西藏樟木口岸2004.12～2005.8传染病监测结果分析

目的防止传染病由国境口岸传入和传出,为口岸疾病监测工作提供科学依据。方法 2004．12-2005．8西藏樟木口岸出入境检验检疫局对1289名出入境人员、口岸从业人员和尼泊尔司乘人员的疾病监测结果进行分析。结果共检出各种传染病101例,检出率为7．84％。结论在樟木口岸对常年往返的尼泊尔司乘人员应重点加强传染病监测,同时加强对口岸酒吧、餐饮服务人员的监测和宣传工作。     

The surveillance of communicable disease in Vermont: who reports?

The Vermont Department of Health reviewed 2,035 reports of selected notifiable diseases received from January 1, 1986, through December 31, 1987. Laboratories provided 1,160, or 71 percent, of the initial reports on 1,636 confirmed cases. This demonstrates that laboratories, when required by law and when part of active surveillance, can make a significant contribution to surveillance of infectious disease. A survey of primary care physicians indicated that 18 percent always reported notifiable diseases. The most frequently mentioned reason for lack of reporting was an assumption that the laboratory would report the cases.     

三峡库区兴山县疾病监测点1997-2006年传染病疫情分析

目的监测库区法定传染病发病情况。方法按照三峡工程坝区及库区疾病监测方案,收集兴山县疾病监测点1997-2006年法定传染病报告资料进行分析,并进行居民传染病漏报率调查。结果10年间共发生乙类传染病9种1025例,传染病平均报告发病率为351.58/10万,报告发病率最高为1997年（761.25/10万）,最低为2002年（167.79/10万）,痢疾、肺结核、病毒性肝炎3种传染病占报告传染病总数的88.98%。传染病漏报率平均为36.96%,校正发病率为638.86/10万。消化道传染病发病逐年下降,虫媒传染病发病处于基本消灭状态,丙类传染病时有流行。结论漏报情况仍较高,应进一步加强疫情报告管理,提高疫情报告质量。     

FIFA World Cup 2006 in Germany: enhanced surveillance improved timeliness and detection

Enhanced surveillance for infectious disease events, with accelerated routine reporting and daily supplementary reports, was undertaken during the 2006 FIFA World Cup in Germany. We evaluated the surveillance outputs, reporting intervals and detection of World Cup-relevant events for the enhanced system. Outbreak numbers for measles, Norovirus and Campylobacter were significantly higher than in previous years, but all increases were explained by prior trends. The median interval (disease onset to receipt at national centre) fell from 17 days in 2005 to 12 days in 2006. Detection of World Cup-relevant events was 44% (8/18) in the routine system and 77% (14/18) in supplementary reports. We did not identify any significant effect on infectious disease epidemiology relating to the FIFA 2006 World Cup. Daily reporting improved timeliness, and supplementary reporting improved relevant event detection. Enhancing existing systems, without the addition of syndromic surveillance, can be an effective approach to mass-event surveillance.     

地震后彭州市重灾乡镇传染病防控形势分析

目的了解彭州市5.12地震后重灾镇传染病防控形势,为下一阶段防病对策提供依据。方法以典型抽样的方法抽取彭州市6个重灾镇的户籍人口及卫生人员。自行设计调查问卷,辅以现场考察和资料核对。调查内容包括群众的卫生知识与行为,防病意识、食品卫生情况、环境卫生状况,乡村医生对传染病常见症状体征的掌握情况和疫情上报意识。结果被访的13名卫生人员中,7人正确回答病人出现哪些症状应填报《地震灾区传染病（症状）登记表》。卫生人员对常见传染病症状体征回答的正确人数偏低,尤其对灾后常发生的痢疾、伤寒、甲肝等。地震灾害后灾区生活饮用水合格率62.43%。其中分散式供水,安置点供水合格率较低。全部被访者表示自己和家人生病时能够及时就医,11.21%选择自己服药,82.24%选择去医疗点,6.54%选择不做治疗。绝大多数家庭认为生活用水可以满足日常所需,自行消毒处理的占71.30%,基本掌握正确消毒方法。居住地周围十米内有蚊蝇孳生地的占42.28%,其中的90.38%经过消杀处理,3天内完成消杀工作的占83.72%。结论卫生人员有很强的传染病监测和报告意识,但对灾后常见传染病症状体征认知率偏低。受灾群众有比较好的主动防病意识,健康卫生行为率比较高,食品卫生、环境卫生有待进一步改善。     

