一起手足口病暴发疫情的流行病学分析

目的了解某县一起手足口病暴发的流行特征和临床表现，为早期预防提供依据。方法通过疫情报告获取某县疫情初期所有手足口病病例共109人，采用个案调查的方法收集患儿的基本信息和临床病历资料，进行描述性流行病学研究和统计分析。结果本次疫情的发病人群主要为0～3岁的农村儿童，占发病总数的89．0％，0～3岁的发病率在105／10万～115／10万之间，1～3岁男童发病率高于女童，临床表现主要为发热和手、足、口腔等部位的皮疹，各系统伴随症状发生率较低，重症病例占16．5％。结论手足口病的发病高危人群为婴幼儿，应针对该群体采取有效的综合性措施进行早期干预。     

蚊媒传染病与卫生检疫对策

蚊类不仅吸取人和动物血液、骚扰人们工作与生活、影响休息和睡眠，还可以携带病毒、病菌等导致传染病传播和蔓延。全球曾经以及正在流行的蚊媒传染病给世界人民造成了巨大危害，严重影响着世界各地人民的经济政治生活和身体健康。蚊类能够传播疟疾、淋巴丝虫病和多种病毒性疾病。对于大家普遍关心的艾滋病，科学家表示目前尚无证据表明蚊子可以传播艾滋病毒。     

Public perceptions about prematurity: a national survey

BACKGROUND: More than 460,000 preterm babies are born annually in the United States, with rates varying depending on the mother's race/ethnicity. Preliminary evidence suggests that the general public may have a lack of knowledge and misconceptions about preterm birth. METHODS: A national telephone survey of U.S. adults, over-sampling for black and Hispanic women, was conducted in 2002 to assess people's knowledge, attitudes, and beliefs related to preterm birth (N=1967). Analyses included racial/ethnic differences among women's responses and comparisons to men's responses. RESULTS: Prematurity was named by <1% of women as the most important issue facing pregnant women and infants. Overall, 34% of women and 31% of men felt that prematurity is a common problem in the United States, and 38% of women and 25% of men believed prematurity to be a serious problem in the United States. More black and Hispanic women considered prematurity to be common and serious. A majority of women (65%) and men (59%) attributed preterm births to risky prenatal maternal behaviors. CONCLUSIONS: Although nearly one in eight babies is born prematurely, most U.S. adults do not consider prematurity to be a serious public health problem. While the etiology can be identified in only half of spontaneous preterm births, the public largely blames the mother's prenatal behavior. Misperceptions are prevalent and may impede future research and prevention efforts if not corrected.     

Communicating infectious disease prevalence through graphics: Results from an international survey

BackgroundGraphics are increasingly used to represent the spread of infectious diseases (e.g., influenza, Zika, Ebola); however, the impact of using graphics to adequately inform the general population is unknown.ObjectiveTo examine whether three ways of visually presenting data (heat map, dot map, or picto-trendline)—all depicting the same information regarding the spread of a hypothetical outbreak of influenza—influence intent to vaccinate, risk perception, and knowledge.DesignSurvey with participants randomized to receive a simulated news article accompanied by one of the three graphics that communicated prevalence of influenza and number of influenza-related deaths.SettingInternational online survey.Participants16,510 adults living in 11 countries selected using stratified random sampling based on age and gender.MeasurementsAfter reading the article and viewing the presented graphic, participants completed a survey that measured interest in vaccination, perceived risk of contracting disease, knowledge gained, interest in additional information about the disease, and perception of the graphic.ResultsHeat maps and picto-trendlines were evaluated more positively than dot maps. Heat maps were more effective than picto-trendlines and no different from dot maps at increasing interest in vaccination, perceived risk of contracting disease, and interest in additional information about the disease. Heat maps and picto-trendlines were more successful at conveying knowledge than dot maps. Overall, heat maps were the only graphic to be superior in every outcome.LimitationsResults are based on a hypothetical scenario.ConclusionHeat maps are a viable option to promote interest in and concern about infectious diseases.     

