德江县2006～2011年流行性脑脊髓膜炎监测分析

【摘要】目的了解和掌握德江县流行性脑脊髓膜炎（流脑）发病情况和流行病学特征,为制订防治流行性脑脊髓膜炎工作策略提供科学依据。方法对2006～2011年德江县报告流行性脑脊髓膜炎病例开展个案调查和随访调查,开展监测工作,对报告病例采集血清和（或）脑脊液进行流脑实验室检测。结果（1）2006～2011年德江县共报告流脑病例10例,年均发病率为0．31／10万,病死率为40％。2～6月份均有病例发生,但2、3、4月份高峰,占总病例数的80．0％。发病年龄在16岁以下,0～6岁学龄前儿童发病数占总病例数的60％：男女性别比2．23：1。（2）采集1例流脑病例血清和（或）脑脊液标本,实验室诊断率为10．O％。（3）流脑疫苗接种史无和不详的占总病例数的80％,职业分布主要以散居为主,占总病例数的40％。青龙镇发病人数6例,最多,占发病数的60％。结论德江县2、3、4月是流脑发病高峰,有明显季节性,青龙镇为德江县城镇,人口密集,发病率高,有明显地区性,发病年龄在16岁以下,6岁以下儿童发病率较高,加强以流脑疫苗接种为主的综合措施,为今后德江县流脑预防和控制工作提供科学依据。     

1983-2012年154例流行性脑脊髓膜炎临床特征及流行病学分析

目的：了解30年来该院收治的经细菌学确诊的流行性脑脊髓膜炎（简称流脑）临床与流行病学特点,为流脑防治工作积累经验。方法对1983—2012年154例患者的临床资料按发病时间不同分为两组（ A组：1983—2002年,共80例, B组：2003—2012年,共74例）,对两组临床资料进行回顾性分析,统计学分析采用t检验和卡方检验。结果近30年来流脑发病呈低水平散发状态,无大规模流行。 A组以0～5岁人群为主,占48．75％,B组以16～20岁人群为主,占41．89％。发病季节均以冬春季为主,其中以3～5月份最多见,占68．18％。 B组患者平均年龄（15．78岁）高于A组（9．87岁）,暴发型流脑发生率（18．91％）比A组（7．50％）为高,出现瘀点瘀斑比例（63．51％））低于A组（88．75％）,出现意识障碍比例（43．24％）高于A组（26．25％）,中性粒细胞百分比值平均值（85．62％）高于A组（78．64％）,且均有统计学差异。患者对头孢曲松、头孢噻肟未出现耐药,对青霉素的耐药率为4．44％,对磺胺药由2003年之前的30．67％耐药到2003年之后100％耐药。结论流脑发病总体呈低水平散发状态,两组患者发病季节均以冬春季为主,B组患者临床症状较A组为重,发病年龄高峰上移。治疗上以青霉素、头孢曲松为首选。     

南华县2005～2007年流行性腮腺炎流行病学分析

目的分析南华县2005-2007年流行性腮腺炎疫情动态,遏制流行性腮腺炎的流行。方法采用流行病学的回顾性调查法,对南华县3年流行性腮腺炎的流行特征进行分析。结果 2005-2007年南华县共登记流行性腮腺炎143例,占法定传染病的12%。全年均有发病,以冬春为主,农村发病明显高于城市,城乡之比0.43：1,在幼儿园、小学、中学时有多发、爆发的倾向。在143余例病例中有发热113余例,腮腺肿大116余例,颌下腺肿大39例,并发症有67例,其中前3位为脑炎37例（55.22%）,脑膜炎13例（19.40%）,胰腺炎炎10例（14.93%）,男性患病率高于女性,男女比率为2：1,以16岁以下人群发病为主,占该病的96.09%,78.34%的病例集中在6-12岁的年龄组,62.47%的患者是小学生。结论 6-12岁的儿童,尤其是农村此年龄段的儿童是实施腮腺炎疫苗或联合疫苗免疫接种控制该病的重点。     

