安庆市麻疹监测系统运转状况分析

为客观评价安庆市麻疹监测系统 (MMS)现状 ,对 1998年以来MMS运转状况进行了分析。 1998～ 2 0 0 2年 ,全市共报告麻疹疑似病例 14 86例 ,采集血清标本 115 4份 ;麻疹IgM抗体阳性 5 16例。血清标本采集率和麻疹IgM抗体阳性率分别由 1998年的 71 0 5 %和 2 2 2 2 %上升到 2 0 0 2年的 87 94 %和 5 5 2 7%。通过加强基层卫生人员麻疹监测的培训 ,对麻疹监测工作开展经常性督导和主动搜索 ,MMS的敏感性和及时性得到了明显的改善。2 0 0 2年与 2 0 0 1年相比 ,血清标本采集率由 6 7 5 7%上升到 87 94 % ;标本运送及时率由 70 5 4 %上升到 84 5 9% ;实验室结果及时反馈率由 38 5 1%上升到 4 7 0 1% ;麻疹IgM抗体阳性率由 4 1 2 9%上升到 5 5 2 7% ;实验室确诊病例由 38 0 7%上升到 6 7 97%。 2 0 0 1～ 2 0 0 2年共有 13起麻疹爆发 ,病例 2 32例 ,学龄儿童病例占 6 6 38%。分析麻疹病例的免疫史 ,说明安庆市的常规免疫工作仍存在一些问题 ,要着重提高麻疹疫苗接种的及时性和接种质量 ,抓好接种资料的管理。针对MMS存在的病例漏报、迟报、误报问题 ,要通过增加人员培训和加强管理来解决。     

德州市1999～2002年麻疹控制与监测分析

为了解德州市麻疹流行病学特点和麻疹监测系统运行状况 ,对 1999～ 2 0 0 2年麻疹监测的数据进行了分析。结果显示 :4年共报告麻疹疑似病例 2 6 4例 ,比常规传染病报告系统多出 138% ,确诊麻疹 12 3例 ,及时报告、及时调查和血清标本采集率分别达到 10 0 %、10 0 %、99%。麻疹发病呈散发和爆发并存的流行病学模式 ,爆发病例占总发病数的 5 1%。麻疹散发以学龄前儿童和成年人为主 ,爆发病例以学龄儿童为主。确诊病例中有麻疹疫苗 (MV)免疫史者占 32 5 2 % ,无免疫史者占 19 5 1% ,免疫史不详者占 4 7 97%。 3年麻疹监测报告的及时性、完整性和病例调查的完整性均达到 10 0 %。发病主要原因是MV接种率低和免疫失败。应在提高常规免疫接种率和接种质量的同时 ,要抓好大年龄儿童的MV强化免疫 ,进一步提高人群的免疫水平 ,预防控制麻疹爆发。     

蚌埠市1996～1999年急性迟缓性麻痹病例监测系统评价

目的　评价急性迟缓性麻痹 (AFP)病例监测系统。方法　对 1996～ 1999年蚌埠地区AFP病例监测系统资料采用 Epi Info软件进行统计分析。结果　共报告 AFP病 6 2例 ,每年 15 a以下儿童 AFP病例报告发病率达到 1.32 / 10万。 AFP病例 48h内调查率 95 .16 % ,14d内双份合格粪便标本采集率 90 .32 % ,粪便标本 7d内送至省卫生防疫站占 87.10 %。零病例旬报及时率96 .46 % ,麻痹 6 0 d后随访并将随访表 75 d内送至省卫生防疫站占 91.94% ,AFP病例就诊 2 4h内报告率 75 .81%。结论　蚌埠市 AFP病例监测系统各项监测指标已达到规划要求。     

2013-2014年东莞市麻疹监测系统的运转情况

目的 分析2013-2014年东莞市麻疹监测系统运转情况,为加强麻疹监测、消除麻疹提供参考。 方法 采用描述性流行病学方法对东莞市2013-2014年麻疹监测系统指标进行分析。 结果 2013-2014年东莞市报告麻疹监测病例数1 211例,其中实验室诊断病例946例(78.12%),临床诊断病例16例(1.32%),排除病例249例(20.56%)。48 h内完整调查率分别是98.89%和98.98%,血标本3 d内送达率分别是94.65%和94.89%,血清学检测结果7 d内报告率分别是97.11%和96.81%,监测病例血标本采集率分别是98.69%和98.27%,暴发疫情实验室确诊率100%,暴发疫情病原学标本采集率100%,排除病例报告发病率分别是1.53/10万和1.47/10万。 结论 东莞市麻疹监测系统的监测指标略低,系统敏感性有待进一步提高。     

河北省2001年麻疹流行病学分析与监测系统运转状况评价

为了掌握河北省麻疹的流行病学特点 ,对 2 0 0 1年麻疹监测系统运转情况进行了分析。全年共报告麻疹疑似病例 6 95例 ,临床诊断 73例 ,实验室确诊 2 76例 ,实验室排除 346例。根据分析结果 ,2 0 0 1年河北省麻疹的流行病学特征是 :春季高发 ;学龄前儿童和小学生为重点发病对象 ;18 6 %的报告病例无免疫史 ,4 7 9%免疫史不详。针对病例的地域和年龄分布 ,提出在 2 0 0 2年对重点地区和人群开展麻疹疫苗的后续强化免疫。分析相关年龄麻疹病例的免疫史 ,说明常规免疫工作存在一些问题 ,要着重提高麻疹疫苗接种的及时性和接种质量。一些监测指标 ,如报告及时率、病例调查率、标本采集率等有待提高。     

