一起社区诺如病毒腹泻暴发的调查分析

[目的]对龙岩市华龙社区发生一起腹泻疫情进行调查。[方法]采用现场流行病学调查方法,了解疫情发生情况及可疑的传播因素,并对粪便标本进行检测。[结果]本次共发现腹泻239例,罹患率2．7％。检测粪便标本7份,6份诺如病毒抗原阳性,4份检出诺如病毒核酸片段。疫情符合经水传播特征。[结论]本次疫情为感染诺如病毒而引起一起群体性急性胃肠炎暴发,可疑的传染源为被污染的自备水源水。     

进口废旧物品的卫生学调查分析

[目的]防止国外病媒昆虫、医学动物、病原微生物、放射性物质随废旧物品带入我国,造成传染病的流行。[方法]对进口数量较大的旧设备、废纸进行采样调查。[结果]旧设备细菌总数1～100个/ml的72份,占65.45;>100个/ml至无法计数的38份,占34.55％。废纸1～100个/ml的38份,占34.55％;>100个/ml至无法计数72份,占65.45％。大肠杆菌旧设备阳性14份,阳性率12.73％;废纸阳性36份,阳性率32.73％。金黄色葡萄球菌旧设备阳性7份,阳性率6.36％;废旧物品阳性17份,阳性率15.45％。绿脓杆菌旧设备未检出;废纸阳性6份,阳性率5.45％。霉菌检出1～100的32份,占29.09％;101至无法计数的78份,占70.91％。HBsAg旧设备阳性14份,阳性率73％;废纸16份,阳性率14.55％。另外,还检出部分条件致病菌。[结论]进口废旧物品存在严重污染情况,亟待制定出进口废旧物品的卫生学标准。     

凭祥市1997～2002年疟疾监测

[目的]了解凭祥市达到基本消灭疟疾标准后，所采取监测措施是否适合本地防治需要，为了巩固防治成果，总结防治经验，及今后疟疾防治工作提供科学依据。[方法]对临床诊断为疟疾，疑似疟疾．疑似感冒，原因不明的发热病人进行登记和血检；对确诊的疟疾病人进行根治;对病家及村组进行全民性的预防服药和用杀虫剂室内外滞留喷洒防止媒介按蚊，对接触病人的人群进行二代虫率的调查。对旧病灶点进行血清学荧光抗体试验；对外来流动人员和本地外出回归者进行登记和血检；并做按蚊分类鉴定。[结果]全市共血检“四热”病人11018人，疟疾内源性发病率为0。流动人口和当地居民外出回归者血检1335人次，输人性疟疾病人3例，阳性率为0．22％。血清荧光抗体调查2218人次，阳性率为0．05％。经卵、成蚊分类鉴定为中华按蚊、微小按蚊、日月潭按蚊分别占46．34％、20．73％、32．93％。[结论]今后继续开展疟疾监测，做好病例监测，重点是加强流动人口和本地外出回归者疟疾监测管理，同时继续做好血清IFA检测和防蚊灭蚊工作，以及广泛开展疟疾健康教育，提高群众对疟疾的防治意识。     

一起由输入病例引起登革热暴发的流行病学调查

[目的]分析一起登革热暴发的流行病学特征和发病原因,为制定预防控制措施提供科学依据。[方法]明确病例定义,对病例进行回顾性调查,采集病例血清进行登革热抗体检测。[结果]本起疫情共发病38例,流行历时84d,登革热抗体阳性21例,分离登革热Ⅰ型病毒3株。经采取以快速灭蚊,清除蚊虫孳生地为主的综合性防治措施后,疫情很快得到控制。[结论]本起疫情是由登革热Ⅰ型病毒引起,传染源输入是本次疫情发生的主要原因,早期病例误诊,传染源未被及时发现是造成疫情暴发的重要因素,防蚊灭蚊是防止登革热发生的有效措施,加强对输入病例的监测是我市今后登革热防治的一项重要工作。     

