上海市1988年甲型肝炎暴发的血清流行病学研究

本文以人群为基础,调查了上海市长宁区居民1649人。结果显示甲型肝炎(简称甲肝)罹患率为5.76％,发病以青壮年为主,男女性别无显著差別(p>0.05)。调查人群中食毛蚶者甲肝罹患率为15.86％,未食者为0.64％。相对危险度(RR)为24.78,特异危险度(AR)为15.22％,特异危险度百分比(AR％)为95.96％,人群特异危险度(PAR)为5.12％,人群特异危险度百分比(PAR％)为88.89％。甲肝发病与食蚶量及食蚶方式有关(p<0.0001)。对1649名居民采血470份,检测抗HA和抗HAIgM。血清学调查结果显示人群对甲肝易感性随年龄的增加而降低。人群的甲肝易感性平均为30.21％。抗HA阴性易感者食毛蚶的甲肝罹患率为29.41％,感染率为38.24％;未食蚶易感者甲肝罹患率分别为1.35％和5.41％。RR分别为21.79和7.07。本次甲肝流行隐性传染率为1.91％。     

1988年上海地区甲型肝炎传播途径的探讨——120对配对病例对照研究

120对1:2配对病例对照研究结果表明,1988年上海地区甲型肝炎暴发流行与接触肝炎患者、外出用餐、注射或输血、服用某些药物等传播途径无关,而与生食毛蚶有关(OR=23.20,X~2=69.22,p<0.0001),且罹患甲型肝炎的危险性OR值随生食毛蚶量上升(X_t~2=62.11,p<0.0001),控制年龄混杂因素后,仍有剂量反应关系。病例家属和(或)对照家属生食毛蚶者比未生食毛蚶者罹患甲型肝炎的危险性要高(OR=9.01,X~(MH)~2=29.97,p<0.0001)。     

上海1988年甲型肝炎流行起因与预防措施研究

1988年1月,上海市发生甲型肝炎暴发流行,病例30余万,疫情之猖獗,医学史上未见报道。经流行病学、病原学研究证实了流行起因,阐述了促成流行的动因。社会经济学和临床研究分析了该次流行对社会所造成的危害及流行中病例的临床特点,为控制流行的再度发生,研究了相应的预防措施。通过现况调查和人群血清甲肝抗体检测查明,食用毛蚶者罹患率显著高于未食用者,相对危险度18左右。食蚶量越大,罹患率越高;食蚶量越大,显性发病比例愈高;呈现明显的剂量效应关系。毛蚶上市后一个月流行发生,间隔期相当于     

毛蚶与甲型病毒性肝炎间关系的病例-对照研究

经对病人血清中特异性抗甲型病毒性肝炎(甲肝)IgM抗体的检测结果证实,1988年元月上海市区爆发的急性肝炎为甲肝。配对的病例-对照调查表明其直接发病原因为居民生食不洁毛蚶。经均衡可能混杂因素的成组分层分析得到的食用毛蚶比不食毛蚶罹患甲肝的相对危险度高62.4倍。     

1988年春季福州市区甲型肝炎暴发流行调查报告

福州市区1988年春季肝炎暴发流行,报告4169名病例,罹患率达547.1/10万。开展对6万人的流行病学调查、230对病例对照研究、618份血清研究和13份早期病人粪便与20份毛蚶提取液用EIA及免疫电镜进行HAAg检测。结果:抗-HAVIgM检出率83.66％,证实本次流行以甲型肝炎为主。流行因素可能为春节期间进食不洁的毛蚶。     

濮阳市甲肝暴发疫情流行病学调查报告

目的查明暴发原因和传播途径,分析流行因素,评价控制效果。方法对每一例病人做个案调查,了解病例的三间分布;采用病例对照研究,以29名病人为病例组,选择29名性别年龄相同健康儿童为对照,比较病例组与对照组的甲肝疫苗接种率差异和饮用水源情况。结果病例组与对照组甲肝疫苗接种率有非常显著性差异(χ2=32.29,P<0.001);集中供水与分散供水水源使用率无差异(χ2=0.1,P>0.05,OR=1.53)结论此次暴发的传播途径为日常生活接触;及时发现、报告和隔离病人,加强对生活饮用水、公共场所的消毒和甲肝防治知识宣传,提高甲肝疫苗接种率是控制甲肝暴发的有效措施。     

