中国2001～2003年流行性感冒流行特征分析

目的 分析中国2001～2003年流行性感冒(流感)流行特征。方法 收集2001～2003年全国流感监测网流感样病例(ILI)监测资料,流感病毒分离与鉴定结果以及爆发疫情信息进行分析。结果 2001～2003年,中国北方地区流感流行高峰为12月或次年1月,南方地区则为4、5、7、8月和11、12月。北方、南方地区ILI就诊百分比基线值分别为13.68％、13.08％。ILI的年龄构成与流感流行季节类型有关。流感爆发疫情以5月份最多(32％),一般在6月前后流感疫情毒株类型发生改变。结论 中国南、北方流感流行特征有所不同。南方地区可能存在春季流行高峰,尚需进一步监测和分析。南方地区4～6月期间流感爆发的毒株类型变化值得关注。     

浙江省2001～2006年流行性感冒流行特征

目的 分析浙江省2001年10月-2006年3月流行性感冒（简称流感）流行特征，为流感防制提供策略／科学依据。方法收集浙江省2001年10月-2006年3月流感样病例（ILI）监测资料和2004年1月-2006年3月流感病毒分离与鉴定结果以及爆发疫情信息进行分析。结果每年的3—5月份、7．8月份以及11月一次年1月流感活动较强。15岁以下儿童组是流感的高发群体，暴发疫情主要集中在学校。ILI就诊百分比基线值为10．6％．各监测点ILI就诊百分比相差较大。54％的暴发疫情集中乡镇中小学校，尤其是宁波、温州、杭州、湖州地区，以3月份最多（24．7％），一般在1、10月前后流感疫情优势毒株类型易发生改变。结论我省可能存在春季和夏季流行高峰，需进一步长期监测。流感暴发优势毒株类型在10月和1月前后发生改变，应提高警惕。     

南京市2009年流行性感冒监测分析

[目的]分析南京市流感的流行病学特征,为流感防治提供科学依据。[方法]对2009年南京的流感样病例监测资料、病原学监测资料进行分析。[结果]2009年流感监测显示,南京存在秋、冬季流感流行高峰,ILI年龄构成以低年龄为主,全年流感毒株构成变化很大。[结论]流感监测对预防流行有重要意义,监测工作应重点关注优势流感毒株的变化。     

重庆市2004～2006年流行性感冒流行特征分析

[目的]探讨重庆市流行性感冒(流感)的流行特征,为制定流感防制策略提供科学依据。[方法]对重庆市2004、2005流感监测年度的流感样病例(ILI)监测资料、病毒分离鉴定结果及暴发疫情信息进行描述分析。[结果]2004年3月～2005年8月,ILI%平均为11.79%,2005年9月～2006年3月为0.80%。2004年ILI%存在4月和10月2个高峰,2005年存在4月、8月和11月3个高峰。两年病毒分离率分别为20.21%和33.62%。2年共有流感暴发疫情75起,2005年明显高于2004年,高峰月均出现在4月和11月。[结论]我市可能存在春季和秋季流感流行高峰,春季高峰比较固定,秋季高峰有一定波动性。暴发疫情呈逐年上升趋势,主要发生在中小学校。两年10月前后均出现优势毒株型别的变化值得关注。     

无锡市2005—2008年流行性感冒监测分析

[目的]监测和分析无锡市流行性感冒(流感)的流行动态和病原学特征,为流感的预防控制提供科学依据。[方法]对2005年10月至2008年3月无锡市流感监测哨点的流感样病例(Influenza Like Illness,ILI)发病动态、流感病毒分离和爆发疫情资料进行监测和分析。[结果]2005年10月至2008年3月,无锡市共监测报告ILI病例37 998例,ILI占门诊病例总数的比(ILI%)平均为3.67%。采集咽拭子标本1 796份,分离出流感病毒395株,分离率为21.99%。ILI和ILI%的高峰期均为2005年12月、2006年3月、2007年7月,ILI、ILI%和流感病毒分离率三者的高峰相互吻合,并与流感优势毒株交替变化一致。ILI的年龄构成中14岁以下儿童占91.03%,学校是发生爆发流行的主要场所。[结论]我市流感病毒比较活跃,关注ILI动态、ILI%动态、毒株型别交替变化和新型毒株的出现,可以评价和预警流感流行情况。对儿童和学校等流感重点人群和场所,应在流行高峰前采取流感疫苗接种为主导的综合性预防措施。     

潮州市哨点医院2009年～2014年流感监测分析

目的监测潮州市2009年~2014年间流感流行情况,掌握季节性流感病毒优势毒株的变化及流行特征,为流感防控提供科学依据。方法对潮州市2009年~2014年流感样病例(influenzalike illness,ILI)报告数据,病原学监测数据及流感/ILI暴发疫情报告情况进行分析。结果在受理的3619份流感样病例标本中,流感病毒核酸阳性标本约占19.45%。流感病毒的优势毒株每年都发生型别变化,优势型别交替出现。病毒感染率以5岁~14岁组和15岁~24岁组较高,与其它组比较存在统计学差异(P<0.05)。结论 2009年后潮州市虽然没有发生流感大流行,但流感监测工作仍不能放松,特别是需要警惕新型流感毒株的出现,同时加强学校等聚集性场所疫情监测。     