2008—2011年江西口岸出入境人员传染病监测结果分析

目的了解江西口岸出入境人员传染病的感染现状,为有效开展传染病的监测与防控提供依据。方法对2008—2011年江西口岸出入境人员传染病监测情况进行统计分析。结果江西口岸4年间共进行传染病监测体检38 226人次,检出各种传染病5 095例,总检出率为13.33%。检出率最高的是乙肝表面抗原(HBsAg)阳性4 815例,为12.60%;其次是梅毒抗体阳性181例,为0.47%;肺结核92例,为0.24%;艾滋病病毒(HIV)抗体阳性7例,为0.02%。不同职业人群传染病检出率差异具有统计学意义(χ2=51.272,P<0.01),其中以劳务人员检出率最高,其次为涉外婚姻人员。结论乙肝和梅毒是江西口岸出入境人员感染的主要传染病,劳务人员和涉外婚姻人员是江西口岸传染病重点监测对象。开展多种形式的健康教育,普及疾病预防知识,提高出入境人员的自我防护意识,采取有效的预防控制和行为干预措施,减少传染病的流行。     

Mapping climate change vulnerabilities to infectious diseases in Europe

Background: The incidence, outbreak frequency, and distribution of many infectious diseases are generally expected to change as a consequence of climate change, yet there is limited regional information available to guide decision making.Objective: We surveyed government officials designated as Competent Bodies for Scientific Advice concerning infectious diseases to examine the degree to which they are concerned about potential effects of climate change on infectious diseases, as well as their perceptions of institutional capacities in their respective countries.Methods: In 2007 and 2009/2010, national infectious disease experts from 30 European Economic Area countries were surveyed about recent and projected infectious disease patterns in relation to climate change in their countries and the national capacity to cope with them.Results: A large majority of respondents agreed that climate change would affect vector-borne (86% of country representatives), food-borne (70%), water-borne (68%), and rodent-borne (68%) diseases in their countries. In addition, most indicated that institutional improvements are needed for ongoing surveillance programs (83%), collaboration with the veterinary sector (69%), management of animal disease outbreaks (66%), national monitoring and control of climate-sensitive infectious diseases (64%), health services during an infectious disease outbreak (61%), and diagnostic support during an epidemic (54%).Conclusions: Expert responses were generally consistent with the peer-reviewed literature regarding the relationship between climate change and vector- and water-borne diseases, but were less so for food-borne diseases. Shortcomings in institutional capacity to manage climate change vulnerability, identified in this assessment, should be addressed in impact, vulnerability, and adaptation assessments.     

三峡库区宜昌监测点传染病发病趋势的Joinpoint回归分析

目的 了解三峡库区宜昌监测点2004－2017年传染病发病率趋势变化情况。方法 收集2004－2017年三峡库区宜昌监测点传染病发病资料及人口资料,应用Joinpoint转折点回归分析对传染病数据进行时间趋势分析。结果 三峡库区蓄水运行后,2004－2017年库区监测点累计报告传染病7 409例,年均发病率564.48/10万,报告发病率在2004－2009年间呈现明显上升(APC=15.00%, P=0.009),2009年后发病率趋于平稳(P=0.532)。男性发病明显高于女性(χ²=326.52, P<0.001)。库区传染病主要以乙型肝炎、肺结核、手足口病、其他感染性腹泻和流行性腮腺炎为主,占发病总数的89.70%。按病种分析显示库区乙肝发病率在2004－2010年间呈现快速上升(APC=30.75%,P=0.006),肺结核在2007－2017年呈现缓慢下降趋势(APC=-6.53%,P=0.011)。 结论 三峡库区宜昌监测点2004－2017年法定传染病报告发病率未发生特异性变化,与我国传染病流行的情况基本一致。需针对库区乙型肝炎、肺结核和手足口病等重点传染病制定相应的预防控制策略。     