甲型肝炎的传播途径与排毒规律研究

上海医科大学和上海市卫生防疫站等单位对1982～1983年市区甲型肝炎暴发流行作了大规模的系统性流行病学调查,首次提出了该次流行与食用毛蚶有关。发现生吃毛蚶者患甲肝的危险性是无生吃史者的6倍。并设计了模拟水生贝壳类动物实验感染甲肝病毒的方法,通过组织培养(亚历山大肝癌细胞株)从实验感染第8天的毛蚶消化腺中,分离到HAV,TCLD_(50)为10~(-1·81)/ml。经1∶30倍稀释后,仍能     

某市1起甲肝暴发流行的调查报告

目的为今后防控工作提供依据。方法运用流行病学方法进行调查。结果共报告病例39例,罹患率0.19‰,病例对照调查,病例组和/或接触过双井水与对照组比较差异有统计学意义(χ2=28.45,P=0.001,or=37,95%cl=6.55-251.36)。结论因水源污染引起的甲肝暴发流行。     

某校甲肝爆发疫情的流行病学调查

目的 探明甲型肝炎(以下简称甲肝)爆发的原因。方法 对该校甲肝爆发疫情进行爆发的流行病学调查。结果 查出该校学生甲肝31例，年龄8-12岁，平均罹患率10.04％。结论 建议广泛开展中、小学生健康教育，严格管理甲肝传染源。     

深圳某酒店同餐次两批聚餐人群食物中毒的调查

目的对同时发生在某酒店的两组人群食物中毒进行调查和分析,探讨之间的关系。方法采用现场调查、病例对照方法,结合实验室检测结果对危险因素进行分析。结果本次疫情共报告96例病例,其中婚宴病例39人,公司庆典病例57人,两人群罹患率分别为10.83%和20.21%。两组人群有相似的临床表现,病例对照结果显示两组人群食谱中吃过扬州炒饭与发病具有较强的统计学关联。112份采集样本中12份肛拭子分离出肠炎沙门菌,其中11株肠炎沙门菌进行脉冲场凝胶电泳(PFGE)分子分型,图谱类型完全一致。结论结合流行病学调查、临床表现和实验室检测,判定这是一起由聚餐引起的肠炎沙门菌食物中毒事件。     

Hepatitis B virus infection among street youths in Montreal

BACKGROUND: Street youths are at high risk for many health problems, including sexually transmitted diseases and bloodborne infections. The authors conducted a cross-sectional anonymous study from December 1995 to September 1996 involving street youths in Montreal to estimate the prevalence of risk behaviours for hepatitis B virus (HBV) infection and of markers of past and present HBV infection. METHODS: Participants were 437 youths aged 14 to 25 meeting specific criteria for itinerancy who were recruited in collaboration with the 20 major street youth agencies in Montreal. Sociodemographic and lifetime risk factor data were obtained during a structured interview, and a blood sample was taken to test for HBV markers (hepatitis B surface antigen and antibodies to the hepatitis B core antigen). Univariate analyses and multivariate logistic regressions were conducted. RESULTS: The mean age of the subjects was 19.5 years; 69.3% (303/437) were males. Many subjects had high-risk behaviours: 45.8% (200/437) had injected drugs, 24.5% (107/436) had engaged in prostitution, and 8.7% (38/437) reported having a sexual partner with a history of unspecified hepatitis. The prevalence rate for one or both HBV markers was 9.2% (40/434) (95% confidence interval [CI] 6.7%-12.3%). Multivariate logistic regression analysis showed that being over 18 years of age (adjusted odds ratio [OR] 4.5, 95% CI 1.8-11.7), having injected drugs (adjusted OR 3.5, 95% CI 1.5-8.3) and having had a sexual partner who had unspecified hepatitis (adjusted OR 3.2, 95% CI 1.3-7.5) were all associated with HBV infection. INTERPRETATION: Street youths are at high risk for HBV infection. Early and complete HBV vaccination among this vulnerable population is urgently needed.     

