弓形体感染的病例对照研究

以IHA检测弓形体抗体,阳性者为“病例”、阴性者为对照,按1∶1配对进行了病例对照研究。资料分析结果,养猫者感染弓形体的COR和aOR_(mh)(95％可信限)分别为4.87及5.01(3.40～7.38);接触生猪肉者感染弓形体的COR和aOR_(mh)分别为3.13及3.41(1.80～6.45)。养猫与接触生猪肉是人感染弓形体的两个重要危险因素。     

南屯煤矿矿工弓形体感染的流行病学研究

以IHA检测弓形体抗体,1493名煤矿矿工弓形体感染率为7.70±0.69%。资料分析表明,养猫与弓形体感染之间有很强的联系(P﹤0.001,RR=9.95),接触猫是矿工弓形体感染的主要受染方式。在有妊娠和分娩史的妇女中,弓形体抗体阳性者发生不明原因流产的RR为4.95。     

济南地区孕妇弓形体感染调查

用 ELISA 和 IHA 法对济南市市区和郊区的3483名孕妇弓形体感染情况进行了检测。结果显示,感染率为8.79±0.48%,IgM 抗体阳性率为3.42%;农民感染率显著高于一般工人,商业、服务行业和机关干部的感染率;郊区居民感染率显著高于市区;家庭养猫者的感染率显著高于不养猫者;饲养时间<1年、1～2年和≥2年感染弓形体的相对危险度估计值(ORmh)分别为1.29、2.75和3.48,呈明显的剂量反应关系(P<0.05)。     

某传染病院工作人员血清弓形体抗体的调查

弓形体病是一种人群感染率较高的人畜共患寄生虫病。全世界至少有四分之一的人感染弓形体。1983～1986年,崔君兆等对19个省、市、地区人群弓形体感染率进行调查,弓形体抗体平均阳性率为5.17%(0.33%～11.79%)。此病多为后天感染,并可经多种途径传播。传染病院医务人员接触病人血清机会较多,而对其传播尚无报     

天津地区产妇弓形体感染的调查

本文报告了天津地区产妇弓形体感染率平均为3.44％,畜禽为7.48％。产妇感染的主要来源与接触动物和喜食未熟肉类的习惯有关。农村产妇感染率明显高于市区。35岁以上的产妇感染率也显著高于35岁以下者。本文还报告了本次异常孕产妇弓形体感染率较正常高7.87倍。分娩畸形死胎产妇弓形体感染率为分娩外观正常新生儿产妇的11.76倍。     

催化模型在弓形体感染流行病学调查中的应用

本文应用简单催化模型对广西等地弓形体感染率进行了流行病学分析,发现弓形体的易感人群达85~95%,传播速度为0.0521~0.1286。说明每1000人中每年将约有50~130人接触而感染弓形体。与国外一些地区相比具有易感人群多、传播速度快的特点。弓形体感染应引起重视。     

302名特殊人群弓形体感染的行为危险因素

目的 了解特殊人群弓形体感染的行为危险模式。方法 采用实验检验与卷调查结合的方式。结果 调查302人，弓形体感染率19.20%，有5项与弓形体感染有关的行为因素被回归方程选入；弓形体感染染来自于生猪的接触。结论 回归方程选出的与弓形体感染相关的行为危险因素，形成的行为推理理论与其生物学感染方式相似，对上述危险行为的纠正将有助于控制疾病的发生。     

弓形体病流行病学研究进展

弓形体病(Toxoplasmasis)是由刚地弓形体(Toxoplasma gondii)引起的一种人、畜共患性寄生虫病。本病广泛分布于世界各地,人群感染率各地不等,许多国家或地区感染率在20～50%左右,高者可达80%以上。Kean综合世界文献,估计全球人类弓形体平均感染率33%。推测全世界约有5～10亿人有弓形体感染。近年来,我国调查19个省、市、自治区81968人平均感染率5.17%(0.33～11.79%),全国人口标化阳性率为6.02%。     

间接血凝试验检测孕晚期弓形体感染对胎婴儿的影响

弓形体病是全球性人畜共患疾病 ,中国人感染率为1.0 0 %～ 2 5 .0 0 % ,孕产妇的感染率为 3.44 %。孕妇感染弓形体后可通过胎盘导致胎儿宫内感染 ,致流产、畸形、死胎早产及胎儿宫内生长迟缓 ,并增加妊娠并发症。我院应用间接血凝试验 (IHA)检测孕晚期弓形体感染对胎婴儿的影响     

