2006-2017年楚雄州3种鼠传疾病流行分析

目的 分析2006-2017年楚雄州肾综合征出血热、恙虫病、斑疹伤寒流行特征,为制定防控策略提供科学依据。方法 收集《中国疾病预防控制信息系统》中报告的2006-2017年楚雄州3种鼠传疾病进行统计分析。结果 2006-2017年间楚雄州共报告肾综合征出血热、恙虫病、斑疹伤寒3种鼠传疾病共3207例,报告死亡4例,年均报告发病率9.83/10万,其中以恙虫病报告病例最多,占3种鼠传疾病病例总数的85.53%(2743/3207)。肾综合征出血热报告发病率位居第1的是楚雄市,恙虫病和斑疹伤寒报告发病率位居第1的是永仁县;肾综合征出血热的报告发病高峰是4月,恙虫病的报告发病高峰是7-10月,斑疹伤寒的报告发病高峰是8-9月;肾综合征出血热和恙虫病发病人群均以农民为主,斑疹伤寒发病人群以农民、学生和散童为主。结论 楚雄州3种鼠传疾病疫情呈上升趋势,发病有明显的地区性、季节性和人群分布特征,应在高发季节做好重点地区、重点人群的防控工作。     

1950-2021年中国斑疹伤寒流行特征分析

目的分析斑疹伤寒在我国的流行病学特征, 探讨我国斑疹伤寒防控工作面临的问题及挑战和策略。方法资料来源于中国公共卫生科学数据中心传染病历史数据库和中国疾病预防控制信息系统传染病报告信息管理系统1950-2021年斑疹伤寒报告数据, 采用描述性统计方法、Mann-Kendall检验和圆形分布法对斑疹伤寒的发病情况、死亡情况、病死率进行分析, 研究我国斑疹伤寒流行的时间、空间、人群分布和诊断现状。结果 1950-2021年, 我国共报告斑疹伤寒发病数452 965例, 死亡数7 339例, 分别在20世纪50年代、60年代和80年代的14年中报告发病数均过万。20世纪90年代以来, 斑疹伤寒发病数和发病率大幅降低, 流行强度以散发为主, 但安徽省、湖北省和湖南省报告发病数呈上升趋势。斑疹伤寒在全年均可发病, 但可呈现一定的季节聚集性, 我国斑疹伤寒的发病率高峰集中在夏、秋季, 不同省份斑疹伤寒的月发病高峰从北方至南方逐渐向前推移。斑疹伤寒发病的男女性别比为1.01∶1(18 529∶18 366), 近年来女性发病数逐渐超过男性;≤9岁人群发病数占比最大(18.9%), ≥50岁人群发病数呈...     

2010年湖北省发热伴血小板减少综合征的流行病学分析

目的 探讨湖北省新发传染病——发热伴血小板减少综合征(SFTS)的流行特征和危险因素。方法 2010年在湖北省随州、黄冈、武汉市乡镇卫生院和二级以上综合医院设置监测点, 培训全省县级及以上医疗机构感染科医生, 开展报告病例的流行病学个案调査, 采集血样检测和分离病毒, 在高发地区开展健康人群和家畜抗体水平调查及媒介蜱监测。结果 2010年湖北省报告病例来自11个市(州)、32个县(区)和100个乡镇, 共报告188例, 其中死亡21例, 报告发病率为0.33/10万, 病死率为11.2%。流行病学调査显示, 病例报告地区为丘陵地带(海拔28~940m);报告发病时间为4—12月, 高峰在5—9月;病例年龄11?81(M=56)岁;农民占95.3%;病例发病前两周内均无外出史, 93.6%从事与农业生产相关工作, 64.2%有皮肤破损, 52.8%有明显蜱暴露史, 22.0%有明确蜱叮咬史。采集病例血液标本129例(68.6%), 87例(67.4%)Realtime-PCR检测发热伴血小板减少综合征病毒(SFTSV)阳性;用微量中和试验检测急性期和恢复期血标本, 11份SFTSV中和抗体阳转或呈4倍增高;2例血标本分离到SFTSV。健康人群总抗体阳性率为3.8%, 犬、羊和牛总抗体阳性率分别为55.0%(6/11)、36.7%(2/3)和80.0%(4/5);草蜱、牛蜱、羊蜱PCR检测阳性。结论 湖北省SFTS疫区内人和家畜感染SFTSV。蜱可能是传播媒介, 人群劳作中皮肤破损、接触蜱或被蜱叮咬可能是该病的危险因素之一。     

