贵港市急性脑炎及脑膜炎症候群病原体监测

目的 了解华南地区急性脑炎及急性脑膜炎的发病强度、病原谱和流行病学特征，为急性脑炎、脑膜炎的临床诊治和预防控制提供参考依据。方法 在广西贵港市建立涵盖市辖区、桂平市和平南县的急性脑炎、脑膜炎流行病学监测网络，按照筛检标准评估疑似病例，进行流行病学调查和采样，对标本开展细菌学培养和10种常见病毒检测。结果 2007年5月—2008年10月监测期内，共评估急性脑炎及急性脑膜炎症候群病例 883例，死亡 41例，细菌学培养和PCR检测发现存在肺炎链球菌、流脑、Hib、猪链球菌等致病菌，病毒学检测发现肠道病毒、腮腺炎病毒和乙脑病毒是病毒性脑炎脑膜炎的主要病原，贵港市确诊的细菌性、病毒性脑炎脑膜炎年均发病率分别为0.92/10万和6.42/10万，细菌性、病毒性脑炎脑膜炎均以夏秋季多见，10岁以下儿童为主，职业分布细菌性脑炎脑膜炎以散居儿童和农民为主，分别占48.65%和29.73%，病毒性脑炎脑膜炎以散居儿童和学生为主，分别占59.64%和21.08%。结论 广西贵港市急性脑炎脑膜炎病例以病毒性感染占多数，病原诊断的细菌性脑炎脑膜炎发病率处于较低水平。

Pathogenic surveillance on acute meningitis and encephalitis syndrome in populations of Guigang city

Objective To analyze the prevalence and pathogen of acute meningitis and encephalitis in Guigang city,Guangxi Zhuang Autonomous Region.Methods A surveillance network for detection of acute meningitis and encephalitis cases was set up in Guigang,which covered all the population in Guigang and 12 hospitals at county level and above.Suspicious cases were selected and evaluated according to disease screening criteria.All cases met the diagnostic criteria received a questionnaire survey and their blood and cerebrospinal fluid(CSF)samples were collected.Bacteriological culture and detections of 10 common viral IgM with PCR and enzyme-linked immunosorbent assay(ELISA)were conducted for the samples.Data were input and analyzed by using Epi Info 2002.Results During the surveillance period from May 2007 to April 2008,a total of 883 cases met the diagnostic criteria with 41 cases of death.The bacteriological pathogens of the cases included Streptococcus pneumoniae(Sp.),Neisseria meningitides(Nm),haemophilus influenza B(Hib),and Streptococcus suis.The enteroviruses,mumps virus and Japanese encephalitis(JE)viruses were the main pathogens of viral encephalitis.The incidence rate of bacteriological and virus encephalitis for the city were 0.92/100 000 and 6.42/100 000,respectively.Most of the cases occurred in summer and autumn and were under 10 years old.Conclusion The main cause of acute encephalitis and meningitis in Guigang city was viral infections.The incidence of bacterial encephalitis and meningitis is at a low level.