某SARS隔离区疫情的流行病学调查及效果评价

目的：分析深圳市某SARS隔离区内4例SARS疑似病例的流行病学调查和处理，对主要控制措施的效果进行初步评价，为今后控制类似社区SARS爆发提供经验和借鉴。方法：收集该隔离区人口、地理、卫生条件等基本情况．SARS疑似病例个案调查表、临床资料、密切接触者个案调查表、隔离人群医学观察资料、发热人员情况、实验室检查结果等，以及根据现场流行病学调查所采取的处理措施进行流行病学分析和评价。结果：该临时住宅区共有人口345人，自5月14日发生首例SARS疑似病例后．在一个潜伏期内先后共有29人发热，8人显示肺部有不同程度改变，共4人诊断为SARS疑似病例，采集发热病人急性期咽拭子及血清检测流感病毒及SARS病毒抗体，一例疑似病人的SARS病毒抗体可疑阳性。通过采取隔离、消毒、预防服药、加强医学观察、监测、健康教育等综合措施有效控制疫情蔓延。结论：社区获得非典病例应根据现场流调确定有针对性的预防控制措施，防止该病爆发和蔓延。     

上海市闵行区2例SARS病例流行病调查体会

在SARS病例个案调查中 ,极少数病人由于害怕隔离、担心亲戚、朋友和他接触而受“牵连” ,在此心理因素的影响下 ,提供虚假的流调信息。作为流调人员切忌盲目听信 ,应注重病人所叙述的每一个活动环节和时间节点 ,以求在病人的单位、居住社区等地进行调查时互相印证其信息的可信程度 ,避免密切接触者确定错误 ,影响流行病学追查质量和社会安定。此外 ,要加强一线流调人员的业务培训 ,尤其在流行病学调查方法和技巧上培训 ,通过培训和流行病学调查质量控制 ,不断提高流调人员的现场流行病学调查处理水平 ,尽可能将后续追查中容易发生的问题在…     

江苏省传染性非典型肺炎数据库建立及其应用

传染性非典型肺炎(SARS)2002年11月首先在我国广东省发现，短短几个月时间内波及全国大部分省、市、自治区。江苏省4月20日报告首例疑似病例，5月上旬局部地区也出现了轻度流行。为提供本省SARS疫情分析、控制措施评价、科学研究准确的数据源，我们及时地建立了本省SARS数据库，收入临床诊断病例、疑似病例、密切接触者发病资料及流行病学调查等资料，为本省SARS疫情控制提供了有力的支持。     

上海市长宁区一起新型冠状病毒肺炎家庭聚集性疫情流行病学调查

目的 分析上海市长宁区一起新型冠状病毒肺炎(简称新冠肺炎)家庭聚集性疫情流行病学特征,为新冠肺炎聚集性疫情防控提供科学依据. 方法 应用现场流行病学调查方法,对2020年上海市长宁区一起新冠肺炎家庭聚集性疫情的病例与密切接触者进行调查,采用实时荧光定量RT-PCR方法对采集的呼吸道标本进行新型冠状病毒核酸检测.结果 病...     

一起国际航行船舶传染性肺结核调查处置

目的总结传染性肺结核病例的调查处置的经验,完善口岸密切接触者排查处置体系。方法对疑似肺部结核病患者进行诊断,并对密切接触者进行流行病学调查;同时采取一系列医学排查和卫生处置措施。结果未发现22名密切接触者患有"传染性结核病"的明确证据。结论本次调查对密切接触者进行了严格的医学筛检和流行病学调查,为口岸密切接触者排查处置体系建设提供宝贵经验。     

天津市第137例新型冠状病毒肺炎病例在京感染风险分析

目的 了解天津市第137例新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)确诊病例的疑似传染源(IgM抗体检出阳性,以下简称S)在京感染风险.方法 2020年6月23-24日,对S进行流行病学调查,收集其5月30日后在京活动史及其密切接触者,采集并检测S在京密切接触者的咽拭子和血样...     

