法,这些方法的建立有利于 伤寒的早期诊断,也大大提高了伤寒副伤寒的诊断率。但是 目前在我国伤寒付伤寒的病原学诊断和肥达氏反应仍被广泛使用。特别是缺乏细菌室的广大基层医院（如乡镇医院）,肥达氏反应仍是诊断伤寒、副伤寒的重要依据,本文就９８例甲型 副伤寒患者其肥达氏反应中的几个问题作了探讨,现报告如 下：１材料与方法…     

赤壁市1989～2001年伤寒检测结果分析

目的 为系统掌握赤壁市伤寒菌株的生化特点，制定科学的防治对策。方法 对1989～2001年14起爆发疫点和门诊就诊的可疑伤寒病人采取患者血、大便32l份和外环境井塘水35份进行伤寒杆菌培养，并对其有生化反应、血清学鉴定、肥达氏反应、药敏试验、噬菌体分型进行了分析。结果 血、大便321份，检出伤寒杆菌80株，甲型副伤寒杆菌2l株，检出率为31．46％，井塘水35份标本，检出伤寒杆菌2株，检出率5．7l％。采集可疑伤寒患者血98份，进行肥达氏反应“0”抗体GMT为l：401．3，“H”抗体GMT为l：217．0，阳性率为84．2l％。在生化特性上，大便中培养的伤寒菌株28．57％，血、外环境中培养的伤寒菌株50％产生少量气体和4．85％菌落菌体发生变异，并有6．80％菌株培养时间延长至15d。药敏对广谱抗菌素均呈高度敏感；噬菌体分型、人群分别为A、D1、D2型，塘水为E7型，井水为D1型。结论 我市流行的伤寒菌群以A、D1、D2型为主。     

一起自来水引起伤寒暴发流行调查分析

１９９６年８月２日至９月８日,永安市洪田镇马洪村发生一起伤寒暴发流行。疫情由市立医院报告,经我站进行流行病学调查,证实为一起土自来水污染引起的水型伤寒暴发流行,报告分析如下：１　材料与方法对病人进行个案调查,采集病人血和粪便经增菌、ＳＳ琼脂培养,分离鉴定伤寒杆菌。用病人２～４周血做肥达氏反应,Ｏ抗体凝集效价在１∶８０以上,Ｈ抗体凝集效价在１∶１６０以上者,为特异性抗体阳性。按《生活饮用水卫生标准》检测土自来水,并培养分离伤寒杆菌。２　流行病学调查２．１　发病概况　该村为山区,林业公路穿越村庄,村…     

一所中学伤寒暴发流行的调查分析

[目的]调查某中学伤寒暴发流行因素，制定相应防制措施。[方法]以流行病学个案调查结合临床表现、病原菌培养分离、血清肥达氏反应检测。[结果]罹患率8．2％(115／1400)。从病人血液、肛拭子和井水中检出伤寒杆菌3株，283份血清肥达氏反应68份阳性．42份病人双份血清前后滴度呈4倍增长3份。健康对照“O”、“H”滴度均在≤1：40范围。[结论]根据流行病学调查，实验室检测结果，证实是一起经水传播的伤寒暴发流行。     

酶标方法检测食品中O157大肠杆菌

〔目的〕O_(157)大肠杆菌是污染食品引起食物中毒的主要病原菌,针对进出口食品卫生监测的需要,研究1种简便、快速、准确的实验方法。〔方法〕采用辣根过氧化物酶标记在特异性的O_(157)大肠杆菌单克隆抗体上(1gM型),利用抗原-抗体的特异性结合反应,最后通过反应的颜色来判断阴、阳性结果。〔结果〕本方法检出率高,每克样品中有5个细菌即可检出,48h即可报告结果。〔结论〕酶标方法检测食品中O_(157)大肠杆菌快速、准确检测周期短,既可提高检出率,又可节省检测时间。     

从一起副伤寒疫情分析实验室病原学检查的结果

柳城县 2 0 0 1年 10月爆发一起甲型副伤寒 ,发病 2 92例。此起疫情实验室病原菌血培养、粪便培养、血清肥达反应阳性率均较低 ,有 19.12 %血培养阳性患者的血清肥达反应呈阴性。1.材料和方法 :( 1)标本采集 :采集可疑患者 (疫区内不明原因持续发热≥ 3天 ,病程 1～ 2周 )静脉血 5 .0ｍｌ加入 10倍量的胆汁葡萄糖肉汤内 ,立即轻轻摇匀 ,送检。或待血凝固后 ,取出血清做肥达反应 ,血块搅碎后加入 2 0～ 3 0ｍｌ胆汁葡萄糖肉汤中 ,置 3 7℃培养 1～ 7天 ,再转种血平板。采粪便标本 (病程一般2～ 4周患者 )进行粪便培养。( 2 )检测方法和试剂 :…     

脉冲凝胶电泳分型在伤寒暴发中的应用

目的:探讨深圳市某区伤寒暴发在不同厂区,不同来源的伤寒沙门菌之间的遗传相关性,建立分子流行病学研究,进行同源性分析,并与表型分型比较。方法:对深圳市某街道社区10个工厂的伤寒患者分离的28株伤寒沙门菌,根据不同厂区、不同来源的伤寒菌株,采用传统的生化分型、血清学分型,肥达反应,药物敏感分型,荧光PCR及脉冲场凝胶电泳(PFGE)分子生物学分型的技术进行研究。结果:从93例发热现症病人的血和粪便中分离出28株伤寒沙门菌,肥达反应阳性(“O”≥1∶80;“H”≥1∶160;)59例,分离出伤寒沙门菌患者中,肥达反应阳性19例。从伤寒沙门菌菌株中抽取4个工厂患者中分离的11株伤寒沙门菌和1株乙型副伤寒沙门菌,进行了荧光PCR和脉冲场凝胶电泳(PFGE)全基因DNA指纹图谱分析,12株伤寒沙门菌的指纹图谱完全相同,有高度的同源性。对12株伤寒沙门菌荧光PCR检测均呈阳性,28株伤寒沙门菌生化表型相同,血清学分型相同,药敏结果有差异,肥达实验抗体滴度与健康人群比较,差异有统计学意义。结论:生化表型和血清学分型不能进行同源性分析,而通过脉冲场凝胶电泳(PFGE)全基因DNA指纹图谱分析,可追溯其同源性,通过12株伤寒菌株的PFGE分型图谱分析,菌株之间有高度的同源性,确认是由相同病原菌引起的一宗伤寒疫情。     

伤寒杆菌抗原胶体金层析法的研制及应用

目的:建立一种早期、简便、快速、准确的诊断伤寒的检验方法。方法:采用单克隆抗体,胶体金标记技术,运用双抗体夹心法,免疫层析原理,建立伤寒杆菌抗原胶体金层析法。与肥达反应、血培养、ELISA法进行对比。结果:伤寒杆菌抗原试纸条的灵敏度较肥达反应、血培养高,特异性与ELISA法接近,灵敏度比ELISA法稍低。结论:伤寒杆菌抗原试纸条具有简便、快速、结果易懂、无需特殊仪器的优点,能满足急诊检验的需要,提供了便利条件,适合于广大基层门诊推广、体检普查以及流行病学调查。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.