上海市浦东新区HIV高危人群感染HBV和HCV的流行病学调查

目的 了解上海市浦东新区HIV高危人群的乙肝病毒（HBV）、丙肝病毒（HCV）感染状况,分析危险因素,建立更有针对性的HBV、HCV防制策略。方法 采用整群抽样和连续抽样等方法抽取2019—2020年浦东新区HIV高危人群,开展问卷调查、实验室检测,描述并比较HBV、HCV感染率的异同,采用Logistic回归分析HBV、HCV感染的危险因素。结果 共调查5 784人,HIV感染率为2.46%,HBV感染率为7.16%,HCV感染率为2.52%,HBV-HCV合并感染率为0.14%,HIV-HBV合并感染率为0.21%,HIV-HCV合并感染率为0.03%,无HIV、HBV、HCV合并感染者。HBV感染的危险因素为年龄45岁以上、男性、高中以上文化程度、肝炎家族史、手术治疗史、牙科诊疗史、静脉注射吸毒、针灸史、创伤性美容、修面或修足、不安全性行为。HCV感染的危险因素为年龄35岁以上、本市户籍、婚姻状况离异或丧偶、输血或血制品、静脉注射吸毒,婚姻状况已婚为保护因素。结论 浦东新区HIV高危人群HBV、HCV感染率高于一般人群,建议加强HIV高危人群的HBV、HCV筛查工作,通过接种乙肝...     

PRELIMINARY INVESTIGATION ON SERUM MARKERS OF HEPATITIS B VIRUS IN PA''TIENTS WITH SCHISTOSOMIASIS JAPONICA

Five serum markers of viral hepatitis B (HBV) infection including HBsAg (RPHA), anti-HBs (PHA), anti-HBc (ELISA), HBeAg and anti-HBe (ELISA) were tested in chronic and late cases of schistoso- miasis and in natural population. HBV infection (any marker positive) rate in late cases was 54.55To, signifi cantly higher than that in chronic early cases (15.52%) and natural population (8.08IO). At the same time, the liver function tests were performed in the late cases, showing that the liver injury in HBV infection cases was more significant than in those with no in- fection. This suggested that late cases after HBV infection had a more serious form of schistosomiasis.     

351例各类肝病患者血清抗—HCV的调查

应用固相酶联免疫洲定方法(ELISA),检测351例不同类型肝病患者血清丙型肝炎病毒抗体(抗-HCV)。输血后非甲非乙型肝炎(NANBH)、散发性NANBH和非乙型肝硬化抗-HCV阳性率分别为86%、34.9%和76.2%;28例急性甲肝均阴性;乙肝患者为23.3%;原发性肝癌为16.0%。有输血史乙肝患者抗-HCV阳性率高于无输血史者。提示除甲肝外,各类肝病患者均为HCV高危人群。输血液制品是乙肝合并丙肝的主要原因。     