某市2001年至2011年流行性脑脊髓膜炎的流行特征分析

目的探讨平顶山市流行性脑脊髓膜炎流行特征,为完善预防控制措施,有效控制流脑流行提供理论依据。方法对《平顶山市疫情资料汇编》及流行性脑脊髓膜炎监测报告资料等进行描述分析。结果 1957-2011年平顶山市流脑发病总体呈下降态势,期间年平均发病率为4.33/10万,年平均病死率为5.03%,发病以10岁以下年龄段为主,主要集中在7岁以下28例,占40%;15岁以上发病16例,占22.86%,发病随着年龄的增长有逐渐上升的趋势。以学生及散居儿童为主,占87.14%;县(市)发病高于城区;发病呈现明显的季节性,即使在疫苗后时期,疫情仍有周期性波动迹象;2009年发现C群流脑病例,但病例较少,呈高度散发。结论平顶山市流脑发病率呈明显下降趋势,但近年有流行优势菌群变化的可能,提高儿童流脑疫苗的有效接种率是控制流脑流行的关键。     

When to vaccinate travellers against meningococci

(1) Among travellers to regions with ongoing epidemics of meningococcal meningitis, those most at risk are children and young adults who have prolonged, close contact with local inhabitants; this includes migrants visiting their country of origin. (2) The need for vaccination depends on the epidemic situation and the type of visit.     

Infant immunisation with a pneumococcal conjugate vaccine: from the age of two months, for all infants

(1) In France, before widespread infant immunisation with the 7-valent pneumococcal conjugate vaccine, there were about 13 deaths a year and about 145 cases of pneumococcal meningitis, often with serious sequelae. The peak incidence of pneumococcal meningitis occurs at approximately 5 months of age. (2) About 65% of the pneumococcal serotypes that cause meningitis in French children are covered by the 7-valent vaccine. (3) Several trials have yielded similar results: vaccination during infancy reduces the risk of invasive pneumococcal infection due to serotypes covered by the vaccine by 80% to 90%, leading to a relative reduction of 60% to 70% in the risk of invasive pneumococcal infections due to all serotypes. (4) In the United States, since the introduction of routine vaccination for all infants under 2 years of age, infant mortality due to invasive pneumococcal infections has fallen, with roughly one death prevented per 200 000 infants. Infant vaccination also appears to reduce the circulation of vaccine serotypes among unvaccinated subjects, especially those over 50 years of age. There is some evidence of replacement by non-vaccine serotypes, but the magnitude of occurrence is small. (5) The efficacy of the 7-valent pneumococcal conjugate vaccine in the prevention of acute otitis media in infants has been tested in several clinical trials: it is minimal to non-existent. (6) The adverse effects of the 7-valent pneumococcal conjugate vaccine are similar to those of other commonly used vaccines, and include fever, rash, urticaria, reactions at the injection site, and agitation. Serious allergic reactions have occurred: at least one spontaneous report of one serious allergic reaction per 500 000 vaccinated children. (7) There is consensus on the vaccination schedule: 3 intramuscular injections given at least 4 weeks apart, plus a booster at 12-15 months, if vaccination is started at 2 months of age. (8) In France, routine vaccination would prevent about a dozen deaths, several dozen cases of meningitis, and a few hundred hospital admissions per year, at a cost of at least one serious allergic reaction. (9) The risk-benefit balance is very favourable in infants who are at a high risk of invasive pneumococcal infection. It is also positive in other infants, and should therefore be routinely offered from the age of 2 months. Epidemiological monitoring must continue.     

