2011-2013年湖南省流行性感冒暴发疫情流行特征分析

目的了解湖南省2011-2013年流行性感冒(简称流感)暴发疫情的流行病学特征和毒株变异情况,评价预防控制措施效果,为流感防控提供科学依据。方法收集2011-2013年全省突发公共卫生事件管理信息系统报告的流感暴发疫情资料,进行描述性流行病学分析。结果 2011-2013年全省报告16起流感暴发疫情,发病999例,平均罹患率为5.85%(999/17 077),无死亡病例。暴发病原类型主要是新A(H1N1)亚型、A(H3N2)亚型和B型流感病毒;暴发时间以冬春季节为主(2-3月和11-12月);主要发生在中小学校(13起,占81.25%);9起(56.25%)发生在农村,7起(43.75%)发生在城市及县城;发病人群罹患率小学生高于中学生和成人;A(H3N2)亚型和B型流感病毒暴发疫情中首例发病时间至疾病预防控制机构接到报告、处置时间与疫情持续时间呈正相关(r=0.81,P=0.004)。结论中小学校是流感暴发的高发场所。加强学校流感样病例监测,提高事发单位报告敏感性,及早对事件采取相应的处理措施是控制流感暴发的关键。     

四川省5所学校流感暴发疫情中2022—2023年季节性流感疫苗保护效果回顾性队列研究

目的 分析2022—2023年流感季接种流感疫苗在学校流感暴发疫情中的保护效果,为流感疫苗接种策略提供科学依据。方法 以2023年2—4月四川省5所发生流感暴发疫情的小学、初中,幼小综合学校班级确诊病例数≥2例的班级学生为调查对象,采用回顾性队列研究方法评估流感疫情期间疫苗的保护效果。采用多因素logistic回归计算流感疫苗对临床诊断病例和确诊病例的保护效果[VE_adj=(1-RR_adj)×100%],调整的变量为就读学段、学校和年龄组。结果 共纳入4 087名研究对象,流感疫苗接种率为19.0%。发病1 352例,发病率为33.1%,其中,疑似病例401例、临床诊断病例659例、确诊病例292例。接种流感疫苗对临床诊断病例和确诊病例的VE_adj(95%CI)为26.0%(0.6%～44.9%)。分层分析显示,接种时间与发病时间间隔在[14,120] d和(120,180] d的VE_adj(95%CI)分别为78.3%(59.8%～88.3%)和58.6%(35.6%～73.4%),时间间隔>...     

2018—2020年珠海市学校流感样病例暴发疫情流行特征及影响因素分析

目的 分析珠海市2018—2020年学校流感样病例暴发疫情的流行特征和影响疫情规模的相关因素,为制定防控策略提供依据。方法 采用描述流行病学方法分析学校流感样病例暴发疫情流行特征,采用χ2检验和Logistic回归分析疫情规模的影响因素。结果 2018—2020年珠海市学校累计报告67起流感样病例暴发疫情,累计发病人数1 746例。发病高峰为每年3月—6月和12月—次年1月,主要发生在小学,流感样病例的发病年龄高峰为6～8岁。病原体主要为B型、A(H3N2)亚型和A(H1N1)亚型流感病毒。暴发疫情涉及病例咽痛发生率>50%的学校发生大规模流感样病例暴发疫情的风险是咽痛发生率≤50%学校的4.308倍(95%CI:1.100～16.864)。结论 2018—2020年珠海市学校流感样病例暴发疫情主要集中在冬春季节的小学,高咽痛发生率是学校发生大规模疫情流感样病例暴发疫情的危险因素。     

2016—2021年上海市崇明区学校流感流行病学特征分析

目的 了解上海市崇明区学校流感暴发疫情的流行特征，为今后防控学校流感暴发疫情提供科学依据。方法 收集2016—2021年中国流感监测信息系统中报告的崇明区学校流感暴发疫情相关资料，进行描述流行病学分析。结果 2016—2021年崇明区共报告学校流感暴发疫情9起，累计发病160例，波及人数5 056人，发病率为3.16%(160/5 056)。暴发疫情主要发生在1月和12月。8起疫情主要发生在小学。病原学类型以B型Victoria系为主，其次是A型H1N1(2起)和H3N2(2起)。疾控介入天数与疫情持续时间呈正相关（r=0.836,P=0.005）。结论 崇明区学校流感暴发疫情高危场所为小学，冬春季易发，及早采取有效的防控措施是预防学校流感暴发的关键。     

水痘疫苗2剂次接种程序对四川省大英县水痘发病率的影响

目的 分析《大英县中小学托幼机构水痘预防和控制工作方案(试行)》(简称《方案》)实施前后,大英县水痘发病、暴发疫情及疫苗接种的变化,评价2剂次水痘疫苗接种的作用。方法 通过收集中国疾病预防控制信息系统中2015—2022年报告的大英县水痘病例监测资料和暴发疫情现场流行病学调查相关资料,以及四川免疫规划管理信息系统中水痘疫苗接种资料,进行描述性流行病学分析。结果 2019年《方案》实施后,总接种剂次、第1剂、第2剂分别增加73.82%、10.96%、190.03%。2015—2022年大英县共报告水痘病例1 443例,年均报告发病率为45.12/10万。《方案》实施后,年均发病率下降62.45%(χ²=15.915,P<0.001)。1～14岁年龄组儿童水痘发病率下降77.20%,其中5～9岁年龄组发病率下降幅度最大,为88.99%,15～24岁年龄组水痘发病率上升91.83%。暴发疫情总罹患率由1.35%下降至0.55%,每起疫情发病人数由9.50人下降至7.00人,每起疫情持续时间由33.00 d下降至23.50 d,每起疫情代次由1.57代下降至1.12...     

