我国流感监测（1990—1993）

３年多监测结果表明，１９９０年１０月～１９９３年３月流感病毒在我国的活动特点，具有地区性差异。在３年多监测时间内，我国共发生过２次流感爆发流行，分别发生在１９９１～１９９２和１９９２～１９９３年流感流行季节，同时均发生在北方，而南方处于平静状态。其次在北方流感病毒活动具有严格的季节性，每年活动高峰均在冬季，而在南方见不到有严格的季节性。疫情上具有局限性，受主要侵袭的为青少年和婴幼儿，故发生爆发流行的主要集中在大、中、小学校和托幼单位。病原上表现出，乙型病毒株活动增强而甲型病毒株活动相对减弱并表现出不同亚型病毒株间交替占优。同时还表现出抗原性的多样性，无论Ｈ３Ｎ２亚型病毒株还是乙型病毒，在人群中可同时流行着两种以上抗原性不同的病毒株，哪个为主要流行株往往一时难判断。我们的研究结果指出，流感监测光靠疫情显然不够，必须同时要有病原监测。而且证实了流感监测在我国南北方具有同等的重要性。     

Occupational asthma as identified by the Surveillance of Work-related and Occupational Respiratory Diseases programme in South Africa

BACKGROUND: The nationwide Surveillance of Work-related and Occupational Respiratory Diseases in South Africa, SORDSA, was established in 1996 to provide systematic information on occupational respiratory diseases. OBJECTIVE: SORDSA's objectives are to monitor the nature, extent and distribution of occupational respiratory diseases, and to increase awareness of their diagnosis and prevention. This paper describes the programme and results obtained for occupational asthma in the first 2 years, ending in October 1998. METHODS: SORDSA identifies newly diagnosed cases of occupational respiratory disease through voluntary reporting by pulmonologists, occupational medicine doctors and occupational health nurses. Initially, recruitment of the above health care providers was done through the membership infrastructure of their respective professional societies. Booklets with prescribed monthly reporting forms were distributed annually to all reporting members and a core of reporting providers was established through a proactive method of data collection. Information dissemination and reporting feedback takes place through quarterly newsletters and issue-specific brochures on certain hazardous agents. RESULTS: Over the initial 2-year period, 3285 cases of occupational respiratory disease were reported to SORDSA by 203 doctors and 97 occupational health nurses. After pneumoconiosis and associated respiratory conditions, occupational asthma was the second most commonly reported disease with 225 cases (6.9%). The average annual incidence for occupational asthma in South Africa was 13.1 per million employed people, with the highest incidence reported from the Western Cape province (37.6 per million). Latex was the most frequently reported agent for occupational asthma, followed by isocyanates and platinum salts. Low molecular weight agents accounted for 59.6% of the cases of occupational asthma. CONCLUSION: The results from this initial phase show that despite some limitations, SORDSA has the potential to obtain useful data on the industries, agents and occupations causing occupational asthma in South Africa.     

广东省2009年高危人群HIV哨点综合监测结果分析

目的通过对吸毒人群（DUs）、暗娼（FCSWs）、男男性行为者（MSMs）和男性性病门诊就诊者（MSTDs）四类艾滋病（AIDS）主要高危人群的综合监测,了解他们的艾滋病病毒（HIV）流行情况及其高危行为。方法按照艾滋病行为和血清学监测方案的操作程序及调查方法对四类人群进行行为及血清学监测。结果 13620例DUs、5309例FCSWs、970例MSMs、4273例MSTDs的HIV阳性率分别为3.7%、0.2%、4.7%、0.3%,梅毒阳性率分别为4.5%、3.1%、12.0%、6.5%,丙肝阳性率分别为34.5%、0.6%、0.5%、0.7%,注射吸毒率分别为68.1%、0.7%、0.3%、3.7%,商业性交率分别为23.3%、100.0%、17.2%、41.4%,艾滋病知识知晓率分别为73.4%、69.4%、82.9%、66.4%,干预覆盖率分别为40.8%、47.0%、74.7%、31.5%。结论四类高危人群中均检出HIV感染者,感染率以MSMs最高,其次为DUs,FCSWs感染率最低,各高危人群均存在感染HIV的诸多危险因素,应加大综合干预力度。     