Enteroviral meningitis in children in Turkey

In the indexed medical literature, there have been a very limited number of studies to investigate the epidemiologic and clinical features of enteroviral meningitis in Turkey. The aim of the present retrospective study is to update the actual situation to recognize the spectrum and magnitude of this important clinical entity. Between June 1999 and December 2004, 612 cases of aseptic meningitis were followed up at our hospital. Enteroviral meningitis was defined by isolation of enteroviruses from cerebrospinal fluid (CSF) and/or stool samples. Mumps virus was detected in 310 cases (50.7%) and enteroviruses were the etiologic agents in 104 (17%) of the patients with aseptic meningitis. Most of the enteroviral meningitis cases (36 cases, 34.6%) were diagnosed in August and 70 (67.3%) of them were male. The mean age was 5.6 ± 3.4 years. The most common initial symptoms were fever (81.7%), vomiting (77.9%) and headache (57.7%). In the physical examination, 46.2% of the cases had neck stiffness and 38.5% had pharyngitis. Echovirus 30 was the most frequently (38 cases, 36.5%) isolated enterovirus with peaks in 1999, 2002 and 2004. The other frequently isolated enteroviruses were Coxsackie virus type B (17 cases, 16.3%), echovirus 6 (11 cases, 10.6%), echovirus 11 (6 cases, 5.8%), and echovirus 13 (4 cases, 3.8 %). Mean hospitalization time was 6.2 ± 2.4 days. All patients recovered without any sequelae. Enteroviruses have an important role in childhood aseptic meningitis cases in Turkey too, and the predominant serotypes vary according to years.     

The impact of three influenza epidemics on primary care in England and Wales

The numbers of persons with influenza presenting to general practitioners in England and Wales during the epidemics of late 1989, late 1993, and early 1995 are estimated to be approximately 760,00, 480,000 and 192,000, respectively. The expected numbers used to derive these estimates were obtained by averaging incidence by week over the 9 winters of 1986/87 to 1994/95, excluding those weeks in which influenza was prevalent. These 3 epidemics varied in magnitude and in the relative impact on persons in different age groups. The influenza B epidemic in 1995 scarcely affected elderly people. During the 3 epidemic periods, increased numbers of persons consulted their general practitioners with other respiratory diseases, including pneumonia, acute bronchitis and otitis media. The patterns of increase were not consistent between the epidemics, partly because of the differing impact on the various age groups and partly because of the effect of other respiratory viral illnesses prevalent at the same time. No increase occurred in the numbers of persons reported with new episodes of cerebrovascular accident or of acute myocardial infarction. A similar method was used to estimate excess deaths, which amounted to 25,000 in 1989, 13,000 in 1993, and 500 in 1995. In the periods immediately following the influenza epidemics, the observed pattern of deaths conformed to the expected, demonstrating that persons dying during the epidemics were not just dying a few weeks prematurely.     

Sensorineural hearing loss in children with epidemic meningococcal meningitis at Tikur Anbessa Hospital

There are several reports on epidemic meningococcal meningitis in some areas of Ethiopia, which lie in the meningococcal meningitis belt of Africa. Very little is known about the neurological sequel of epidemic meningococcal meningitis, especially that of hearing loss. This hospital-based study was conducted prospectively at the Ear Nose Throat clinic of the Pediatric Outpatient Department of the Tikur Anbessa Hospital during the meningococcal meningitis epidemic from May to October 2000 in order to assess the hearing status of patients after completion of their course of treatment. Demographic, clinical, microbiologic, audiometric data were collected using a preformed questionnaire. One hundred forty one cases of pyogenic meningitis were examined at discharge and on subsequent visits. Most of the patients (73.5%) were between 5 and 12 years of age. The major bacteriological isolate from the cerebrospinal fluid in 48 cases (35.3%) of the specimens was meningococci. Hearing loss was the commonest neurological sequel at discharge constituting 25% of the cases. At least 12.5% of the patients had severe to profound sensorineural hearing loss. This level of hearing loss would affect communication abilities and impair studies in school if left without rehabilitative measures including hearing aids or other means. Large scale community based studies are required to determine the magnitude of hearing loss associated with epidemic meningococcal meningitis.     