湖北省2011年手足口病流行特征分析

目的了解湖北省2011年手足口病(HFMD)流行特征,为制定防治措施提供依据。方法采用描述流行病学方法,对2011年湖北省各地上报HFMD病例以及重症、死亡病例数据进行分析。结果 2011年湖北省共报告HFMD病例63 767例,发病率为111.41/10万;其中重症病例159例,死亡24例。高发年龄为6月龄～3岁儿童,发病时间呈4～7月和10～12月双流行高峰,重症和死亡病例主要发生在4～7月流行高峰。病原学检测结果为肠道病毒71型(EV71)阳性1 439例(占53.02%),科萨奇病毒A16型(CoxA16)阳性776例(占28.59%),其他肠道病毒阳性499例(占18.39%),EV71为重症和死亡病例绝对优势病原。结论 2011年湖北省HFMD疫情处于较高流行水平,应重点加强第一个流行高峰和高发地区的HFMD预防控制工作。     

2011—2021年萍乡市上栗县手足口病流行特征分析

目的 分析2011—2021年上栗县手足口病的流行特征,为手足口病的有效防控提供科学依据。方法 从中国疾病预防控制信息系统传染病报告信息管理系统中导出2011—2021年上栗县手足口病的病例报告数据,采用描述性流行病学方法进行分析。结果 2011—2021年上栗县累计报告手足口病病例11 894例,重症病例为42例,无死亡病例;年均报告发病率为226.81/10万。不同年份手足口病发病率差异有统计学意义(χ²=2 159.846,P<0.001),其中2018年最高(352.49/10万),2019年最低(103.89/10万),总体呈“隔年高发”的特点。手足口病发病具有季节性特征,4～7月和10～12月为发病高峰。男性发病多于女性,发病年龄主要集中在1～3岁(76.53%),散居儿童和幼托儿童多发(98.76%)。病原学监测显示,实验室诊断病例以其他肠道病毒感染为主,占51.67%;2016年后,EV71的比重逐年降低。结论 上栗县手足口病具有隔年高发的特点,存在明显的季节、人群和地区流行特征。可根据重点时段、重点地区、重点人群制定针对性的手足口病防控策略...     

2005-2010年北京市立克次体病流行病学特征分析

立克次体(Rickettsia)是一类严格细胞内寄生的原核细胞型微生物,人类通过节肢动物人虱、鼠蚤、蜱或螨的叮咬而感染立克次体.近几年,恙虫病、人粒细胞无形体病等立克次体病在我国部分地区发病呈上升趋势,目前我国至少存在10余种立克次体病,其中包括流行性斑疹伤寒、地方性斑疹伤寒、恙虫病、北亚蜱传斑点热、黑龙江蜱传斑点热、内蒙古蜱传斑点热、Q热、人单核细胞埃立克体病、人粒细胞埃立克体病、人粒细胞无形体病,以及巴尔通体病等疾病[1-3].为了解北京市立克次体病的发病趋势及流行规律,为合理制订防控措施提供科学依据,笔者对2005 -2010年北京市恙虫病、斑疹伤寒和人粒细胞无形体病等3种立克次体病病例的流行病学特征进行分析,现报告如下.     

2006—2020年深圳市恙虫病流行特征分析

目的 分析2006—2020年深圳市恙虫病的流行特征,为制定本市恙虫病的防控策略提供数据支持。方法 对2006—2020年深圳市于“中国疾病预防控制信息系统”中报告的恙虫病病例信息,进行描述性流行病学分析。结果 2006—2020年深圳市共报告恙虫病病例547例,死亡2例,年均发病率0.30/10万人,历年发病率呈波动上升的趋势,2019年年均发病率达到最高,为0.59/10万;时间分布呈双峰型,发病高峰期为5—11月(490例),占89.58%,10月累计报告病例数(86例)为最高,占15.72%。深圳市各辖区中以南山区累计报告病例数(208例)最多,年均发病率1.07/10万;病例多发生在40～59岁年龄组,占报告病例总数的45.34%;家务及待业人员和工人为职业高发人群,占52.10%。结论 2006—2020年深圳市恙虫病发病呈波动性增长,有明显的季节性和地区差异。     