广州市2009年登革热疫情监测结果分析

目的分析广州市2009年登革热疫情的流行病学特征。方法对广州市疫情监测与报告信息系统、实验室监测信息系统,以及相关的现场调查报告,疫情简报等数据信息进行统计与分析。结果广州市2009年报告登革热病例18例,本地感染病例3例,累计发病率0.08/10万,无死亡病例,输入性病例或来广州就诊病例占全年报告病例的83.33%（15/18）,实验室监测表明,2009年广州市病毒流行株为登革Ⅲ型病毒。结论 2009年广州市登革热流行处于散发流行状态,流行的登革病毒型别与往年监测结果有所不同,较多的输入性病例或异地来广州就诊的登革热病例对广州市登革热流行存在潜在风险。     

广州市2009年肾综合征出血热监测分析

目的分析广州市肾综合征出血热（HFRS）的流行特征和规律,探讨防制对策。方法采用人间疫情监测、健康人群抗体水平监测、宿主动物监测方法,其中实验室用间接免疫荧光法检测血清特异性IgG抗体,直接免疫荧光法检测鼠肺汉坦病毒（HV）抗原。结果共报告HFRS71例,死亡1例,发病率为0.69/10万,病死率为1.41%;排查病例抗体阳性率为16.14%（188/1165）,健康人群抗体阳性率为0.50%（2/400）;鼠密度为4.60%（361/7856）,鼠肺抗原阳性率为8.31%（30/361）,鼠血清抗体阳性率为7.43%（26/350）,优势鼠种为褐家鼠。结论广州市HFRS疫情形势较为平稳,但仍然存在病例数上升的压力,应加强疫情监测,落实防鼠灭鼠为主的综合性预防控制措施。     

2008-2009年广州市鼠疫宿主动物及媒介监测结果分析

目的了解广州市鼠疫宿主动物及媒介的种群构成及数量分布情况,为鼠疫防治工作积累基础资料。方法采用夜笼法,对捕获鼠类及捡获蚤类进行鉴定,计算鼠密度;计算鼠带（染）蚤率和蚤指数;用鼠疫IHA法检测鼠疫F1抗体。结果捕获鼠形动物1890只,分属2目2科4属7种。其中啮齿目动物1 633只,食虫目动物157只,总鼠密度（捕获率）为11.97%,鼠密度（捕获率）为10.35%;在210只鼠形动物中发现染蚤鼠55只,捡获蚤126匹,鼠体表蚤经鉴定为印鼠客蚤、缓慢细蚤、适存病蚤;鼠染蚤率为26.19%,总蚤指数为0.60;黄胸鼠蚤指数为0.63;未查出鼠疫F1抗体。结论未发现鼠间鼠疫流行迹象,褐家鼠仍是广州市主要鼠种,主要蚤种是印鼠客蚤。     

广州市2004—2007年肾综合征出血热监测

目的分析广州市2004—2007年肾综合征出血热（HFRS）的流行特点和趋势,为制定防治策略提供依据。方法收集广州地区疫情资料,描述其流行病学特征。HFRS抗体与抗原检测采用免疫荧光分析。结果广州市2004—2007年共检出HFRS患者337例,年发病率0．59／10万～0．92／10万（平均0．73／10万）,病死率0．89％。病例多为青壮年男性民工及商业服务者,主要分布于海珠和天河等地,发病高峰主要在春秋季。鼠问疫情监测显示鼠密度为10．3％,总带毒率为3．6％（160／4457）,优势鼠为褐家鼠,带毒率为4．8％（132／2756）。结论广州HFRS疫情有上升趋势,应加大疫情监测力度,认真做好防鼠灭鼠及重点人群的疫苗接种工作。     

Antimicrobial susceptibility of Gram-positive bacteria isolated from European medical centres: results of the Daptomycin Surveillance Programme (2002–2004)