保山市2002～2011年流行性乙型脑炎发病流行病学特征及其原因分析

【摘要】目的对2002～2011年保山市乙脑疫苗接种后流行性乙型脑炎（乙脑）发病及死亡率进行调查分析。方法对保山市疾控中心2002～2011年的乙脑疫情资料和乙脑疫苗接种情况进行调查,分析保山市乙脑发病的流行病学特征。结果从乙脑死亡率看,从2002年1月～2011年10月呈逐年下降趋势;从地域分布来看,隆阳区的发病例数占了总发病的84．6％：近5年来流行性乙型脑炎死亡率显著降低,同时发病率也明显减低。结论乙脑疫苗的接种以及诊疗水平的提高从根本上改善了保山市乙脑的发病率,经过系统调查分析,保山市乙脑的下步工作还是应着重于预防．提高各地的诊断水平。     

2006～2007年某市水痘流行特征分析

目的:了解某市近两年的水痘流行特征,为相关部门制定水痘预防控制措施提供科学依据.方法:采用描述流行病学方法,对某市2006～2007年水痘病例及水痘爆发事件进行分析.结果:2006～2007年某市共报告水痘病例3 660例.无死亡.14岁以下病例占86.21%;有明显季节性,6月和12月为发病高峰;2006～2007年全某市共报告水痘事件8起,其中5起发生在学校.结论:春末夏初和冬季是水痘发病高峰,发病以14岁以下人群为主,乡村小学是水痘事件发生的重要场所.     

The 1996 pertussis epidemic in New Zealand: descriptive epidemiology

AIM: To describe the 1996 pertussis epidemic. METHODS: Hospitalisation, notification and laboratory data were used to describe the 1996 pertussis epidemic and compare it with previous epidemics. RESULTS: The 1996 epidemic spanned 24 months. The crude hospitalisation rate from 1 June 1995 to 31 May 1997, was 10.1 per 100,000 person years, being highest for children aged six weeks to two months (42 to 90 days old inclusive; 1402 per 100,000). The 1996 epidemic involved more hospitalisations than the 1991 and 1986 epidemics, and a greater proportion for children under the age of one year (77%), compared to previous epidemics (60-70%). There were no deaths. Pertussis only became notifiable from 1 June 1996. The crude notification rate for the following twelve months was 19.8 per 100,000 (equivalent hospitalisation rate 6.7 per 100,000); children aged six weeks to two months of age had the highest notification rate (531 per 100,000; equivalent hospitalisation rate 1021 per 100,000). In 1996-97, children aged under 15 months accounted for 21% of notifications, but 82% of hospitalisations. Europeans tended to have higher rates of notifications than non-Europeans, but lower rates of hospitalisation. CONCLUSIONS: New Zealand continues to experience high rates of pertussis as a result of inadequate immunisation coverage. The increase in hospitalisations during the 1996 epidemic may reflect a real increase in the population-based incidence, or other changes (e.g. hospitalisation practice, increase in vulnerable children with poor access to primary care). Improved rates, accuracy and completeness of pertussis notifications will improve the ability of notification data to accurately describe future epidemics and estimate vaccine effectiveness. Further debate is required regarding the aims of pertussis immunisation; accelerating the timing of the first three doses and adding further doses of pertussis vaccine on the national immunisation schedule; and the role of acellular pertussis vaccines. In the meantime, the priority must be increasing on-time immunisation coverage.     

