一起甲型副伤寒爆发调查分析

目的了解疫情爆发原因,总结经验教训。方法所有病例都采用统一表格进行个案调查,病例诊断标准参照国标,由临床医生和防疫医生共同诊断。在爆发期间有流行病学史,临床症状明显或症状不典型但白细胞数下降的定为临床病例;血或粪便培养副伤寒杆菌阳性,或血清肥达式反映达辅助诊断意义的定为确诊病例。结果共发病223例,无死亡病例,总罹患率为2.42%(223/9215)。其中学生发病211例,罹患率为2.56%(211/8215);教职工发病12例,罹患率为1.20%(12/1000)。本次疫情是因沙门氏菌污染食物造成的副伤寒爆发,后期疫情延续是因接触性传染引起的。结论本次疫情延续时间较长,主要是由于发现和报告时间较迟,失去早日控制疫情的时机,造成后期接触性传染。因此必须重视学校传染病疫情监测和报告工作,以防肠道传染病的爆发流行。

An Investigation of the Outbreak of Paratyphoid Fever

Objective To perform an epidemiological study of an outbreak of paratyphoid fever. Method Questionnaire type of survey and standard clinical examination were carried out by the clinicians and epidemiologists. Patients with clinical symptom, or the symptom was not typical but the number of the leucocyte count was low, were classified as the clinical case. Patients with positive identification of typhoid bacillus in blood, excrement or urine train packs were classified as confirmed cases. Result There were 223 cases of paratyphoid fever. Nobody was killed by the infection. The attack rate was 2.42%(223/9215). Among the 223 cases, 211 were middle school students (attack rate was 2.56%, 221/8215),and 12 were teachers and employee (attack rate was 1.20%,12/1000)Epidemiological study showed that the outbreak was due to food contamination with Salmonella. The disease was subsequently spread out through the contact with contaminated materials. Conclusion The prolonged epidemic of paratyphoid fever was due to the delayed notification of the disease outbreak. Hence the disease could not be controlled at the early stage of outbreak.In the future,the hygienic conditions in school should be closely monitored.