症状监测在突发事件中的应用

目的 评价症状监测系统在传染病监测中的效果.方法 数据收集通过临时安置点医务室医生使用的"接诊登记表",数据日分析、解释、分发由当地CDC受指派医务人员执行,监测到的数据按症候群分成4类,包括呼吸道症候群(咳嗽、咽痛、流涕),消化道症候群(每日腹泻次数、恶心、呕吐),发热症候群(体温≥37.3℃)和其他症候群(头昏、头痛、乏力及其他症状),疑似病例进行实验室确诊.结果 总计人群中有7566(73%)就诊人次,共识别了44%呼吸道症候群,9%消化道症候群,1%发热症候群,46%其他症候群.21%(1578/7566)的就诊者是60岁及以上的老年人.男女性别比为0.76:1.呼吸道、消化道、发热症候群总计4380组,就诊高峰发生在2006年3月30日和4月3日.报告一例疑似麻疹病例,经血样检测后排除麻疹,避免了大面积接种麻疹疫苗.共发现71例发热患者,其中高热患者8例(体温≥39℃).报告一起疑似急性出血性结膜炎爆发,全部21例病例进行了流行病学调查后证实是硫化氢引起的急性眼刺激征.结论 症状监测有助于监测传染病病例,能迅速显示症候群消长趋势,实施成本低廉,在突发事件中实施有效可行,对类似的事件有实际应用价值.

Application of syndromic surveillance in the emergency events

Objective To evaluate syndromic surveillance effect in the emergency events, nethod We collected data from doctors using outpatient registers in the temporary settlements. Analysis, interpretation and dissemination of data were implemented daily by designated medical personnel of local CDC. symptoms were categorized in 4 clusters including respiratory symptoms(cough, angina, sniveling), gastrointestinal symptoms(diarrhea, nausea, vomiting), fever symptoms(T≥37.3 ℃ ) and miscellaneous symptoms( dizziness, headache, nerveless and other symptoms ). Specimens of suspect case were collected for laboratory confirmation. Results Overall, 73% outpatients were identified, included 44% respiratory symptoms, 9% gastrointestinal symptoms, 1% fever symptoms, 46% miscellaneous symptoms, 21% outpatients were 60 years old and above. The sex ratio is 0.76:1. Remove miscellaneous symptoms, respiratoryend gas trointesfinalend fever symptoms were totally 4380 capita and the peak of prevalence rate occurred at 30th March and 3rd April. One suspect measles case was reported on 29th, blood specimen were tested, and confirmed nettle rash and avoided inoculation of measles. 71 fever (T≥37.3 ℃ )patients were detected including 8 high fever patient(T≥39 ℃ ). An outbreak of suspicious acute hemorrhagic conjunctivitis(AHC)was detected and all of 21 cases were investigated, and confirmed acute eye irritation caused by hydrogen sulfide. Conclusions Syndromic surveillance enables us to show the trend quickly and it can be carried out with smaller costs. Syndromic surveillance is effective in the emergency events. It should be considered to apply at similar events.