The potential cost-effectiveness of vaccination against herpes zoster and post-herpetic neuralgia

A clinical trial has shown that a live-attenuated varicella-zoster virus vaccine is effective against herpes zoster (HZ) and post-herpetic neuralgia (PHN). The aim of this study was to examine the cost-effectiveness of vaccination against HZ and PHN in Canada. A cohort model was developed to estimate the burden of HZ and the cost-effectiveness of HZ vaccination, using Canadian population-based data. Different ages at vaccination were examined and probabilistic sensitivity analysis was performed. The economic evaluation was conducted from the ministry of health perspective and 5% discounting was used for costs and benefits. In Canada (population = 30 million), we estimate that each year there are 130,000 new cases of HZ, 17,000 cases of PHN and 20 deaths. Most of the pain and suffering is borne by adults over the age of 60 years and is due to PHN. Vaccinating 65-year-olds (HZ efficacy = 63%, PHN efficacy = 67%, no waning, cost/course = $150) is estimated to cost $33,000 per QALY-gained (90% CrI: 19,000-63,000). Assuming the cost per course of HZ vaccination is $150, probabilistic sensitivity analysis suggest that vaccinating between 65 and 75 years of age will likely yield cost-effectiveness ratios below $40,000 per Quality-Adjusted Life-Year (QALY) gained, while vaccinating adults older than 75 years will yield ratios less than $70,000 per QALY-gained. These results are most sensitive to the duration of vaccine protection and the cost of vaccination. In conclusion, results suggest that vaccinating adults between the ages of 65 and 75 years is likely to be cost-effective and thus to be a judicious use of scarce health care resources.     

2002~2019年东莞市大岭山镇艾滋病疫情数据统计及流行病学特征分析

目的统计并分析2002~2019年东莞市大岭山镇艾滋病(AIDS)疫情数据,并对其流行病学特征进行分析。方法分析2002~2019年东莞市大岭山镇人类免疫缺陷病毒(HIV)/AIDS患者的性别、年龄、婚姻、职业分布、文化程度、最有可能的感染途径以及生存情况。结果大岭山镇2002年~2019年12月31日累计报告329例HIV/AIDS患者,其中HIV感染患者248例, AIDS患者81例;近6年报告数增加较快,共报告273例,占总报告数的82.98%;全镇23个村(居委会)均有HIV/AIDS报告,户籍以外省为主,占85.11%(280/329)。329例患者男女性别比例为7.89∶1;患病年龄段占比最高的为30~39岁,占比为33.43%(110/329);患病最多的年份为2019年,占比为17.63%(58/329)。职业类型比较多,分布较为广泛,其中占比最高的职业为工人,为40.12%(132/329);其次为家务及待业13.98%(46/329),商业服务11.25%(37/329),农民10.64%(23/329)。初中学历占比最高,为51.98%;其次为高中或中专、小学、大专及以上、文盲。最有可能的感染途径中最常见的为性传播,占比为95.74%;其次为血液传播、母婴传播。329例HIV/AIDS患者中,存活309例,死亡20例,存活率为93.92%,死亡率为6.08%。结论就2002~2019年东莞市大岭山镇AIDS疫情数据分析来看,近6年呈快速增长。     

Heroin-related deaths in regional New South Wales, 1992-96

The coronial files of all 188 heroin-related fatalities that occurred in regional New South Wales between 1992 and 1996 were inspected. There was a significant increase in fatalities, rising from 23 deaths in 1992 to 53 during 1996. The regions in which the most deaths occurred were Wollongong/ Illawarra (43 deaths), Newcastle/Hunter (35) and the far north coast (25). The mean age of cases was 31.5 years and 83% were male, and there were no significant trends in demographic characteristics of cases over the study period. The median blood morphine concentration of cases was 0.39mg/l (range 0.05-4.5mg/l). Alcohol was detected in 50% of cases and benzodiazepines in 29%. There were large regional variations in toxicology results, with median blood morphine concentrations ranging from 0.25mg/l among south coast cases to 0.56mg/l in mid-western New South Wales. Compared to Sydney metropolitan cases, regional cases had a higher median blood morphine concentration, were less likely to have cocaine detected, were more likely to have died in a home environment and to have been born in Australia.     