Policy for managing a community infectious disease outbreak

OBJECTIVE: To identify guidelines for the management of an infectious disease emergency. SETTING: In February 1990, the discovery of hepatitis A in three foodhandlers prompted city and state health officials to offer mass immunization to residents of several counties in eastern Pennsylvania. In an attempt to facilitate the immunization effort, local hospitals were asked to establish and staff clinics to supplement the efforts of the health bureaus. RESULTS: Over a four-week period, combined efforts resulted in approximately 10,000 people receiving immunization with immune serum globulin (IgG). CONCLUSIONS: This was one of several infectious disease emergencies the community has faced in the recent past. Recognizing that future incidents of this nature are likely to occur, one 435-bed community teaching hospital devised an infectious disease emergency policy that allows for rapid deployment of personnel and services in the event of an infectious disease outbreak.     

A two-year follow-up survey of antibody to Cryptosporidium in Jackson County,Oregon following an outbreak of waterborne disease.

To estimate the duration of Cryptosporidium-specific antibody, a Western blot assay measured antibody in paired sera from 124 residents of Jackson County, Oregon collected 0.5 and 2.5 years after the end of an outbreak in Talent, Jackson County. The outcome measure was the intensity of antibody responses, (which may approximate to a titre), to 27-kDa and 15/17-kDa antigens. Intensity of response to the 27-kDa antigen(s) declined to 54% of the 1992 value while responses to a 15/17-kDa antigen(s) remained close to the initial values. Increasing age of the donor predicted higher intensity of antibody to the 15/17-kDa antigen(s) in both the initial (P = 0.004) and follow-up (P = 0.038) surveys. No relationship was observed between age and antibody intensity for the 27-kDa antigen(s) during either survey (P > 0.10). Both the initial and follow-up surveys showed significant elevations in antibody intensity for Talent residents, possibly indicating a high endemic rate of infection/re-infection or high levels of chronic infection.     

一起急性呼吸道感染症暴发疫情的病原学和流行病学研究

目的：对一起急性呼吸道感染症暴发疫情进行流行病学和病原学研究，以明确诊断，控制疫情。方法：通过流行病学调查描述疫情流行特征；采用病例对照研究分析流行因素；患者的咽拭子标本中提取核酸；PCR法检测病毒特异性基因片段；组织培养法（Hep-2细胞）分离病毒；电子显微镜观察病毒形态；型特异血清及型特异引物鉴定分离毒株型别；中和实验检测患者急性期和恢复期血清抗体效价。结果：疫情报告病例871例，波及10个乡镇，主要为在校中小学及幼儿园学生（占94．37oA），具有班级聚集性。病例对照研究显示危险因素为与病人的接触、与鸡接触及家庭内共用毛巾等。35份咽拭子标本分离出15株病毒，分离阳性率42．9％。分离病毒经鉴定为腺病毒3型。PCR法检测腺病毒DNA，112份咽拭子标本中68份阳性，阳性率60．7％。18例双份血清中13例中和效价呈4倍以上增长或转阳，阳性率72．2％。对病毒进行全基因序列测定，确定为腺病毒3型。结论：本起急性呼吸道感染症暴发疫情由腺病毒3型引起，传播途径以呼吸道传播和密切接触为主。     

如何在CIQ2000系统中实现对来自国外检疫传染病疫区货物的管理

为防止检疫传染病传入我国，应加强国境口岸入境货物的检验检疫及对来自疫区货物的卫生处理。本阐述了在《出入境检验检疫综合业务计算机管理系统》(简称CIQ2000系统)中实现对来自国外检疫传染病疫区货物进行管理的方法、存在的技术问题及改进意见。     

Healthcare-seeking behaviour for common infectious disease-related illnesses in rural Kenya: a community-based house-to-house survey

Community surveys of healthcare-use determine the proportion of illness episodes not captured by health facility-based surveillance, the methodology used most commonly to estimate the burden of disease in Africa. A cross-sectional survey of households with children aged less than five years was conducted in 35 of 686 census enumeration areas in rural Bondo district, western Kenya. Healthcare sought for acute episodes of diarrhoea or fever in the past two weeks or pneumonia in the past year was evaluated. Factors associated with healthcare-seeking were analyzed by logistic regression accounting for sample design. In total, 6,223 residents of 981 households were interviewed. Of 1,679 children aged less than five years, 233 (14%) had diarrhoea, and 736 (44%) had fever during the past two weeks; care at health facilities was sought for one-third of these episodes. Pneumonia in the past year was reported for 64 (4%) children aged less than five years; 88% sought healthcare at any health facility and 48% at hospitals. Seeking healthcare at health facilities was more likely for children from households with higher socioeconomic status and with more symptoms of severe illness. Health facility and hospital-based surveillance would underestimate the burden of disease substantially in rural western Kenya. Seeking healthcare at health facilities and hospitals varied by syndrome, severity of illness, and characteristics of the patient.     