成都地区幽门螺杆菌感染现状及相关影响因素分析

目的 了解成都地区人群幽门螺杆菌 （Helicobacler pylori, Hp）感染现状及相关影响因素,为制定本地区Hp防治方案提供依据。方法 以在四川大学华西医院健康体检中心行常规体检的成都籍常住居民为研究对象,通过¹⁴C尿素呼气试验 （¹⁴C-urea breath test,¹⁴C-UBT）检测Hp感染状况;随机抽取部分个体进行问卷调查,了解Hp感染的相关影响因素。结果 共纳入体检者8 365例,500份问卷中共收集合格问卷497份。受检人群的Hp总感染率为53.1%,男性高于女性〔54.1% （2 673/4 941）vs. 51.7%（1 771/3 424）, P<0.05〕;30岁及30岁以上各年龄段的Hp感染率均达到或超过50%。藏族人群的Hp感染率高于汉族〔74.2% (23/31) vs. 48.6%(216/444),P<0.05〕;生吃大蒜者Hp感染率低于不食用者〔52.6% (231/439) vs. 67.9%(38/56),P<0.05〕;有呕吐症状者的Hp感染率高于无症状者〔63.4%(59/93) vs. 52.2%(211/404), P<0.05〕。男性〔标准偏回归系数(β)=0.155 9〕、藏族(β=0.148 9)、有呕吐症状(β=0.146 9)是Hp感染的危险因素,生吃大蒜(β=-0.149 0)是防止Hp感染的保护因素。结论 成都地区人群具有较高的Hp感染率。男性、藏族、有呕吐症状是Hp感染的独立危险因素;而经常生吃大蒜则对Hp感染有一定的保护作用。     

The prevalence of markers of infection with hepatitis B virus in a mixed-race Australian community

A seroepidemiological study of markers of infection with hepatitis B virus was conducted in Brewarrina, a mixed-race township in north-western New South Wales. Six hundred and forty-three subjects, who represented 41.5% of the town's population, were screened for a range of serological markers of hepatitis B virus infection. Of the Aboriginal subjects, 72% had markers which indicated previous infection with hepatitis B virus, with 19.2% of subjects being identified as hepatitis B surface antigen (HBsAg)-seropositive. In the non-Aboriginal subjects, the prevalence of infection with markers of hepatitis B virus was 13.1%, with 2.2% of subjects being HBsAg-seropositive. The marker prevalences for Aboriginal and non-Aboriginal subjects in the 15- to 19-year-old age-group were 86.7% and 28%, respectively. The prevalence of hepatitis B virus infection in the total non-Aboriginal sample was higher than it is in the general Australian blood-donor population. The extent to which hepatitis B virus infection may result from cross-infection between coexisting "high-risk" and "low-risk" population groups is speculative. Furthermore, the risk of infection to non-Aborigines is unlikely to be spread evenly across the non-Aboriginal community. The cost of vaccine remains high, and until further data become available, mass vaccination of the population probably is not warranted. Initially, control measures should concentrate on the reduction of hepatitis B virus infection in the Aboriginal population and in non-Aboriginal households which contain a HBsAg-seropositive member.     

百色少数民族地区不同人群庚型肝炎病毒感染的研究

应用ＥＬＩＳＡ检测各类人群８２２例血清抗－ＨＧＶ,对５６例抗－ＨＧＶ阳性及１４例抗－ＨＧＶ阴性患者血清应用ＰＴ－ｎＰＣＲ检测ＨＧＶ－ＲＮＡ。结果：ＨＧＶ－Ｍ阳性率肝病组（３７９０％）显著高于肺结核组（１３４０％）和献血员组（７３５％）,Ｐ＜００１,三者均显著高于自然人群组（１４０％）,Ｐ＜００１;肝病组、肺结核组具有随年龄增长呈递增趋势;自然人群组以２９～３０岁年龄段为高;肝病组男性显著高于女性（Ｐ＜００５）,该组男女分别高于其他各组（Ｐ＜００１）;肝病组各临床类型均显著高于自然人群组（Ｐ＜００１）。５６例抗－ＨＧＶ阳性患者ＨＧＶ－ＲＮＡ阳性４５例（８０４％）,１４例抗－ＨＧＶ阴性ＨＧＶ－ＲＮＡ阳性５例（３５７％）。认为①本地区存在ＨＧＶ感染,其感染率以肝病组最高,自然人群组以青壮年为高;②ＨＧＶ可与甲～戊肝炎病毒重叠感染;③非甲－戊型肝炎中的ＨＧＶ感染只是一种病因,尚有其他病毒感染;④ＨＧＶ持续感染可能导致肝硬化和肝细胞癌;⑤检测抗－ＨＧＶ对筛查ＨＧＶ感染有一定的价值