Leptospirosis in Germany, 1962-2003

Epidemiologic trends of human leptospirosis in Germany were investigated by analyzing national surveillance data from 1962 to 2003 and by conducting a questionnaire-based survey from 1997 to 2000. After a steady decrease of leptospirosis incidence from 1962 to 1997, surveillance data indicate an increase in disease incidence to 0.06 per 100,000 (1998-2003). Of 102 laboratory-confirmed cases in humans from 1997 to 2000, 30% were related to occupational exposures. Recreational exposures were reported in 30% (including traveling abroad in 16%), whereas residential exposure accounted for 37% of the cases. Direct contact with animals, mostly rats and dogs, was observed in 31% of the cases. We conclude that recent changes in transmission patterns of leptospirosis, partially caused by an expanding rat population and the resurgence of canine leptospirosis, may facilitate the spread of the disease in temperate countries like Germany. Preventive measures should be adapted to the changing epidemiology of leptospirosis.     

2017—2020年上海市传染病类公共卫生苗子事件监测分析

[目的]了解上海市传染病类公共卫生苗子事件的流行病学特征,探讨传染病类公共卫生苗子事件监测的效果,为完善苗子事件监测系统提出建议,为传染病综合监测防控策略提供依据.[方法]统计2017—2020年上海市16个区的传染病类公共卫生苗子事件相关数据,与同期上海市报告的传染病突发公共卫生事件数据进行比较分析.[结果]2017...     

滁州市2004年法定传染病网络直报疫情分析

目的了解滁州市传染病流行特征及防治效果,为今后预防控制传染病提供科学依据。方法用描述流行病学方法分析2004年滁州市传染病疫情。结果2004年滁州市传染病报告发病率154.50/10万,发病率与2003年相比上升6.24%。2004年发病以肺结核(56.01/10万)、病毒性肝炎(51.86/10万)、痢疾(21.94/10万)、疟疾(8.36/10万)、淋病(6.95/10万)为主,占发病总数的88.51%。结论传染病疫情总体趋势平稳,应加强疫情监测,突出重点传染病防治,有针对性地采取防治措施。     

2005-2016年北京市海淀区丙类传染病流行特征分析

目的 分析北京市海淀区丙类传染病的流行特征及发病趋势,为其有效的防控措施提供科学依据。方法 基于北京市海淀区各级医疗机构传染病上报系统,对2005-2016年丙类传染病进行流行病学特征分析,包括发病顺位、时间、人群、职业及地区分布特征,并运用卡方趋势性检验进行率的比较。结果 该区12年间共报告丙类传染病11种,累计报告病例125998例,年均发病率为339.86/10万,发病呈“波浪型”趋势（P＜0.001）,无死亡病例报告;发病高峰在5-9月;男性发病率（378.05/10万）高于女性（300.01/10万）。主要发病人群是散居儿童（29.37%）、幼托儿童（17.44%）和学生（15.69%）。发病前三位地区主要集中于北下关街道（7.40%）、清河街道（6.55%）和北太平庄街道（6.43%）。其他感染性腹泻病和手足口病是主要发病病种,分别占丙类传染病的57.09%和32.83%。结论 北京市海淀区丙类传染病重点监控病种是其他感染性腹泻病和手足口病,应加强对幼托儿童、散居儿童和学生丙类传染病的预防和控制。     

Referenznetzwerke aus Nationalen Referenzzentren mit assoziierten Konsiliarlaboratorien in Deutschland