西安市2003年SARS流行特征分析

目的描述并分析西安市2003年4-6月SARS流行特点。方法采用全国统一的SARS流行病学调查表收集资料。结果西安市2003年4-6月共发生11例SARS病例，其中9例为输入性病例，确诊病例未发生1例死亡；确定疑似病例累积71例，其中7例转为确诊病例，截止到6月8日，其余64个疑似病例全部排除。在SAILS流行期间共调查1代和2代接触者2530例。结论通过早期发现、早期治疗和早期隔离，西安市未发生大的SARS流行，为非SAILS疫区。     

流行病学调查在1例新型冠状病毒肺炎疑似病例鉴别诊断中的应用

目的 通过对1例新型冠状病毒肺炎(简称新冠肺炎)疑似病例的流行病学调查分析,探讨流行病学个案调查在新冠肺炎病例鉴别诊断中的应用。 方法 应用新冠肺炎流行病学个案调查方法,对1例新冠肺炎疑似病例的发病就诊信息、接触史、暴露史、既往史等进行调查,对可能的新冠病毒感染来源和感染途径进行分析,为病例的鉴别诊断提供依据。 结果 流行病学调查未发现本例患者有明确的新冠肺炎患者接触史和集贸市场、医院等高风险环境暴露史,但有其他传染病流行病学史,为病例的进一步诊断提供了方向。 结论 对临床表现高度疑似但无病原学证据支持的新冠肺炎疑似病例进行流行病学调查时,除了重点关注新冠肺炎的流行病学史外,应同时关注其他相关传染病的流行病学史,全面的调查分析可为病例的临床诊断提供流行病学依据。     

湖北省38例疑似传染性非典型肺炎个案分析

目的 分析湖北省传染性非典型肺炎(WHO命名为严重急性呼吸综合征SARS)与疑似SARS流行病学特点，为该病的鉴别诊断提供参考。方法 采用统一的流行病学个案调查表对SARS与疑似SARS进行调查，分析其在湖北省的流行特点以及排除SARS的病因。结果 全省累计报告疑似SARS38例，其中临床确诊6例，确诊率为15．79％；排除32例，排除率为84．21％。排除的病因以肺炎、肺部感染、支气管炎、肺结核及肺部阻塞性病变等呼吸系统疾病为主(25例，占78．13％)。治愈34例，治愈率为89．47％；死亡4例，病死率为10．53％。结论发病第一周，SARS与呼吸系统疾病难以鉴别，应密切观察病情变化，及时排除诊断，可减少对其密切接触者隔离观察及对其到过的场所进行消毒等一系列措施的投入。     

湖南省2003年传染性非典型肺炎防治工作及效果评价

目的 评价湖南省2003年传染性非典型肺炎防治工作情况及其效果。方法 使用统一的调查表对湖南省2003年报告的传染性非典型肺炎临床诊断病例、疑似病例和医学观察病例的发病、诊治、报告、流行病学调查处理等情况进行调查，将调查结果用SPSS11．0录入和进行统计分析。结果 湖南省13例临床诊断病例和疑似病例发病到被发现的间隔时间中位数为4d；医学观察病例的中位数为1d；76．92％的临床诊断病例、疑似病例被发现后1h得到报告。64．92％的医学观察病例能在2h内报告；临床诊断病例和疑似病例100％得到及时隔离治疗，医学观察病例的病例隔离治疗率为79．57％；所有临床诊断病例和疑似病例的流行病学调查工作均在接到报告后1h内开展，81．95％的医学观察病例的流行病学调查工作在接到报告后2h内进行；所有疫点或可疑疫点均得到了消毒，消毒率100％；临床诊断病例和疑似病例的密切接触者调查率、医学观察率均为100％，医学观察病例的密切接触者被调查率和医学观察率分别为92．51％和78．00％。结论 湖南省2003年落实了“早发现、早报告、早隔离、早治疗”、严格疫情调查处理等措施，其防治工作是有效的。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.