The antimicrobial susceptibility patterns of 9322 contemporary (2002-2004) gram-positive bacterial isolates collected from 31 medical centres in 14 countries in Europe were evaluated by broth microdilution methods according to CLSI guidelines. The isolates collected comprised Staphylococcus aureus (4842 isolates), coagulase-negative staphylococci (CoNS; 1942 isolates), Enterococcus faecalis (1147 isolates), Enterococcus faecium (391 isolates), beta-haemolytic streptococci (660 isolates) and viridans group streptococci (340 isolates). The organisms were tested against daptomycin and more than 20 comparator agents in Mueller-Hinton broth, supplemented with calcium to 50 mg/L when testing daptomycin. Overall, methicillin (oxacillin) resistance rates were 26.7% and 77.0% for S. aureus (MRSA) and CoNS, respectively, and the vancomycin resistance rate among enterococci was 6.1%. MRSA rates varied from 0.6% in Sweden to 40.2-43.0% in Belgium, Greece, Ireland, the UK and Israel, and VRE rates varied from 0% in Switzerland to 21.2% in Ireland. More than 99.9% of isolates tested were considered susceptible to daptomycin according to breakpoints established by the United States Food and Drug Administration and the CLSI. Daptomycin was active against all gram-positive species, with the highest MIC being 2, 8, 0.5 and 2 mg/L for staphylococci, enterococci, beta-haemolytic streptococci and viridans group streptococci, respectively. Daptomycin activity was not influenced adversely by resistance to other agents among staphylococci or enterococci. This novel lipopeptide (daptomycin) appears to be an excellent alternative therapeutic option for serious infections caused by multidrug-resistant gram-positive organisms isolated in Europe.     

2009-2013年菏泽市曹县麻疹病毒感染特征分析

目的 分析曹县麻疹病例实验室检测结果、流行病学和临床特点,为当地预防控制麻疹提供指导.方法 从国家疾病监测信息报告管理系统收集2009-2013年曹县麻疹疫情数据,以及麻疹疑似病例,开展麻疹IgM、风疹IgM检测和分析麻疹病毒分离情况、病例特点.结果 2009-2013年度共报告227例麻疹疑似病例,血清标本采集率72.69％,麻疹IgM阳性率为18.71％,12例咽拭子标本中分离出5株麻疹病毒,为H1a基因型.确诊168例麻疹病例,＜4岁年龄组的构成比为80.95％,幼托儿童、散居儿童是麻疹发病的主要人群,占89.29％;主要临床表现包括发热,超过38.5℃者占86.63％,皮疹首发部位为面部,占72.95％,有口腔黏膜斑者占72.80％,麻疹并发症前三位分别为肺炎、心肌炎、喉炎.结论 经血清学和病毒学证实,曹县当地存在麻疹病毒传播,病例以散发为主,麻疹野病毒为H1基因型,麻疹发病与年龄、性别、职业、季节有关.     

Timely measles surveillance in the Republic of Korea, 2002–2009: Impact of sentinel laboratory surveillance

In order to sustain the elimination of measles, timely reporting is important. The surveillance data in Korea from 2002–2009 was analyzed to determine the effect of sentinel laboratory surveillance, which was introduced in 2006, on the timeliness of measles reporting. The data were stratified by two surveillance periods, (A) before and (B) after 2006, and by cases confirmed clinically and cases confirmed by laboratory measures. During Period A, 113 suspected cases were reported, and 241 during Period B. There was no difference in the proportion of timely reporting among cases confirmed clinically between the two periods, whereas the proportion of cases confirmed by laboratory measures has increased. The mean notification interval in cases confirmed by laboratory measures was shortened from 39 to 16 days. In Korea, sentinel laboratory surveillance has enhanced earlier detection of suspected cases that had not been reported, improving the timeliness of measles surveillance. Adopting this new method may improve the timely collection of cases in other countries. J. Med. Virol. 86:322–328, 2014. © 2013 The Authors. Journal of Medical Virology Published by Wiley Periodicals, Inc.     