泉州市出境船员艾滋病流行现状及监测结果分析

[目的]了解泉州市出境远洋船员有关艾滋病知识、态度、行为和观念（KABP）以及人群艾滋病感染情况，为开展健康干预提供依据。[方法]按KABP模式设计艾滋病调查表，收集市出入境检验检疫局办理出境手续的泉州籍船员的人群特征以及注射毒品、共用注射器和安全套的使用等某些高危行为的情况，并采集调查对象静脉血，采用WHO推荐的两次酶联免疫吸附试验检测HIV抗体，检测阳性者判定为HIV抗体阳性。[结果]泉州市出境船员身体素质较好，处于性活跃期年龄，文化参差不齐，传统性道德观念淡薄，对性需求心理的自我调节能力差，艾滋病相关知识缺乏，检出HIV抗体阳性率为0．23％，乙肝表面抗原阳性率为19．71％；丙肝抗体阳性率为0．46％；未检出梅毒抗体阳性者。[结论]泉州市出境船员对艾滋病的知识不全面，态度和行为上有导致艾滋病传播的危险因素，应尽快进行艾滋病健康干预。     

海南省三亚市10年来疟疾疫情分析

[目的]分析三亚市10a疟疾疫情状况。[方法]1989－1999年10a间,据三亚市疟疾疫情报告统计疟疾发病率。[结果]疟疾发病率（除1994年外均有逐年大幅度下降,（由1989年的483．13／10万降到1999年的97．25／10万）,14个疟疾联防乡镇、农场“四热”病人血检阳性率和居民带疟原虫率也是逐年下降趋势,疟疾感染来源以上山感染为主;不同地形与季节的疟疾发病也有较大差别;人口流动是造成疟疾传播、暴发的重要因素。[结论]积极贯彻《流动人口疟疾管理方法》,完善疫情管理制度,巩固加强疟疾联防工作,以控制疟疾的流行。     

青海省2007年一起风疹暴发的血清学诊断和基因型别鉴定

[目的]调查2007年4月青海省互助地区中小学发生的疑似风疹暴发流行,并确定引起此次暴发的风疹病毒的基因型别. [方法]采集风疹急性期患者的血标本和咽拭子标本,使用酶联免疫吸附实验(ELISA)检测风疹IgM抗体对本次疫情进行证实,使用Vero/SLAM细胞对采集的咽拭子进行病毒分离,随后采用逆转录-聚合酶链反应(RTPCR)和序列测定的方法对分离的风疹病毒进行基因定型. [结果]对采集的20份疑似风疹血清标本进行风疹IgM抗体检测,其中14份为阳性结果,阳性率为70%,证实为风疹暴发;并成功分离到9株风疹病毒,全部鉴定为1E基因型,同时基因亲缘性关系树显示,该9株病毒在型内又形成两个小分支. [结论]从流行病学上来看,此次暴发是由至少两个不同传播链的1E基因型风疹病毒引起的.     

芦山县血吸虫病流行病学调查与分析

目的了解芦山县在血吸虫病传播控制达标后的血吸虫病流行现状。方法对芦山县三个村5岁以上的居住人群和所有耕牛部分狗进行血清流行病学调查,采取问卷调查血阳者疫水接触、既往病史、主诉症状和体征,开展钉螺调查。所有数据使用SPSS17.0分析。结果对4524人采血做ELISA检测,血检血阳者197人,血检阳性率4.36%,未发现粪检阳性病人;对12头家畜采血做金标法检测,血检阳性家畜为0,家畜血检阳性率0,未发现粪检阳性家畜。问卷调查血阳者179人,其中92.18%年内有疫水接触史,62.01%患过血吸虫病,67.60%接受过治疗,主要主诉症状和体征出现率为腹痛(53.63%)、腹胀(29.05%)、食欲减退(18.44%)、乏力(16.76%)、肝区痛(14.53%)、腹泻(11.17%)。对总面积6320m2的三个调查点在春秋季开展螺情调查共2次,平均活螺密度为0.52/0.02只/0.1m2,压碎法共解剖340只活钉螺,均未发现有感染性钉螺。结论芦山县血控达标后的防治工作成效稳固,血吸虫病疫情得到有效控制,同时应加强对人群血检阳性者和螺情的监测力度。     