2017—2021年宜兴市学校流感暴发疫情分析

目的 分析近年宜兴市学校流感暴发疫情的流行特征以及影响因素,为防控学校流感暴发提供参考依据。方法 收集2017—2021年流感暴发疫情数据以及现场流调的相关资料,对疫情流行特征进行描述性分析;采集病例咽拭子标本,采用RT-PCR法进行流感病毒核酸及分型分析;对首发病例到疫情接报的时间间隔和流感暴发持续时间进行分析。结果 2017—2021年宜兴市共报告16起学校流感暴发疫情,累计发病318例,罹患率为1.20%;共采集205份样品,流感核酸阳性检出率为66.78%,疫情主要发生在12月—次年3月(占75.00%);疫情主要发生在小学(占81.25%),发病年龄主要为6～9岁(占78.23%),以乙型Victoria型流感病毒暴发疫情为主(占56.25%)。首发病例到疫情接报日期时间间隔与疫情持续时间存在正相关(r=0.57,P<0.05)。结论 宜兴市学校流感暴发疫情以冬春季高发,小学是流感暴发的高发场所;未来应加强监测,提高报告的及时性将有利于快速控制疫情。     

甲型H1N1流感疫苗接种对其暴发疫情的影响

目的了解甲型H1N1流感(甲流)疫苗接种后对甲流暴发疫情的影响。方法对2011年4—5月发生在学校的1起甲流暴发疫情进行流行病学描述性分析,用回顾性队列研究的方法分析甲流疫苗接种对该起暴发疫情的影响。结果该校542名师生中191人患病,罹患率为35.24%,发病时间主要集中在4月19—25日,发病人群主要为1～6年级的小学生(χ2=9.972,P0.01),住校生发病高于非住校生,112名接种过甲流疫苗的师生发病率为16.96%,明显低于未接种疫苗的师生(40%),差异有统计学意义(χ2=20.661,P0.05),OR=0.306(95%CI∶0.180～0.521)。结论接种甲流疫苗可以有效预防甲型H1N1流感的发生,减少暴发疫情的发病率。     

2009-2015年淄博市流感样病例暴发疫情监测分析

目的 分析2009-2015年山东省淄博市流行性感冒（简称流感）样病例暴发疫情的流行特征和毒株变迁,为流感防治提供科学依据。方法 收集淄博市2009-2015年流感监测信息系统和突发公共卫生事件报告管理信息系统中流感样病例和流感暴发疫情的信息,采用描述性流行病学方法对收集的数据和结果进行分析。结果 淄博市2009-2015年共报告40起流感样病例暴发疫情,罹患率6.08%;疫情报告时间主要集中在12月份,占42.50%（17/40）;疫情报告年份主要集中在2009年和2014年,分别占37.50%（15/40）和27.50%（11/40）;疫情主要发生在初中、小学和幼儿园,占72.50%（29/40）;导致流感样病例暴发疫情的病毒亚型主要为H3N2亚型和新型甲型H1N1,每年度优势病毒亚型不同。首发病例到采取措施的时间与疫情的持续时间呈正相关（r_s=0.796,P<0.001）。结论 淄博市流感暴发疫情具有明显的季节性,初中以下学校及幼儿园是流感暴发疫情的主要高发场所,暴发流行的优势毒株循环交替,尽早采取控制措施是降低流感暴发规模的有效手段。     

2017—2021年佛山市高明区流感流行特征及影响因素分析

目的 分析2017—2021年广东省佛山市高明区流感流行特征及影响因素，为佛山市高明区预防流感提供理论依据。方法 根据佛山市高明区的流感资料，对流行病学特征进行描述性分析，根据流感持续时间为结局变量，以采取措施的时间、聚集场所、流感病毒分型、流感疫苗接种情况等为自变量，采用logistic回归分析流感发生持续时间的影响因素。结果 2017—2021年佛山市高明区累计报告流感病例5 782例，男性占比(51.45%)高于女性(48.55%);流感发病年龄主要在3～8岁(50.47%);发病季节主要集中在冬季(69.82%);2017—2021年佛山市高明区流感病例涉疫场所主要为幼托机构(49.44%)和小学(29.78%);引起流感暴发的流感病毒主要甲型H1N1系(48.88%)和乙型Yamagata系(23.11%);多因素logistic回归分析显示采取措施的时间、疫苗接种情况是流感疫情持续时间的保护因素。结论 佛山市高明区流感主要集中在3～8岁儿童，以冬季高发，幼托机构和小学是流感高发场所，应倡导学生积极接种疫苗，快速采取措施，可降低流感暴发的持续时间。     

2015-2018年贵阳市流感暴发疫情流行病学特征分析

目的 分析2015-2018年贵阳市报告流感暴发疫情情况及流行病学特征,为防控流感暴发疫情提供科学依据。方法 收集2015-2018年贵阳市报告的流感暴发疫情资料,对疫情发生时间、地区、人群进行描述性流行病学分析,采集流感样病例咽拭子标本用实时荧光定量PCR进行流感病毒检测。结果 2015-2018年贵阳市共报告流感暴发疫情46起,累计发病人数1233人,平均罹患率2.08%。暴发疫情主要发生在9月~次年4月,疫情主要发生在中小学校,暴发疫情病毒包括有A型H1N1亚型,A型H3N2型,B型Victory亚型,B型Yamagata亚型,四种型别同时流行,交替成为优势病毒。结论 贵阳市流感暴发疫情主要集中在9月~次年4月,中小学是流感暴发高发场所,应加强对学校流感样病例暴发疫情的监测,病毒优势毒株变化频繁,需密切关注病原学变化。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.