我国人群弓形体感染和弓形体病的评价

采用IHA对我国15个省市自治区61494人进行弓形体抗体血清学检测发现,阳性2988人,平均阳性率4.86%,其中既往感染率4.12%(2325/61494),新近感染率0.89%(548/61494),活动性感染率0.18%(115/61494),新近感染和活动性感染合计总罹患率1.07%(663/61494),在5个省检测30088人,阳性980人,阳性率3.26%,发现弓形体病人11例,在检测人群中的弓形体病病人发现率是3.66‰,在阳性者中病人发现率是112.24/万,病人数与感染阳性者之比为1:89(1:35～1:139)。根据我们调查的数据推测,1986年我国约有5138万人感染弓形体,其中育龄期妇女感染人数约为1315.8万人,1986年出生活产儿的感染弓形体的孕妇数约106.9万人,估算可能出生8.6万名与弓形体有关的畸形儿,估计我国可能有39万例弓形体病患者分布在各地被诊断出来,新近感染和活动性感染者约有1131万人。     

山东省烟台市人与动物新型布尼亚病毒感染调查及同源性分析

目的 了解山东省烟台市人和动物发热伴血小板减少综合征布尼亚病毒 （SFTSV）感染及流行情况。方法 2011年4－11月分别在烟台市的蓬莱和莱州2个SFTS病例高发地区连续采集与人密切接触的5种家养动物 （羊、 牛、 猪、 犬、 鸡） 血清标本3 576份,应用双抗原夹心ELISA方法和Real time RT-PCR方法检测血清中SFTSV总抗体和病毒核酸; 观察不同月份感染情况; 采集两地人群血清2 590份,应用间接ELISA方法检测SFTSV IgG抗体; 用Vero细胞从核酸阳性的人和动物血清中分离病毒,通过RT-PCR方法对 SFTSV S片段进行序列扩增、 同源性分析。结果 3 576份动物血清标本中SFTSV血清总抗体阳性1 439份,阳性率为40.24%,病毒核酸阳性163份,阳性率为4.56%。其中羊、 牛、 鸡、 犬、 猪抗体阳性率分别为62.78%、 52.97%、 45.56%、28.73%和1.45%,核酸阳性率分别为5.72%、 4.63%、 3.02%、 5.25%和3.73%。动物体内的抗原抗体随季节消长而变化。2 590份人群血清SFTSV IgG抗体阳性率为5.41%。对10株来自人的毒株和3株来自动物的毒株进行S片段基因序列扩增分析,显示其同源性在95.23%～100.00%,与国内其他省市分离毒株比较,其同源性在94.72%～99.13%,高度同源。结论 烟台地区存在SFTSV流行,人与家养动物普遍易感,其基因序列高度同源,提示家养动物可能作为SFTSV的增殖宿主和扩散宿主,应引起高度重视。     

Evolution and factors associated with biological-risk accidents reported in a university hospital in Spain, 1989 to 1995

BACKGROUND: The objective of this study was to describe the profile and evolution of accidents involving risk of transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) reported in a large Spanish hospital, together with the preventive measures administered and the factors associated with high-risk accidents. METHODS: Data used were the accidents recorded in the hospital during the period from January 1989 to December 1995. A logistic model, using age, gender, service, occupation, and year of accident as independent variables was constructed to study the factors associated with these accidents. RESULTS: The study included 1,009 accidents. Accidents were more common among nurses, female doctors, younger workers, and persons who worked in surgical settings. Of the total sources of infection studied, 11.6% were positive for HBV, 28.2% for HCV, and 24.4% for HIV. No seroconversions were detected in the partial follow-ups conducted. The factors associated with high-risk accidents were gender (relative risk [RR], 2.01; 95% confidence interval [CI95], 1.24-3.60); occupation as physician (RR, 2.57; CI95, 1.54-4.29) or as nursing staff (RR, 1.80; CI95, 1.12-2.89); and working in a surgical service (RR, 2.01; CI95, 1.27-3.18). Younger workers had more accidents overall, but older workers were more likely to have high-risk exposure. In the multivariate analysis, the occupation (physician and nursing staff) was the most important variable when adjusted by the other factors. CONCLUSIONS: Our results suggest that a greater effort still is required in the application and evaluation of preventive measures. New safety systems, with clearly proven cost-effectiveness, should be developed and applied.     

农村育龄妇女绝育术后心身反应的预测研究

在对湖南农村育龄妇女输卵管绝育术心身状况进行前瞻性群组研究的基础上,应用群组Logistic回归模型分析方法首次证明:农村育龄妇女绝育术后心身反应是多种潜在危险因子的联合效应。依据相对危险度(RR)的大小,定量评估了受术者术前潜在危险因子与术后心身反应的关联强度:不良应付方式(RR=37.71)、暗示性(RR=4.53)、情绪稳定性(RR=3.44)、疼痛敏感性(RR=2.14)和手术地点(RR=2.05)。建立了女性绝育术后1年内出现心身反应的概率预测模型。该预测模型的病例回代判别分析的阳性预告值为73.6％,阴性预告值为95.4％,总一致性为91.61％。证明预测模型具有较高的筛检实验效力,可作为术前预测筛选工具。     