Since 1995, the Robert Koch-Institute in agreement with the Federal Ministry of Health in Germany has increased the funding of National Reference Centers (NRC) and Consiliary Laboratories (CL) for laboratory-based surveillance of selected infection pathogens and infectious disease syndromes. Their goal is to improve efficient protection from infections and to supplement infectious disease surveillance by monitoring selected pathogens. Currently there are 19 NRC and 48 CL, nominated for a duration of 3?years. In order to enhance the effectiveness and cooperation of the system, ten National Networks were launched in 2009. The aim of these networks is to facilitate exchange on diagnostic methods and prevention concepts and to improve the geographic coverage of the services. Furthermore, the networks provide an opportunity to work on issues beyond single pathogens more productively and efficiently. In addition, the inclusion of external and international specialists should to be included more often in the future. The activities of the networks are evaluated by the commission for infectious disease epidemiology. The commission develops promotion modalities to support collaboration between NRC and CL and to adapt it to more closely meet the requirements at the national and international levels.     

宜昌市2003-2012年法定传染病流行趋势

目的分析宜昌近10年法定传染病发病水平,为制定预防控制措施提供依据。方法收集国家疾病监测信息报告系统宜昌市数据,运用描述性流行病学方法进行分析。结果宜昌市2003．2012年法定传染病报告27种168927例,年平均发病率427．11／10万,死亡464例,年均死亡率1．17／10万,病死率0．27％。呼吸道传染病年均发病率为157．65／10万,肠道传染病年均发病率为149．05／10万,血源及性传播传染病年均发病率为117．28／10万,自然疫源及虫媒传染病年均发病率为3．13／10万。结论宜昌市手足121、流行性腮腺炎等丙类传染病上升明显,乙肝、艾滋病、梅毒、手足口病、流行性腮腺炎是当前重点防治传染病,输入性传染病仍需加强监测和防控。     

江苏省镇江市2009-2018年15岁以下少年儿童法定报告传染病流行特征

目的 了解2009-2018年镇江市15岁以下少年儿童法定传染病的流行趋势,为开展防控工作提供依据。方法 从中国疾病预防控制信息系统中收集2009-2018年镇江市15岁以下少年儿童法定传染病疫情资料进行分析。结果 2009-2018年镇江市累计报告15岁以下少年儿童法定传染病病例22种65135例,年报告发病率134.51/万～263.23/万之间,发病率呈现上升波动趋势（〖XC小五号.EPS;P〗趋势=1932.389,P<0.001）;死亡病例12例,年均死亡率0.03/万;累计病例中男童发病数为38156例（58.58%）,年均发病率204.86/万;女童发病数为26979例（41.42%）,年均发病率159.81/万,不同性别间发病率差异有统计学意义（〖XC小五号.EPS;P〗=997.605,P<0.001）。无甲类传染病报告;乙类传染病累计报告病例16种2587例,年均发病率为7.29/万,发病呈下降趋势（〖XC小五号.EPS;P〗趋势=78.566,P<0.001）;丙类传染病累计报告病例6种62548例,年均发病率176.16/万,发病呈上升趋势（〖XC小五号.EPS;P〗趋势=2177.178,P<0.001）。肠道传染病、呼吸道传染病、血源及性传播传染病、自然疫源及虫媒传染病、其它传播途径传染病分别占累计发病总数的86.95%（56636例）、12.65%（8240例）、0.25%（166例）、0.03%（17例）、0.12%（76例）。发病率前2位的传染病为手足口病和流行性腮腺炎,分别占发病总数的78.43%（51088例）和8.42%（5485例）。结论 少年儿童是传染病发病的重点高危人群,应重点加强手足口病、流行性腮腺炎传染病的监测,采取针对性措施控制少年儿童传染病的发生。     

Clostridium difficile: an update on its epidemiology and role in hospital outbreaks in England and Wales

Data from the surveillance system of general outbreaks of infectious intestinal disease and from laboratory reports collated by the Communicable Disease Surveillance Centre (CDSC) and requests for outbreak investigation by the PHLS Anaerobe Reference Unit were used to evaluate the current epidemiology of Clostridium difficile infection in England and Wales. Between January 1992 and December 1996, CDSC received 10,220 laboratory reports of C difficile isolation from patient's faeces and 26,873 of toxin in faeces. Over 75% of all reports were of people aged 64 years and over. The surveillance system captured a minimum data set on 694 hospital outbreaks of infectious intestinal disease. C. difficile was responsible for 109 (15%) outbreaks affecting 1625 people, of whom 1152 were found to have a C. difficile toxin producing strain. The median duration of outbreaks was 11 days. Fingerprinting by Pyrolysis Mass Spectrometry (PMS) was performed by the PHLS Anaerobe Reference Unit in 60 outbreaks, and typing by Polymerase Chain Reaction ribotyping (PCR) in 14.     

