2010年食源性疾病监测工作质量控制考核

目的提高微生物实验室检测能力和质量控制管理水平,保证日常检测和食源性疾病监测工作结果的正确性和可靠性。方法接受国家疾病预防控制中心考核,按照国标方法完成盲样检测工作。结果考核样中分离出大肠杆菌O157:H7和金黄色葡萄球菌,与国家考核结果完全一致。结论此次考核不仅反映了十堰市做为省级食源性疾病监测点承担监测任务的能力,而且也极大地提高检验人员的检测能力和水平。     

Relations between official and private veterinary services in epidemiology and the control of contagious diseases

Growing budget restrictions in many countries have meant that official Veterinary Services cannot assume responsibility for any new activities. The natural reaction is to turn to private veterinary services to provide the support needed to strengthen the control and surveillance of priority diseases and thereby support the development of the livestock sector and the establishment of safe international trade. In this context, official Veterinary Services must work together with private veterinarians, delegating various technical animal health activities, so that they may focus their efforts on those tasks that cannot be delegated: standardisation, control, auditing, general system co-ordination, epidemiological surveillance, etc., as well as organising veterinary policy in order to make best use of budget resources. For these relations to be efficient, a dynamic, two-way epidemiological information mechanism must be created, whereby private veterinarians periodically keep governments informed, on the basis of an agreed methodology. Moreover, the official Veterinary Services must systematically transmit information on List A and B diseases of the OIE (World organisation for animal health), and perform detailed analyses of epidemiologically significant events. The article proposes the establishment of relations between public and private veterinary services as a way in which to provide the livestock sector with the health and hygiene conditions that are necessary for effective disease control, which in turn provides greater security for international trade and increased consumer protection.     

梁山县风疹血清流行病学监测报告

目的为了解我县人群风疹抗体水平和血清流行病学规律,为防治风疹提供科学依据.方法对我县城乡、不同年龄、性别的人群采取整群抽样的方法采取微量法测定风疹中和抗体.结果监测445人,阳性337人,阳性率为75.73%,GMT 22.33.结论监测结果表明我县人群通过自然感染对风疹有了一定的免疫力.     

Preliminary assessment of an automated surveillance system for infection control.

BACKGROUND AND OBJECTIVE: Rapid identification and investigation of potential outbreaks is key to limiting transmission in the healthcare setting. Manual review of laboratory results remains a cumbersome, time-consuming task for infection control practitioners (ICPs). Computer-automated techniques have shown promise for improving the efficiency and accuracy of surveillance. We examined the use of automated control charts, provided by an automated surveillance system, for detection of potential outbreaks. SETTING: A 656-bed academic medical center. METHODS: We retrospectively reviewed 13 months (November 2001 through November 2002) of laboratory-patient data, comparing an automated surveillance application with standard infection control practices. We evaluated positive predictive value, sensitivity, and time required to investigate the alerts. An ICP created 75 control charts. A standardized case investigation form was developed to evaluate each alert for the likelihood of nosocomial transmission based on temporal and spatial overlap and culture results. RESULTS: The 75 control charts were created in 75 minutes and 18 alerts fired above the 3-sigma level. These were independently reviewed by an ICP and associate hospital epidemiologist. The review process required an average of 20 minutes per alert and the kappa score between the reviewers was 0.82. Eleven of the 18 alerts were determined to be potential outbreaks, yielding a positive predictive value of 0.61. Routine surveillance identified 5 of these 11 alerts during this time period. CONCLUSION: Automated surveillance with user-definable control charts for cluster identification was more sensitive than routine methods and is capable of operating with high specificity and positive predictive value in a time-efficient manner.     

Concepts for risk-based surveillance in the field of veterinary medicine and veterinary public health: Review of current approaches

Background  

Emerging animal and zoonotic diseases and increasing international trade have resulted in an increased demand for veterinary surveillance systems. However, human and financial resources available to support government veterinary services are becoming more and more limited in many countries world-wide. Intuitively, issues that present higher risks merit higher priority for surveillance resources as investments will yield higher benefit-cost ratios. The rapid rate of acceptance of this core concept of risk-based surveillance has outpaced the development of its theoretical and practical bases.     