Prospective study of diet, lifestyle, and intermittent claudication in male smokers

The association between dietary and lifestyle factors and intermittent claudication was investigated in the Finnish Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. The cohort comprised 26,872 male smokers aged 50-69 years who were free of claudication at study entry. At baseline (1985-1988), subjects completed a diet history questionnaire. During a median follow-up period of 4 years (ending in spring 1993), 2,578 men reported symptoms of claudication on the Rose questionnaire, which was administered annually. Smoking status was assessed every 4 months. Smoking, systolic blood pressure, serum total cholesterol, and diabetes mellitus were positively associated with risk for claudication, whereas serum high density lipoprotein cholesterol, education, and leisure time exercise were inversely associated with risk. Dietary carbohydrates, fiber, and n-6 polyunsaturated fatty acids were inversely associated with risk for claudication, as were some dietary and serum antioxidants: dietary vitamin C (highest quartile vs. lowest: relative risk (RR) = 0.86; 95% confidence interval (CI): 0.77, 0.97), dietary gamma-tocopherol (RR = 0.89; 95% CI: 0.79, 1.00), dietary carotenoids (RR = 0.82; 95% CI: 0.73, 0.92), serum alpha-tocopherol (RR = 0.88; 95% CI: 0.77, 1.00), and serum beta-carotene (RR = 0.77; 95% CI: 0.68, 0.86). Smoking cessation reduced subsequent risk for claudication (RR = 0.86; 95% CI: 0.75, 0.99). The authors conclude that classical risk factors for atherosclerosis are associated with claudication. High intakes of antioxidant vitamins may be protective. Further research is needed before antioxidants can be recommended for the prevention of intermittent claudication.     

Predisposing factors in laboratory animal allergy: a study of atopy and environmental factors

A population of 101 laboratory technicians handling laboratory animals was studied with regard to predisposing factors for allergy. Twenty-seven had symptoms indicating laboratory animal allergy (LAA); of these, nine had asthma and were skin prick test positive for animal allergens. The LAA asthmatics had an increased frequency of a family history of allergy (relative risk, RR = 3.8); the predictive value was 0.27. There was also an increase of skin prick positivity against common nonanimal allergens (RR = 15); the predictive value was 0.60. All persons with marked positive skin prick tests (greater than or equal to +2) to environmental allergens had developed animal-test-positive LAA asthma. In 56% of the LAA asthma cases the serum IgE levels were elevated (greater than 100kU/L). In preemployment screening of susceptible individuals two important selection criteria emerged, viz., family history of allergy and positive skin prick reactions against environmental allergens.     

Interlaboratory Interprotocol Comparison of Indirect Immunobead Assay for Sperm-Associated Antibodies in Serum

This investigation was designed to study the effect of two different protocols on the indirect sperm-associated antibody test on serum performed using Bio-Rad immunobead (IBT) at two andrology laboratories. Aliquots of 31 serum samples from infertile couples were analyzed by both protocols. The IBT was negative by both protocols (100% concordance) for 18 serum samples. Seven of the 13 remaining samples were positive by both protocols (≥10% bead attachment by protocol A and ≥20% bead attachment by protocol B), for a concordance of 54%. The remaining six samples were positive by one of the two protocols. The overall concordance for positive and negative results was 81% (25 of 31 samples). Protocol A detected a higher percentage of bead attachments for IgG and IgA, while protocol B detected a higher percentage of bead attachments for IgM. The discordance in the results of IgA attachment obtained by the two protocols was statistically significant (p <. 05). A standardized, uniform protocol for the indirect IBT is needed.     

Prevalence of Coxiella burnetii (Q fever) antibodies in bovine serum and bulk-milk samples

Q fever (Coxiella burnetii) is a zoonotic disease of increasing public health importance. The objective of this study was to estimate the prevalence of, and risk factors associated with, exposure to C. burnetii in cattle in the Republic of Ireland. Bulk-tank milk samples from 290 dairy herds and 1659 sera from 332 dairy and beef herds, randomly sampled, were tested by indirect ELISA to detect antibodies to C. burnetii. In total, 37·9% of bulk-milk sample herds and 1·8% of sera (from 6·9% of herds) were antibody positive. Of risk factors tested using logistic regression analysis, only large herd size (bulk-milk analysis) and dairy breed (serum analysis) significantly increased the odds of being positive for antibodies to C. burnetii. Herds with positive milk or serum samples were randomly distributed throughout the Republic of Ireland and no clustering was observed. The use of an ELISA to test bulk-milk samples collected by randomized stratified sampling is a cost-effective method by which national herd prevalence can be estimated by active surveillance.     