2019年安徽省民营医疗机构传染病监测能力现状

目的 通过评估安徽省民营医疗机构传染病报告质量及管理现状,为提升其传染病监测能力提供参考依据。方法 将纳入“中国疾病预防控制信息系统”中业务范围包含“传染病报告”的安徽省民营医院按医疗机构级别采用分层随机抽样法,共调查45家民营医疗机构,对医疗机构原始登记情况、人员与设备配备、信息系统功能与传染病报告质量进行现场调查。结果 纳入调查的45家民营医疗机构多为非营利性私有制医院,安徽省民营医院法定传染病报告率为78.43%,报告及时率为85.50%;91.11%民营医院建立传染病报告管理组织及相关制度,55.56%的医疗机构门诊日志项目设置不齐全,80.00%的医疗机构门诊日志填写不规范;93.33%的民营医疗机构开展了传染病报告管理知识培训及定期自查工作,仅53.33%的医疗机构针对自查结果进行了有效的奖惩措施;45家医疗机构中只有1家医院的信息系统具备传染病报告管理功能。结论 应进一步加强传染病报告管理的领导和责任落实,强化卫生健康行政部门工作主体责任,并强化各级疾病预防控制中心对辖区内民营医院的技术指导,加强临床医生传染病报告技术培训,多方面提高传染病报告意识,减少漏报、迟报现象的发生。     

Comparing methods of learning clinical prediction from case simulations.

Feedback to physicians about how they use information in making judgments can improve the quality of their judgments, but questions remain about which types of feedback are most effective. The authors conducted a controlled study of feedback in 60 medical students learning to predict the risk of cardiovascular death based on the presence or absence of five risk factors. After a pretest of 40 cases abstracted from patient records, the students worked through 173 computer-simulated cases and a posttest of 40 patient cases. The students received no feedback, probability feedback (correct probability of cardiac death for each case), cognitive feedback (the correct cue weights compared with their own weights derived from the previous set of cases), or both types of feedback. Students who received probability feedback markedly improved both base rate calibration and discrimination. Those who received only cognitive feedback showed no improvement over control on any of the measures of learning. All subjects were highly consistent in their weightings. The superiority of probability feedback differed from previous findings that cognitive feedback was essential for mastery of multiple-cue-probability learning tasks. The information on cue-outcome relationships given by cognitive feedback may be more useful when these relationships are complex and the combining rule is not known, while the precise outcome information provided by probabilistic feedback is more useful when the combining rule is known and the cue-outcome relationships are straightforward. Thus, the optimal method of learning depends on the nature of the task.     

Trends in Infectious Disease Mortality Rates,Spain, 1980–2011

Using mortality data from National Institute of Statistics in Spain, we analyzed trends of infectious disease mortality rates in Spain during 1980–2011 to provide information on surveillance and control of infectious diseases. During the study period, 628,673 infectious disease–related deaths occurred, the annual change in the mortality rate was −1.6%, and the average infectious disease mortality rate was 48.5 deaths/100,000 population. Although the beginning of HIV/AIDS epidemic led to an increased mortality rate, a decreased rate was observed by the end of the twentieth century. By codes from the International Classification of Diseases, 9th revision, the most frequent underlying cause of death was pneumonia. Emergence and reemergence of infectious diseases continue to be public health problems despite reduced mortality rates produced by various interventions. Therefore, surveillance and control systems should be reinforced with a goal of providing reliable data for useful decision making.