贵州从江县巨洞村连续两年疟疾暴发原因分析

[目的]对从江县巨洞村2006～2007年连续两年局部疟疾暴发流行特征及其影响因素进行分析,探讨科学有效的防控措施. [方法]在暴发点进行流行病学调查,病例搜索,采集居民发热病人及病家人群耳垂血涂血片检查疟原虫,按蚊种群及密度调查,分析当地传播媒介组成和叮人率,调查居民蚊帐使用、露宿习惯、大牲畜情况,了解乡村卫生人员下村巡诊频次和疫情报告情况.采用回顾性调查和现场调查的方法收集相关资料,应用描述流行病学分析方法对暴发原因进行分析. [结果]2006年7月23目～8月19日共发生疟疾病例46例(血检阳性43例,临床诊断病例3例),罹患率6.11%,2007年7月4日～8月5日共发生疟疾病例102例(血检阳性87例,临床诊断病例12例),罹患率12.93%.当地传疟媒介为中华按蚊、嗜人按蚊、微小按蚊,蚊帐使用率平均为41.14%,流行季节乡村卫生人员到该村巡回债察月平均少于2次. [结论]当地仍存在我国重要传疟媒介,对疟疾病人的治疗不规范和对病灶点处理不彻底,灭疟质量不高,因受火灾后村民居住简陋,自我防护意识薄弱,乡村卫生人员不及时发现和治疗疟疾病例,使传染源的积累,是造成两年内疟疾暴发的主要原因.应加强重点疟区的防治工作,采取以消灭传染源和病灶区灭蚊并重的综合性防治措施,使该类事件不再发生.     

322份血培养阳性病原菌在需氧、厌氧瓶的检出率比较

目的 分析2010年7月-2011年7月血培养阳性的病原菌在需氧、厌氧瓶检出率.方法 血培养及鉴定采用美国BD9050全自动血培养仪和法国生物梅里埃公司ATBExpression自动细菌鉴定仪.结果 在2700份血培养中阳性322份,阳性率为11.9％,其中革兰阳性球菌占24.5％、革兰阳性杆菌占0.6％、革兰阴性球菌占0.3％、革兰阴性杆菌占65.8％、厌氧菌占2.0％、真菌占6.8％;其中仅需氧血培养阳性130份,占40.4％,仅厌氧血培养阳性60份,占18.6％,需氧与厌氧血培养均阳性132份,占41.0％.结论 同一患者同时进行需氧瓶及厌氧瓶培养,即能充分体现自动血培养仪快速性,又能提高血培养阳性率.     

湖南省郴州市2003-2012年疟疾流行特征及监测效果研究

目的 了解郴州市疟疾流行特征及监测效果,为疟疾防治和消除提供科学依据.方法 运用描述性流行病学方法对郴州市2003-2012年疟疾流行病学及监测资料进行统计分析.结果 郴州市2003-2012年共报告疟疾病例41例,年平均发病率为0.09/10万,死亡1例,无暴发疫情;其中间日疟24例（58.54％）,恶性疟15例（36.58％）,三日疟2例（4.88％）;本地病例4例（9.76％）,输入性病例37例（90.24％）,93.33％（14/15）的恶性疟病例均由非洲输入;发热患者血检107 975人次,阳性率为3.43/万,疟疾病例实验室检测率和确诊率均为100％;传疟媒介主要以中华按蚊为主（86.04％）,蚊密度高峰出现在7-8月.结论 郴州市基本消除疟疾后,疟疾疫情控制在较低水平,病例以输入性为主,在今后的疟疾防治和消除工作中,应加强流动人口监测和发热患者血检.     

广东省消除恶性疟后期监测和防治措施的效果评价

目的对1989年广东省消除恶性疟后期防治措施和监测效果进行评价。方法 1989～2009年广东省消除恶性疟后期所采取的防治措施和监测方法包括:疟疾病例的侦查和分类、现症病人治疗、疫点的处理、居民带虫率调查和防治措施的落实。结果广东省1989～2009年疟疾监测中,共血检12557305人,检出疟原虫阳性人数109706人,阳性率为0.87%。全省治疗有疟史病人76718人次,流行季节预防服药2381893人次,现症病人治疗96788人次,室内滞留喷洒受保护人口2400余万人次,药物浸帐保护人口934余万人次。1989年全省的疟疾发病率为0.58/万,1990～1999年平均年发病率为0.64/万,2000～2009年平均年发病率下降至仅为0.04/万,而且20年没有发现本地感染的恶性疟。结论所采取对传染源控制和传播媒介防制的方法和策略是可以阻断疟疾传播的,特别是没有发现本地感染的恶性疟病例,也没有出现输入性恶性疟的继发病例。     

Parasitological profile of the surveyed population for malaria in an endemic area in Faiyoum Governorate, Egypt

Egypt represents the only focus in the Mediterranean region where Plasmodium falciparum transmission still occurs. A longitudinal parasitological study has been implemented (September 1995 to December 1996) in Faiyoum, Egypt. A total of 9065 blood slides for malaria parasites were taken from all people in the study area as mass blood examination (MBE); those attending the malaria unit as passive case detection (PCD) as well as from neighborhood of the detected cases (NOD). They were stained by Giemsa stain and examined under standard conditions for positivity, parasite species and parasite density. Our results show that MBE detected 61.5% of malaria cases while 23.1% and 15.4% of the confirmed cases were detected through PCD and NOD respectively. The overall parasite rate was 5.7/1000 examined population. P. falciparum was the most predominant species (96.1%), followed by P. vivax (3.9%). The epidemiological factors causing the persistence of malaria transmission in the study area are discussed.     