Influenza surveillance during the 2009-2010, 2010-2011, 2011-2012, and 2012-2013 seasons in Algeria

We report the activity and circulation of influenza viruses in Algeria during four influenza seasons, from a national surveillance study carried out from 2009-2010 to 2012-2013. A total of 2766 samples from in- and outpatients, with no age restriction, were collected. The overall proportion of specimens that tested influenza positive was 46.0%. Overall, 96.6% of influenza A viruses were subtyped, and A/H1 subtypes accounted for 57.3% of influenza A viruses. Influenza A/H1 and A/H3 virus subtypes cocirculated in 2009-2010. In 2010-2011, a high proportion of type B viruses (66.2%) was observed. The subtype H3N2 was identified in 99% of cases typed in 2011-2012. Influenza A/H3N2 and B virus cocirculated in 2012-2013. A remarkably low influenza vaccination rate of 2.4% was observed among all age groups. Antibiotics were prescribed for 926 (41.3%) patients, and no difference was observed between patients with confirmed influenza and patients with influenza-like illness not related to influenza. The burden of influenza is largely undocumented in Algeria and strategies to expand this surveillance across the country are needed. Strategies to increase vaccination coverage are warranted to control and prevent influenza in individuals at risk of complications as well as in the general population.     

2002-2009年上海市人群肠道寄生虫病监测点监测结果分析

目的了解和分析2002-2009年上海市居民肠道寄生虫的感染状况和变化趋势,为今后的防治工作提供科学依据。方法在全市范围内设立监测点,以本市居民为监测对象,应用改良加藤法、直接碘涂片法和试管滤纸培养法进行寄生虫学检查。结果 8年共粪检35186人,查到8种肠道寄生虫,平均感染率为0.52%,年均下降幅度为8.32%。郊区人群的感染率（0.79%）高于中心城区（0.11%）,两者差异有统计学意义（χ2=73.89,P〈0.001）;郊区和中心城区2005-2009年监测的感染率较2002-2004年分别下降了30.39%和88.0%,差异有统计学意义（χ2郊区=4.68,P〈0.05;χ2中心城区=13.93,P〈0.001）;女性感染率（0.61%）显著高于男性（0.41%）,两者差异有统计学意义（χ2=6.43,P〈0.05）;60岁以上年龄组（0.66%～0.93%）和农民（0.92%）的感染率较高,人群感染率有随文化程度的增高呈下降趋势（χ2=53.36,P〈0.001）。结论上海市肠道寄生虫病监测点人群感染率已连续7年低于1%,表明肠道寄生虫感染已不是威胁上海市居民健康的主要危险因素,但在经济相对落后的郊区县仍应重视预防控制工作,老年人及农民为防治的重点人群。     

Occurrence and characterization of carbapenemase-producing Enterobacteriaceae: report from the SENTRY Antimicrobial Surveillance Program (2000-2004)

Emergence and dissemination of Enterobacteriaceae isolates harboring carbapenemases in various geographic regions represents a significant threat to the management of nosocomial infections. Enterobacteriaceae isolates from the SENTRY Antimicrobial Surveillance Program (2000-2004) demonstrating decreased susceptibility to imipenem and meropenem (minimum inhibitory concentration [MIC], > or =2 mg/L) were evaluated for the production of metallo-beta-lactamases and serine carbapenemases using disk approximation and polymerase chain reaction (PCR) tests. Carbapenemase-producing strains were epidemiologically typed by automated riboprinting and pulsed-field gel electrophoresis (PFGE) to establish clonality. Among 37,557 Enterobacteriaceae (5 genus groups) evaluated, 119 (0.32%) had increased carbapenem MIC values, and a carbapenemase was identified in 51 (42.9%) of these strains. KPC-2 and KPC-3 were the most frequently occurring carbapenemases (24 isolates, 20.2%) in the United States and were detected in Klebsiella spp, Citrobacter spp., Enterobacter spp., and Serratia marcescens strains isolated in New York, Arkansas, and Virginia. SME-2-producing S. marcescens were isolated in the New York City area, Texas, and Ohio, while NMC-A was found in one E. cloacae strain from New York. In contrast, metallo-beta-lactamases were prevalent in Europe. IMP-1-producing E. cloacae (11 isolates) were detected in Turkey, while VIM-1-producing strains were found in Italy (Enterobacter spp.) and Greece (Klebsiella pneumoniae). Clonal dissemination of carbapenemase-producing strains was observed in several medical centers on both continents. The occurrence of carbapenemases in various Enterobacteriaceae remains rare but appears to be spreading geographically (not in Latin America), mainly with metallo-beta-lactamases being found in Mediterranean Europe and KPC enzymes in the New York City area.     