An epidemic of type 3 dengue on Niue Island

An epidemic of dengue fever type 3 occurred on the island of Niue late in 1985 and during the first quarter of 1986. Just over 18% of the population reported for medical attention, the disease predominantly affecting teenagers and young adults, with equal sex distribution. The epidemic was of the classical dengue syndrome and there were no deaths. There were some unusual features. The magnitude of antibody rise was unusually high in many of those with no preexisting antibody. Despite the large proportion of the population with preexisting dengue type 2 antibodies, no cases of dengue haemorrhagic fever/dengue shock syndrome were observed, confirming the observations made in many other epidemics that these serious complications do not always follow in sequential epidemics caused by two different types. A high level of awareness, combined public health measures and active community involvement helped to control the epidemic early.     

Antiviral drugs in influenza: an adjunct to vaccination in some situations

(1) Influenza is a common acute respiratory disease due to a virus that causes annual seasonal epidemics. Three major pandemics occurred in the 20th century, in 1918-1919, 1957 and 1968, mainly due to genetic variants of type A influenza virus. (2) In temperate regions the incidence of hospitalisation increases during annual influenza epidemics. More than 90% of deaths linked to influenza involve people over 65 years of age. (3) The clinical manifestations of influenza virus infection are non specific. The main complications are secondary bacterial respiratory tract infections (especially pneumonia); those most at risk are people over 65, infants less than one year old, and people with underlying chronic disorders (pulmonary, cardiac, renal or metabolic) or immune deficiencies. (4) Vaccination is the main preventive measure. During most years the vaccine strain closely matches the epidemic strain. In relative terms, vaccination of people over 65 reduces the number of deaths linked to influenza by about 80%, hospitalisation and pneumonia by about 50%, and symptomatic influenza by about 30%. Yearly vaccination is recommended for younger people with serious chronic disease. (5) Three antiviral drugs are currently approved in France for prevention or treatment of influenza: amantadine and the neuraminidase inhibitors zanamivir and oseltamivir. (6) Efficacy of antiviral drugs has not been evaluated in comparative randomised trials in which death and influenza complications were the primary outcome measures. (7) A systematic review of 20 comparative randomised trials involving about 2500 healthy people showed that amantadine reduced the frequency of flu-like syndromes by about 7% in absolute terms (26.3% versus 33.1% with placebo). Zanamivir and oseltamivir have only been shown to reduce the frequency of serologically confirmed episodes of influenza (0.4% to 2.5%, compared to 4.4% to 14.9% with placebo). (8) In a randomised placebo-controlled trial of oseltamivir, involving 548 institutionalised subjects over 65 years of age, more than 80% of whom had been vaccinated, respiratory tract infections were less frequent in the oseltamivir group, but the relevance of this result is undermined by the small number of observed cases. (9) Efficacy of antiviral drugs on avian influenza (bird flu) was studied during a 2003 Dutch outbreak due to a type A/H7N7 virus. Among the 38 exposed persons who were treated, about 3% developed symptoms, compared with about 10% of 52 exposed persons who refused treatment (p = 0.38). The low statistical power and the lack of randomisation rule out any firm conclusions on preventive effects. (10) The three antiviral drugs have different profiles of adverse effects and drug interactions. Amantadine carries a risk of neuropsychological, atropinic and dopaminergic adverse effects, and can interact with drugs that have similar effects. Zanamivir carries a risk of life-threatening bronchospasm. Oseltamivir was approved relatively recently and its full spectrum of adverse effects is not yet known; its main adverse effects appear to be mild gastrointestinal disturbances, although a few cases of serious cutaneous reactions have been reported. (11) In vitro resistance to the three drugs has been demonstrated, but the possible clinical and epidemiological consequences are unclear. (12) In situations warranting antiviral therapy for the prevention of influenza, oseltamivir, at a dose of 75 mg/day for 10 days, is the drug with the best risk-benefit balance. Its use should be limited to situations where a major potential benefit exists in order to avoid selection for resistant strains. (13) Testing of oseltamivir in children is limited. Oseltamivir should be avoided during pregnancy, because of evidence that it may harm the unborn child. (14) In practice, the use of antiviral drugs in otherwise healthy adults and children is not generally recommended. (15) Despite the lack of convincing data regarding the efficacy of oseltamivir in preventing complications of influenza, its effect on documented infections suggests it may be useful for unvaccinated individuals who are at high risk of infection and severe complications. Under these conditions, treatment should be started within 48 hours after contact with a person who has flu-like symptoms during a seasonal epidemic; residents in institutions in which influenza cases occur may also qualify for preventive treatment. Other preventive measures should also be used, including immediate vaccination, case isolation, use of face masks, and more frequent hand washing. (16) During seasonal influenza epidemics due to viral strains against which the current vaccine is of limited effectiveness, the utility, target populations and optimal duration of preventive antiviral treatment must be determined by examining the groups most at risk and the severity of complications. (17) Most flu-like syndromes are not due to the influenza virus, and the preventive effect of antiviral drugs on complications in persons at risk has not yet been demonstrated. (18) In practice, antiviral drugs are not an alternative to influenza vaccination, but may be a useful adjunct in some situations. It is best to limit their use to short-term prophylaxis of vulnerable persons in situations where the risk of contracting influenza virus infection is high.     