Deforestation and vectorial capacity of Anopheles gambiae Giles mosquitoes in malaria transmission, Kenya

We investigated the effects of deforestation on microclimates and sporogonic development of Plasmodium falciparum parasites in Anopheles gambiae mosquitoes in an area of the western Kenyan highland prone to malaria epidemics. An. gambiae mosquitoes were fed with P. falciparum-infected blood through membrane feeders. Fed mosquitoes were placed in houses in forested and deforested areas in a highland area (1,500 m above sea level) and monitored for parasite development. Deforested sites had higher temperatures and relative humidities, and the overall infection rate of mosquitoes was increased compared with that in forested sites. Sporozoites appeared on average 1.1 days earlier in deforested areas. Vectorial capacity was estimated to be 77.7% higher in the deforested site than in the forested site. We showed that deforestation changes microclimates, leading to more rapid sporogonic development of P. falciparum and to a marked increase of malaria risk in the western Kenyan highland.     

Effects of untreated bed nets on the transmission of Plasmodium falciparum, P. vivax and Wuchereria bancrofti in Papua New Guinea

The impact of untreated bed nets on the transmission of human malaria and filariasis in a village in a hyperendemic area of Papua New Guinea was studied. In anopheline mosquitoes, the Plasmodium falciparum sporozoite antigen positivity rate, filarial infection rates and human blood indices dropped significantly after bed nets were introduced. This reduction in human-vector contact did not affect mosquito density as no significant difference in either landing rates or indoor resting catches was found. The number of bed nets in a house and ownership of dogs were factors significantly associated with a reduction in the number of indoor resting mosquitoes. However, the reduction in the P. falciparum sporozoite antigen rate in mosquitoes was not accompanied by a reduction in either malaria parasite or antibody prevalences or titres against the P. falciparum circumsporozoite protein.     

缅甸克钦邦第二特区拉咱市疟疾流行特征横向调查

目的了解中缅边境上游疟疾疫源地的流行特征,为出入境流动人员疟疾防治提供参考依据。方法根据英国无国界卫生组织设在缅甸克钦邦第二特区的疟疾诊疗点上报的疟疾联防报表中的疟疾病例数计算发病率,并根据现场调查结果对不同疫点的疟疾流行情况、传染源种类、媒介蚊虫形态特征,村民的生产、生活、文化习俗以及卫生服务状况等进行分析。结果 2008年12月1日至2009年11月30日的疟疾发病率为513.01/万,流行病原以恶性疟为主,占疟疾病例总数的75.30%(1067/1417),间日疟占23.85%(338/1417),三日疟占0.14%(2/1417),混合感染占0.71%(10/1417);疟疾疫源地按流行程度分为高、中、低3类疫点村,高疫点村(克章村)距中缅边境线直线距离24.30km,中疫点村(卖沙坝村)距边境线10.20km,低疫点村(扎图广村)距边境线0.50km,其中高疫点村的疟疾带虫发病率高达14.14%(28/198),以恶性疟为主要病原,占67.86%(19/28),是重症疟疾的主要病原;在边境森林地带发现的大劣按蚊是野外作业者感染疟疾的高效媒介;从云南省元江县到缅甸克钦邦第二特区的21例务工者的疟疾患病率及恶性疟比例均为100%,是出境务工人员感染疟疾的典型案例;当地村民的防蚊意识和求医条件均处于较低水平。结论缅甸克钦邦第二特区为中缅边境务工人员感染疟疾的主要疫源地。     

Congenital malaria. Parasitological and serological studies in Niamey (Niger)