沛县2012-2016年手足口病流行病学特征分析

目的了解手足口病流行病学和病原学特征,为制定预防控制措施提供依据。方法利用传染病报告信息管理系统,采用描述性流行病学方法,对沛县2012-2016年手足口病疫情资料进行统计分析。采集部分手足口病临床诊断病例咽拭子、肛拭子开展病原学监测。结果沛县2012-2016年手足口病累计报告6 777例,年均发病率为105.29/10万,各年发病率分别为91.63/10万、59.80/10万、158.06/10万、78.62/10万、139.89/10万,不同年份发病率差异有统计学意义(P<0.05)。发病具有明显的季节性,3-7月病例数占67.7%,11月-次年1月病例数占15.83%。全县27个乡镇均有病例报告,年均发病率居前5位的乡镇为鹿楼(184.86/10万)、栖山(182.49/10万)、城镇(159.30/10万)、杨屯(155.54/10万)、龙固(151.84/10万)。报告病例男女比为1.69∶1,≤5岁组病例占98.20%,散居儿童占96.03%。共检测重症病例标本16份,死亡病例标本1份,普通病例标本360份。16例重症病例中EV71阳性率为87.5%;360份普通病例EV71和CoxA 16、其他肠道病毒阳性率分别为17.78%、14.44%、23.89%。结论应根据沛县手足口病流行病学特征,加强高发季节、重点人群、重点地区的防控及病原学监测,采取综合干预措施,降低手足口病发病率。     

2015—2021年四川省恙虫病流行病学特征分析

目的 分析2015—2021年四川省恙虫病流行特征,为科学防控提供依据。方法 从疾病监测信息报告管理系统中获取所有2015—2021年恙虫病报告卡,采用描述性流行病学方法进行分析。结果 2015—2021年四川省累计报告恙虫病病例4 691例,年均发病率为0.81/10万。全年发病呈季节性单峰分布特征,8月为发病高峰。凉山彝族自治州和攀枝花市两地病例数占全省病例总数的95.35%。男女性别比为0.87∶1,10岁以下儿童组发病率(1.27/10万)最高,其次为50岁中年组(1.16/10万)。职业分布以农民为主,占病例总数的68.32%。结论 四川省恙虫病高发地区为凉山州和攀枝花市,应加强两地恙虫病主要传播媒介和风险因素调查研究,开展针对农民、儿童等重点人群的健康教育综合干预,降低恙虫病发病水平。     

吉林省2012-2016年5岁及以下儿童手足口病流行特征分析

目的 分析吉林省2012-2016年5岁及以下儿童手足口病流行特征,为针对易感人群制定防控措施提供科学依据。 方法 运用描述流行病学方法,对2012-2016年《传染病报告信息管理系统》报告的吉林省5岁及以下儿童手足口病疫情资料进行统计分析。 结果 吉林省2012-2016年5岁及以下儿童累计报告手足口病55 352例,年均发病率870.13/10万,每2年出现1次疫情高峰。发病季节高峰为6-8月,呈单峰分布。平均发病率居前三位的是延边州(1 867.88/10万)、通化市(1 342.02/10万)、吉林市(1 030.50/10万)。各年龄组男性发病率均高于女性(P＜0.01),病例男女性别比1.45:1,以散居儿童为主(占69.15%),2岁组年均发病率最高。实验室检测肠道病毒阳性标本中,其他肠道病毒占39.56%,CoxA16占30.79%,EV71占29.66%;重症病例检测阳性标本中,EV71占79.02%。 结论 吉林省2012-2016年5岁及以下儿童手足口病流行具有明显季节性、地区性和易感人群特殊性。EV71、CoxA16、其他肠道病毒感染交替主导流行,但近两年其他肠道病毒成为优势型;重症和死亡病例以感染EV71为主。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.