2008～2009年流感监测结果分析

[目的]了解深圳市龙岗区流感的流行特征及流行毒株的变迁情况。[方法]回顾性收集2008～2009年的流感样病例监测资料、流感病毒分离和暴发疫情资料进行统计分析。[结果]2008～2009年,各监测点共上报流感样病例63743例,占门诊就诊病例总数的8.02%,2009年的ILI%年平均值显著高于2008年的ILI%年平均值(χ2=256.09,P﹤0.01);共报告流感暴发疫情60起,主要集中在3～8月(90.00%),以学校和托幼机构(80.00%)暴发为主;2008～2009年,A、B型季节性流感均引起流感暴发流行,但2008年以B型流感流行为主,而2009年则以A型流感流行为主;不同年度间流感监测点中ILI标本的病毒分离率差异有统计学意义(χ2=14.57,P﹤0.01)。[结论]A、B型流感在不同年度以不同强度同时或交替在当地交替流行,学校是流感暴发疫情监测的重点,应加强流行高峰前的流感疫苗接种等综合性预防措施。     

江苏省2009-2012年流感监测结果分析

目的掌握江苏省2009-2012年流感的流行特征,为今后的流感防制工作提供科学依据。方法对江苏省2009-2012年流感样病例（influenza-like illness,ILI）报告数据、病原学监测数据及流感/ILI暴发疫情报告情况进行分析。结果江苏省流感高发人群为14岁以下婴幼儿及儿童,2009-2012年每年病例人数分别占各年ILI数的71.64%、81.39%、83.70%和84.03%;流感全年出现冬季12月份和夏季8月份两个小流行高峰,近3年,发病水平呈下降趋势（Z=-247.91,P<0.001）;2009-2012年分离到流感阳性毒株数分别为1 615株、806株、555株和993株,毒株类型以B型和A（H3N2）型交替出现为主,偶尔伴有A（H1N1）等其他毒株散发;2009-2012年,江苏省共报告流感/ILI暴发疫情147起,其中84起发生在中小学校及托幼机构,占总疫情数的57.14%。结论2009年后江苏省虽然没有发生流感大流行,但流感监测工作仍然不能放松,特别是需要警惕新型流感毒株的出现,同时加强学校等聚集性场所暴发疫情监测。     

江苏省2009—2012年流感监测结果分析

目的掌握江苏省2009—2012年流感的流行特征,为今后的流感防制工作提供科学依据。方法对江苏省2009—2012年流感样病例（influenza—likeillness,ILI）报告数据、病原学监测数据及流感／ILI暴发疫情报告情况进行分析。结果江苏省流感高发人群为14岁以下婴幼儿及儿童,2009—2012年每年病例人数分别占各年ILI数的71．64％、81．39％、83．70％和84．03％;流感全年出现冬季1～2月份和夏季8月份两个小流行高峰,近3年,发病水平呈下降趋势（Z=-247．91,P〈0．001）;2009—2012年分离到流感阳性毒株数分别为1615株、806株、555株和993株,毒株类型以B型和A（H3N2）型交替出现为主,偶尔伴有A（H1N1）等其他毒株散发;2009—2012年,江苏省共报告流感／ILI暴发疫情147起,其中84起发生在中小学校及托幼机构,占总疫情数的57．14％。结论2009年后江苏省虽然没有发生流感大流行,但流感监测工作仍然不能放松,特别是需要警惕新型流感毒株的出现,同时加强学校等聚集性场所暴发疫情监测。     

广州市2004-2008年流行性感冒流行特征分析

目的分析广州市2004-2008年流行性感冒（简称流感）流行特征。方法收集2004-2008年广州市流感监测系统流感样病例（ILI）监测资料,对病毒分离与鉴定结果以及暴发疫情信息进行分析,用季节解构、互相关等方法揭示广州市流感流行特征。结果 2004-2008年广州市流感样病例就诊百分比（ILI%）夏季最高,季节指数为1.637;流行季节与非流行季节ILI%差异有统计学意义（P〈0.05）;2004、2005、2007年以H3N2型为主要毒株;2006、2008年以H1N1型为主要毒株。暴发疫情的发生强度以小学最大（P〈0.05）。对暴发疫情序列分别与ILI%、病毒分离率两条序列进行互相关分析,当lag=-1、-2、-3时,病毒分离率与暴发疫情、ILI%与暴发疫情相关系数均有统计学意义。结论 2004-2008年,广州市流感的流行季节为夏季（5～7月）。H3N2和H1N1交替为流感主要毒株,小学是流感暴发疫情的高发地点。广州市流感监测系统可以客观地反映本市流感的流行特点。     

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 human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.