2004-2010年上海市青浦区麻疹监测系统运转状况评价

目的了解上海市青浦区麻疹监测系统运转的各项指标,以期掌握监测系统运转的整体情况。方法收集整理2004—2010年青浦区麻疹疫情资料、麻疹病人个案资料和人口资料,采用描述性分析的方法,对青浦区麻疹监测系统运转灵敏性、及时性和特异性各项指标进行评价。结果在2004-2010年间．青浦区麻疹监测系统报告疑似麻疹病例个案调查率及48h及时调查率均为100．00％,疑似病例血标本采集率达98．40％。实验室血清检测结果7d内及时报告率达98．82％,麻疹暴发疫情血清学确诊率、采集病原学标本的暴发疫情数占暴发疫情总起数的百分比均为100．00％。监测系统的敏感性存在一定程度的波动,2004--2010年7年间有3年排除病例报告发病率低于1／10万。结论青浦区麻疹监测系统总体运行状况良好,及时性和特异性均稳定在较高水平,但系统敏感性存在一定程度的波动,特别在发病率极低的情况下,系统的敏感性有待进一步加强．     

2013 - 2017年拉萨市麻疹监测情况分析

目的 分析拉萨市麻疹监测工作开展情况,提高麻疹监测工作质量。方法 用描述性流行病学方法对2013 - 2017年拉萨市麻疹监测数据进行分析。结果 2013 - 2017年共报告麻疹监测病例662例,其中麻疹确诊病例497例,排除165例（风疹15例）,8月龄以上麻疹病例具有麻疹接种史仅占13.8%。2013 - 2017年以麻疹监测病例个案调查表为数据,48 h内完整调查率为91.0%～100.0%,麻疹监测病例血清学检测结果4 d内报告率为40.9%～72.6%,排除麻疹病例分别占麻疹监测病例的44.4%,34.9%,19.1%,33.3%,23.9%,散发麻疹监测病例血标本采集率分别为98.1%～100.0%,无暴发疫情,麻疹监测工作逐年提高。2014 - 2017年麻疹监测信息系统中48 h内完整调查率仅为29.0～95.7%,检测结果7 d内报告率32.1%,61.3%,41.1%,43.1%。排除麻疹病例仅占监测病例的0～19.9%。血标本采集率为66.3～97.2%。48 h内录入个案率分别为19.4%,31.3%,5.0%,70.1%。结论 应加强预防接种工作,消除免疫空白人群,进一步提高监测工作质量,以适应消除麻疹工作需要。     

四川省2000年急性弛缓性麻痹病例监测分析

目的　了解四川省 2 0 0 0年急性弛缓性麻痹病例发病与报告情况。方法　对四川省 2 0 0 0年AFP病例监测系统运行状况进行分析。结果　 2 0 0 0年全省报告 15岁以下非脊髓灰质炎AFP病例 3 18例 ,报告发病率 1 73 / 10万 ,AFP病例 48h调查率 97 80 % ,14d内合格标本采集率 91 5 1% ,98 3 7%的标本在 7d内送达省脊灰实验室 ,87 74%的AFP病例随访表在麻痹后 75d送达四川省卫生防疫站计划免疫所 ,97 0 7%的标本在 3 0d内完成了病毒分离鉴定 ,病毒分离阳性率为 11 10 %。结论　四川省 2 0 0 0年AFP病例监测系统的敏感性、及时性、完整性及特异性均达到卫生部及WHO的有关要求     

河南省麻疹监测及控制状况分析

为加速麻疹控制,卫生部以河南省为试点,同美国疾病控制与预防中心(CDC)和世界卫生组织(WHO)合作,在开封、南阳市开展麻疹监测工作.同时其它城市也按有关要求开展麻疹监测工作.一年来的实践表明,河南省的麻疹监测系统已经建立,并运转良好.1999年麻疹专报系统报告疑似麻疹病例1852例,年发病率2.00/10万.全省各地均有病例报告,并发生了37起麻疹暴发,暴发病例数占病例总数的28.73%.发病主要集中于4～6月,占全年病例总数的50%.14岁以下儿童发病占84.88%.首次自麻疹病例中分离出麻疹病毒,共分离到15株.部分市(地区)开展了麻疹疫苗初始强化免疫活动,有效地降低了麻疹发病率.但麻疹监测系统的监测质量尚待提高1999年专报系统报告的病例数低于法定传染病报告系统;一些监测指标,如报告及时率、病例调查率、标本采集率和实验室检测及时率等都有待提高.     

2009—2012年成都市麻疹监测系统运转分析

目的分析成都市2009—2012年麻疹监测系统运转情况,为进一步提高全市麻疹监测系统运转质量提供依据。方法采用描述性流行病学方法对成都市2009—2012年麻疹监测系统指标进行分析。结果2009—2012年成都市报告疑似麻疹病例1374例,实验室诊断病例363例（26．42％）,临床诊断病例72例（5．24％）,排除病例939例（68．34％）。2009—2012年排除病例报告发病率分别为0．83／10万、1．31／10万、2．49／10万和1．87／10万。48h完整调查率分别为88．44％、98．74％、99．38％和99．36％;实验室结果7d内及时报告率为别为71．03％、97．74％、97．36％和99．68％。血标本采集率为79．44％、91．18％、96．43％和99．36％。2009—2012年成都市无暴发疫情。结论自2009年新的麻疹信息报告管理系统运行以来,近4年成都市麻疹监测系统运转指标逐年提高,2011—2012年麻疹监测系统及时性和特异性指标都超过95％,但监测系统敏感性有所波动,特别是在发病率较低的情况下,系统敏感性有待进一步提高。     

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.