Eosinophilia and positive skin tests predict cardiovascular mortality in a general population sample followed for 30 years.

The authors investigated whether two objective allergy markers, peripheral blood eosinophilia and skin tests for common aeroallergens, were associated with cardiovascular death. Of 5,382 subjects in the Vlagtwedde-Vlaardingen Study (the Netherlands) with data on allergy markers in 1965-1972, 507 subjects died from cardiovascular disease during 30 years of follow-up. Subjects with eosinophilia had an increased risk of cardiovascular death (relative risk (RR) = 1.7; 95% confidence interval (CI): 1.4, 2.2), including ischemic heart disease death (RR = 1.6; 95% CI: 1.2, 2.2) and cerebrovascular death (RR = 2.3; 95% CI: 1.4, 3.8), independent of major risk factors. This association was limited to subjects with a percentage of the predicted forced expiratory volume in 1 second (FEV1 % predicted) of <100%. Positive skin tests were associated with a significantly reduced cardiovascular mortality in subjects with normal lung function and weight who did not smoke (RR = 0.15; 95% CI: 0.05, 0.46). Conversely, when subjects with positive skin tests had a body mass index of > or =25 kg/m2, had an FEV1 % predicted of <80%, or smoked, they had an increased risk for cardiovascular mortality. These results were not restricted to asthmatics. Our data suggest a possible link between eosinophilia and positive skin tests and cardiovascular mortality, especially in combination with other risk factors associated with its mortality.     

间接酶联免疫吸附试验检测免疫人群血清狂犬病病毒抗体的效能评价

目的 用金标准快速荧光灶抑制试验(rapid fluorescent focus inhibtion test,RFFIT)评价间接ELISA检测免疫人群血清狂犬病病毒抗体的效能。 方法 收集在广西壮族自治区疾病预防控制中心门诊部首次全程接种狂犬病疫苗的个体血清和加强免疫血清共314份,用RFFIT和间接ELISA两种方法对其进行狂犬病病毒抗体检测。 结果 314份血清标本用两种方法检测结果一致率为81.85%,与RFFIT比较,间接ELISA检出阳性结果符合率为83.50%,阳性预计值为96.88%,阴性符合率为52.94%,阴性预计值为15.52%,经McNemar检验两种方法检出结果差异有统计学意义(P<0.05);进一步从RFFIT值分析得出87.76%的假阴性标本都存在于RFFIT值<3.0 IU/ml的标本中,从免疫后时间分析得出93.88%的假阴性标本都存在于免后1~3年标本中,而对于高RFFIT值的血清标本特别是全程免疫后42 d和加强免疫的高几何平均滴度的血清标本,间接ELISA结果假阴性率很低(3.26%及以下),两种方法检测结果一致率高达95.70%及以上,经McNemar检验两种方法检出结果差异无统计学意义(P>0.05)。 结论 间接ELISA可以用在狂犬病疫苗全程免疫后抗体阳转率的普查,用于个人免疫效果的评价方面需谨慎。     

Two outbreaks of occupationally acquired histoplasmosis: more than workers at risk

OBJECTIVE: The objective of this study was to determine the etiology and risk factors for acute histoplasmosis in two outbreaks in Illinois among laborers at a landfill in 2001 and at a bridge reconstruction site in 2003. DESIGN: We performed environmental investigations during both outbreaks and also performed an analytic cohort study among bridge workers. PARTICIPANTS: Workers at the landfill during May 2001 and those at the bridge site during August 2003 participated in the study. At the landfill, workers moved topsoil from an area that previously housed a barn; at the bridge, workers observed bat guano on bridge beams. EVALUATIONS/MEASUREMENTS: We defined a case by positive immunodiffusion serology, a > or = 4-fold titer rise in complement fixation between acute and convalescent sera, or positive urinary Histoplasma capsulatum (HC) antigen. Relative risks (RR) for disease among bridge workers were calculated using bivariate analysis. RESULTS: Eight of 11 landfill workers (73%) and 6 of 12 bridge workers (50%) were laboratory-confirmed histoplasmosis cases. Three bridge workers had positive urinary HC antigen. At the bridge, seeing or having contact with bats [RR = 7.0; 95% confidence interval (CI), 1.1-43.0], jack-hammering (RR = 4.0; 95% CI, 1.2-13.3), and waste disposal (RR = 4.0; 95% CI, 1.2-13.3) were the most significant job-related risk factors for acquiring histoplasmosis. CONCLUSIONS: Workers performing activities that aerosolized topsoil and dust were at increased risk for acquiring histoplasmosis. Relevance to professional and clinical practice: Employees should wear personal protective equipment and use dust-suppression techniques when working in areas potentially contaminated with bird or bat droppings. Urinary HC antigen testing was important in rapidly identifying disease in the 2003 outbreak.