Participatory epidemiology in disease surveillance and research

Participatory epidemiology is the application of participatory methods to epidemiological research and disease surveillance. It is a proven technique which overcomes many of the limitations of conventional epidemiological methods, and has been used to solve a number of animal health surveillance and research problems. The approach was developed in small-scale, community animal health programmes, and then applied to major international disease control efforts. The Global Rinderpest Eradication Program adopted participatory epidemiology as a surveillance tool for controlling rinderpest. This approach was subsequently used in both rural and urban settings in Africa and Asia, for foot and mouth disease, peste des petits ruminants and highly pathogenic avian influenza. Participatory disease surveillance has made an important contribution towards controlling both rare and common diseases. This paper reviews the principal applications of participatory epidemiology and highlights the lessons learned from field applications. In addition, the authors examine future challenges and consider new areas for research.     

EPIZOO: software for veterinary epidemiology training and problem-solving.

Described is a computer software package, EPIZOO, which has been developed specifically for undergraduate and postgraduate education, self-training, problem-solving, and simulation studies in veterinary epidemiology. The program is based on action-oriented animal population health/disease analyses and programming. EPIZOO runs on IBM-compatible personal computers and can be used for any animal population diseases, including those transmissible to man. The software comprises an integral system of selected indicators contained in twelve modules, with about 200 widely applicable methods used in epizootiology. It is user-friendly and includes general methods related to the following: animal population characteristics of health/disease importance; analysis of animal population health and disease situations, structures, dynamics, diagnoses, and consequences; preparation, cost, and evaluation of animal population health programmes; and selected statistical techniques.     

风险分析在食源性疾病监控中的运用

近年来,风险分析的应用开始逐渐深入到卫生领域。2009年6月1日生效的《中华人民共和国食品安全法》（简称《食品安全法》）是我国第一次以法律条文的形式把风险分析的概念正式应用到食品安全领域,也对公共卫生的学科发展提出了更高的要求。本文就风险分析在食源性疾病监控中的应用进展作一综述。     

ICMM定性风险评价在职业病危害预评价工作中的应用

目的 探讨国际矿业和金属理事会(ICMM)定性风险评价在职业病危害预评价工作的应用.方法 分别采用ICMM法和类比法预测某项目职业病危害因素可能存在的风险,并对2种评价方法结果的一致性进行比较.结果 类比法与ICMM法分别对有毒有害作业进行分级,其中一致的有4个岗位,不一致的有2个岗位,2种方法对有毒有害作业分级结果基本一致,但存在一定的差异.结论 ICMM定性风险评价在职业病危害预评价工作中有一定的应用价值,在类比法受到条件限制时,ICMM定性风险评价不失为一种有效的评价方法.     

成本效果分析实际应用于建设项目职业病危害控制效果评价

在职业病危害控制效果评价过程中,合理地应用“成本效果分析”方法,将更有助于职业卫生技术服务机构提升评价服务质量和技术含量,提出合理的评价结论和符合实际的职业病防护措施建议。     

环介导等温扩增技术在钩端螺旋体病监测中的应用

目的:评价LAMP技术在钩端螺旋体检测与监测中的可行性。方法:采用LAMP技术对感染病人血清及钩体标准菌株感染鼠肾进行检测,同时与卫生行业标准推荐的引物G1/G2 PCR方法进行对比。结果:LAMP快速检测方法 60 min内即可完成检测,具有较高的检测灵敏度,对纯培养的钩体检测灵敏度可达1.5 CFU/ml,比PCR法高出两个数量级,结果肉眼直接可观。同时对21种共42株细菌进行LAMP扩增,仅钩体结果为阳性,显示该LAMP方法具有较强特异性。结论:LAMP方法操作简便、特异性强、灵敏度高且成本低廉,在钩体的快速检测和疫情监控中具有良好的应用前景。     