Surgical management of 234 patients with hydatid disease: the Tikur Anbessa Hospital experience

OBJECTIVE: The aim of this study was to evaluate the pattern and surgical management of hydatid disease. METHODS: A hospital based retrospective cross sectional analysis was conducted in Tikur Anbessa Hospital, department of surgery, Addis Ababa, Ethiopia. Patients' medical records and operation theater registers of 234 patients operated upon for hydatid disease between September 1995 and August 2005 were analyzed RESULTS: One hundred and twenty three patients were male and 111 female. Their age ranged from 13-69 years, with median and peak age of incidence of 30 and 21-30 years respectively. Hundred forty five (62.0%) patients were from rural population. Significant number of patients (40.6%) came from Oromiya regional state (p < 0.004). The most common presenting symptoms were pain in 206/234 (88.0%) patients with hydatidosis, mass or organomegally in 106/141(75.2%) patients with intraabdominal hydatid diseases, cough in 91.2% and expectoration in 83.3% of cases of thoracic hydatidosis. Liver and lung (79.6%) are the most commonly affected organs. More than one organ involvement was seen in 13.7% of cases. Ultrasonography and chest roentgenography were the main modalities of investigation of abdominal and thoracic hydatidosis respectively. Surgical techniques employed for removal of cysts was evacuation in 181 (67.3%). capitonnage in 167 (62.1%) and pericystectomy in 47 (17.5%) organs. In 191 (81.6%) patients the postoperative course was uneventful while 15.8% developed postoperative complications. There were six deaths. The follow up period ranged from 1 month to 3 years (mean 5.6 months). CONCLUSION: Hydatidosis is not uncommon in rural communities of Ethiopia particularly in Oromiya. Complete excision of the disease processes with maximum preservation of tissue is safe and ideal for most patients with hydatidosis.     

Experiences with acellular pertussis vaccine in Japan and epidemiology of pertussis

In 1975, with two successive cases of death shortly after whole cell pertussis vaccine, administration of pertussis vaccine was temporarily suspended. The vaccine was soon resumed, but setting the vaccination age at over two years for group vaccination. This caused the fall in pertussis vaccine acceptance rates until 1980, resulting in a nationwide epidemic of pertussis infection, with the peak of the epidemic in 1979. Acellular pertussis vaccine was developed and introduced in 1981, since then the coverage rate with the three-time pertussis vaccination have retained the levels of more than 80%. The number of cases of pertussis infection decreased steadily since 1980 and in 1985, the number of total pertussis patients was as low as those observed before 1974. However, incidence of pertussis patients aged less than 2 year remained higher. Dramatical decrease in side effects of pertussis vaccination was observed after the elevation of the age of the vaccination at mass immunization clinic to two years. Side effects has decreased further after the introduction of acellular pertussis vaccine.