Congenital malaria is defined as the presence of Plasmodium parasites in the erythrocytes of newborns less than seven days old. The aim of this study was to determine the incidence of congenital malaria and its possible clinical consequences. We carried out a prospective survey in Niamey, the capital of Niger (600,000 inhabitants) from July to September 1993. Niamey is in an area of mesoendemic malaria and this period of the year corresponds to the rainy season, when malaria transmission is maximal. Ninety mothers and their newborns were included. We assessed the clinical status of the mother and child at the time of the delivery, and took blood smears to check for parasitemia and blood samples to check for antimalaria antibodies by indirect immunofluorescence (IIF). The placenta was not examined. Clinical signs of malaria (fever, splenomegaly, anemia and jaundice) were absent in all mothers and children and 88 of the 90 children had normal birth weights. Plasmodium falciparum was the only parasite detected, with 49 of the 90 mothers and 12 of the 90 newborns having positive blood smears. Serological tests detected the presence of antimalaria antibodies in 73 of the 90 mothers (81.1%) and 68 of the 90 newborns (75.5%). Thus, we found no cases of congenital malaria with clinical signs in this study, despite the high frequency of parasites and antimalaria antibodies. The reasons for this absence of cases of congenital malaria with symptoms are discussed.     

Anopheline vectors and malaria transmission in eastern Afghanistan

Anopheline vectors and malaria transmission were studied in 2 river-irrigated, rice-growing districts of eastern Afghanistan from May 1995 to December 1996. Clinical malaria was monitored in 12 rural villages (population 14,538) by passive case detection at local clinics. Adult mosquitoes were collected by space-spraying of living quarters and stables and by cattle bait catches. Mosquito head-thoraces (17,255 specimens) were tested for Plasmodium falciparum and P. vivax circumsporozoite protein (CSP) using enzyme-linked immunosorbent assay. The recorded incidence of P. vivax and P. falciparum was 199 and 41 episodes per 1000 person years, respectively. Twelve species of anopheline were recorded; Anopheles stephensi comprised 82% and A. culicifacies 5%. Eight species tested positive for CSP: A. stephensi, A. culicifacies, A. fluviatilus, A. annularis, A. pulcherrimus, A. maculatus, A. splendidus and A. superpictus. Among infected mosquitoes 46% were positive for P. falciparum, 45% for P. vivax VK-247, and 9% for P. vivax PV-210. Estimates of the feeding rates of infective vectors on humans indicated that A. stephensi would contribute 76% of infective bites, A. fluviatilis and A. pulcherrimus 7% each, and A. culicifacies and A. superpictus 3% each. The overall infective vector feeding rate correlated with the P. vivax incidence rate in the human population. The conventional view of A. culicifacies being the main rural vector and A. stephensi important only in urban settings needs to be reconsidered in western outreaches of the Indo-Pakistan subcontinent.     

Point-of-care testing for malaria outbreak management

A rapid antigen assay for malaria was performed on blood samples collected during a simultaneous outbreak of falciparum malaria and vivax malaria on a remote island in the Indonesian archipelago. During the outbreak, a total of 89 patients (4.3% of the population) were diagnosed with malaria within a week. Microscopic examination revealed 78 malaria slide-positive cases, of whom 49 (62.8%) were identified as P. falciparum, 7 (9.0%) as P. vivax and 22 (28.2%) as mixed P. falciparum and P. vivax infections. The rapid malaria assay showed excellent correlation with expert-confirmed routine microscopy for P. falciparum and P. vivax monoinfections and mixed infections with a parasite density >50 parasites/microl. Several slide-negative blood samples collected from febrile patients with clinical malaria tested positive in the rapid test. The estimated sensitivity calculated for the rapid test (91.0%) was slightly higher than that of microscopy (87.6%). The result indicates that rapid antigen detection for malaria could be a useful alternative to microscopy to reduce the workload during emergency outbreak situations.     

宜宾市输入性疟疾的流行特征分析

目的 分析2008—2020年宜宾市疟疾流行病学特征,为探讨相应防控策略提供科学依据。方法 描述疟疾疫情概况、感染来源、分布特征、病例管理情况。结果 报告疟疾病例包括间日疟（35.21%）、恶性疟（52.11%）和未分型疟疾（12.68%）。病例主要来源国家是缅甸、刚果、多哥,分别占37.25%、17.65%、9.8%。宜宾县、翠屏区报告病例最多,6—8月和10月报告病例较多,患者主要为青壮年男性农民工。病例3 d内就诊率达100%,按照“1～3～7”管理规范,24 h上报率、3 d内个案流行病学调查率、7 d内疫点处置率均为100%。医疗机构初诊正确率为60.78%。中华按蚊为主要传播媒介,2018、2019、2020年密度分别为0.01、0和0.006只/（灯·h）。结论 宜宾市输入性疟疾有一定地区性和季节性分布规律,且本地存在再发风险,应根据每年输入病例和媒介监测情况动态掌握各县区风险分层,利用人员出入境时间流动规律,做到早筛查、早发现、早诊断、早治疗。