2006年开江县流行性乙型脑炎流行病学监测与分析

目的探讨2006年开江县流行性乙型脑炎(乙脑)疫情动态及发病趋势,为防制提供科学依据。方法对2006年发生的31例乙脑病例进行流行病学个案调查及乙脑疫苗接种率抽样调查,采集病人早期血清,5月抽取9岁以下健康儿童血清,6-7月各旬分别抽取猪血清。血清检测方法采用ELISA。结果全年发生乙脑病例31例,发病率为5.49/10万。平坝浅丘地区发病率6.98/10万,显著高于山区深丘地区的2.61/10万(χ2=4.41,P<0.05),病例呈高度散发点状分布。7月下旬和8月上旬发病最多,分别占54.84%和29.03%;男性发病多于女性,男女之比为2.88∶1;3岁以下儿童发病数占70.97%。居住环境卫生差和极差的占60.00%,蚊帐使用率为86.67%,患儿监护人乙脑防治知识知晓率为13.33%,31例患者中有乙脑疫苗接种史的占6.45%,后遗症发生率为19.35%(6/31),平均每例门诊和住院医药费等直接经济损失4783.74元,1～7岁儿童乙脑疫苗接种率为46.74%(79/169),临床上以轻型和普通型为主,分别占41.94%及38.71%。2～9岁健康儿童抗体阳性率为63.77%(88/138),2岁年龄组抗体阳性率为33.33%,低于其他各年龄组,但差异无统计学意义(χ2=11.14,P>0.05)。猪乙脑抗体阳性率高峰在6月中旬,6-7月各旬抗体阳性率之间差异无统计学意义(χ2=6.30,P>0.05)。临床病例血清学确诊率为80.64%(25/31)。结论加强农村地区乙脑防治知识的宣传,提高7岁以下儿童乙脑疫苗接种率和覆盖率,做好防蚊、灭蚊,是开江县控制乙脑发生和流行的关键措施。     

半定量及定性风险评估方法在家具制造企业的应用

应用改良后的半定量评估方法以及罗马尼亚模型调查家具制造企业的职业健康风险水平。结果显示,改良后半定量评估方法评估各危害因素的风险水平为中等到高风险,4家企业的总体风险水平为中等到高风险;罗马尼亚模型评估各危害因素的风险水平为非常低到低风险,4家企业的总体风险水平为低风险。     

死因监测质量评价方法及应用

目的探讨质量评价方法，通过质量评价，提高死因监测质量。方法综合指数法，监测指标为：单位报告率、审核率、报告及时性、报告合格率、审核及时性、审核合格率、各区县站报告死亡病例数占总人群死亡病例数的比例、数据库质量、根本死因填报。结果全市单位报告率为83．62％，审核率为98．42％，全市平均报告合格率为60．78％，平均审核合格率为94．27％，全市报告病例数占总人群病例数为36．64％，缺漏项数占报告病例数1．62％，有死因链根本死因正确率为52．71％，无死因链根本死因正确率为82．22％。结论太原市死因监测工作情况表明，质量评价是行之有效的质量管理方法，它可以揭示各区县死因监测中存在的问题，确定下一步工作重点。目前太原市死因监测工作中，需要采取相应措施降低漏报，加强死亡病例报告、审核的及时性，提高根本死因判定的准确性。     

The integration of molecular tools into veterinary and spatial epidemiology

At the interface of molecular biology and epidemiology, the emerging discipline of molecular epidemiology offers unique opportunities to advance the study of diseases through the investigation of infectious agents at the molecular level. Molecular tools can increase our understanding of the factors that shape the spatial and temporal distribution of pathogens and disease. Both spatial and molecular aspects have always been important to the field of infectious disease epidemiology, but recently news tools have been developed which increase our ability to consider both elements within a common framework. This enables the epidemiologist to make inferences about disease patterns in space and time. This paper introduces some basic concepts of molecular epidemiology in a veterinary context and illustrates the application of molecular tools at a range of spatio-temporal scales. Case studies - a multi-state outbreak of Serratia mastitis, a national control program for campylobacteriosis, and evolution of foot-and-mouth-disease viruses - are used to demonstrate the importance of considering molecular aspects in modern epidemiological studies. The discipline of molecular epidemiology is in its infancy and our contribution aims to promote awareness, understanding and uptake of molecular epidemiology in veterinary science.     

伤害监测系统评估方法及应用

伤害监测是预防伤害四步骤公共卫生方法最重要的第一步[1]。通过监测系统收集高质量的伤害相关信息是伤害预防与控制的基础[2]。在192个世界卫生组织(WHO)成员国中,目前只有23个国家拥有的伤害数据是完整的、高质量的,是按