High prevalence of ceftazidime-resistant Klebsiella pneumoniae and increase of imipenem-resistant Pseudomonas aeruginosa and Acinetobacter spp. in Korea: a KONSAR program in 2004

A nationwide antimicrobial resistance surveillance has been conducted since 1997 in Korea. In this study, susceptibility test data generated in 2004 by KONSAR group hospitals were analyzed and compared to those at a commercial laboratory. In hospitals, the rank orders of organisms in 2004 were identical to those in 2003. The most prevalent species was Staphylococcus aureus (20.2%) in hospitals, but Escherichia coli (29.7%) in the commercial laboratory. The proportions of Enterococcus faecium to all isolates of Enterococcus faecalis plus E. faecium were 47.2% in hospitals and 24.9% in the commercial laboratory. The mean resistance rates of significant antimicrobial-organism combinations in hospitals were: oxacillin-resistant S. aureus (68%), oxacillin-resistant (penicillin- nonsusceptible) Streptococcus pneumoniae (68%), vancomycin-resistant E. faecium (25%), cefotaxime-resistant E. coli (14%), ceftazidime- and cefoxitin-resistant Klebsiella pneumoniae (34% and 32%, respectively), and imipenem-resistant Acinetobacter spp. and Pseudomonas aeruginosa (17% and 24%, respectively). In conclusion, oxacillin-resistant staphylococci, expanded-spectrum cephalosporin-resistant K. pneumoniae, and imipenem-resistant Acinetobacter spp. and P. aeruginosa were prevalent in 2004. Increasing trends were observed for vancomycin-resistant E. faecium, cefoxitin- resistant E. coli and K. pneumoniae, and imipenem-resistant Acinetobacter spp. and P. aeruginosa. Certain antimicrobial- organism combinations were also prevalent among the commercial laboratory-tested strains.     

广州市白云区1991—2007年艾滋病疫情监测

目的总结广州市白云区艾滋病流行特征，评估监测效能，为下一步防治工作的深入开展提供依据。方法运用SAS统计软件对广州市艾滋病疫情数据库中白云区属的病例进行相关描述性统计分析。结果截至2007年底，白云区共发现病例1136例，男女比为3．5：1；年龄以15-49岁为主（94．01％）。传播途径以静脉吸毒为主（61．10％），流动人口占疫情的大部分（71．48％）。性传播（x^2=12．009，P=0．001）和职业人群（x^2=44．935，P=0．001）随年份比例增加；常规监测发现病例日趋增加（x^2=5．533，P=0．019）。结论白云区已进入疫情的快速增长期，疫情主要侵袭青壮年男性，吸毒人群和无业人士所占比例较大。由于白云区在经济和生活上的一些特点，流动人口的疫情负担较重，且传播途径向多元化发展。加大监测力度包括高危人群干预专项和监测效能，将有助于迅速准确的掌握疫情。     

Surveillance in von Hippel-Lindau disease (vHL)

Poulsen MLM, Budtz-Jørgensen E, Bisgaard ML. Surveillance in von Hippel-Lindau disease (vHL).
von Hippel-Lindau disease (vHL) is a hereditary multisystem cancer syndrome requiring lifelong prophylactic surveillance. Current surveillance recommendations rely on best medical judgement and no evidence of effect exists. We aimed to evaluate the capability of surveillance in manifestation detection, before these turn symptomatic, in order to prevent disabling or even fatal outcomes. We focus on surveillance of central nervous system (CNS) hemangioblastomas, retinal hemangiomas and renal cell carcinoma (RCC) as these have the most severe consequences. On the basis of full medical records from 54 living vHL -mutation carriers, risks of intercurrent manifestations in-between surveillance examinations were determined and clinical consequences of surveillance findings evaluated. Current recommendations of annual ophthalmic and abdominal examinations corresponded to acceptably low intercurrent manifestation risks (1.7% and 1.2%, respectively), whereas recommendations of biennial CNS imaging corresponded to a risk of 7.2%. Annual CNS examinations, however, significantly reduces this risk to 2.7%. Furthermore, most CNS manifestations found due to surveillance (71%, 106 of 150) had clinical consequence for the patient. Also, pre-symptomatic surveillance increased cumulative incidence of clinical vHL diagnosis from 46% to 72% and from 89% to 94% by age 30 and 50 years, respectively. The present results promote optimization of surveillance, expectantly improving clinical vHL outcomes.