传染病护理人员心理健康状况调查

目的了解传染病护理人员的心理健康状况,为护理管理和干预提供科学依据。方法采用症状自评量表（SCL-90）对首都医科大学附属北京佑安医院传染病护理人员进行调查。结果69例调查对象均为女性,年龄在35岁以下者占78．3％;学历：专科生占63．8％,本科占36．2％。症状自评量表（SCL-90）的各因子分值与国内常模相比均显著增加（P〈0．05）,存在的主要心理问题有躯体化、强迫和人际关系敏感;在人际关系敏感（t=2．259,P=0．027）、偏执（t=2．556,P=0．013）和精神病性（t=2．064,P=0．043）方面,专科生的得分明显高于本科生（P〈0．05）。结论传染病护理人员的心理状况较一般人群差,其中本科生的心理健康状况在一些方面好于专科生,提高护理人员的学历水平对改善心理健康可能有所帮助。     

邮轮呼吸道传染病爆发现场检疫管理模式研究

<正>随着全球邮轮业的发展,我国的邮轮港口倍受青睐。国际旅游组织预测,到2020年,中国将成为世界旅游目的地第一大国,将吸引更多的国际邮轮[1]。邮轮具有载客量大、环境相对封闭、微小气候滞浊、医疗条件有限、航行时间较长等特点,这给传染病在国际邮轮的传播提供了条件,增加了邮轮传染病爆发事件的发生可能。由于邮轮环境和条件的特殊性,其传染病主要以食源性、水源性及呼吸系统传播为主,环境的封闭性导致传染病一旦爆发便往往难以     

Epidemiology of an outbreak of infectious syphilis in Manitoba

An outbreak of 82 cases of infectious syphilis (primary, secondary, and early latent) which occurred in 1984 in the province of Manitoba was analyzed by age, sex, geographic distribution, and stage of disease. In the preceding four years, from 1980-1983, there were 19, 24, 13, and 32 cases, respectively, of infectious syphilis, of which 89% involved males. Compared with 1983, the overall crude incidence rate in 1984 increased by 259%, from 2.9 to 7.5/100,000 population, with a peak incidence in the 25- to 29-year age group of 25.8/100,000 population. This increase was predominantly due to a striking increase in incidence in females which rose 6.3-fold, from 0.4 to 2.5/100,000 females, compared with a 2.3-fold increase in males. This increase was accompanied by a decline in the male-to-female ratio, from 15.0 to 4.9. Of the 68 males, 45 named women as their sexual contacts. Females were 2.4 times more likely to present with early latent disease, whereas males were 7.0 times more likely to present with primary disease (p less than 0.01). There was clustering in suburban locations with regard to clinical presentation (60% primary disease) and overall incidence (46% of all cases). These data suggest the occurrence of a major change in the epidemiology of syphilis in the province of Manitoba, with a shift from homosexual to heterosexual transmission.     

Public perceptions of information sources concerning bioterrorism before and after anthrax attacks: an analysis of national survey data

This study examined data from six national surveys before and after the bioterrorist anthrax attacks in the fall of 2001. Public perceptions of information sources regarding bioterrorism were examined. The findings highlighted the importance of local television and radio and of cable and network news channels as information sources. The findings also showed the importance of national and local health officials as spokespersons in the event of bioterrorist incidents. Periodic surveys of public attitudes provide important, timely information for understanding audiences in communication planning.     

一起暴发性病毒性脑炎的病原学调查

目的 分离鉴定引发2010年河南省一起病毒性脑炎暴发的病原,并进一步分析该病原体分离株外壳蛋白1(VP1)区基因特征。方法 于2010年4月河南省平顶山市鲁山县病毒性脑炎暴发期间,采集8例住院患儿的粪便标本（共8份）,其中3例患儿同时采集脑脊液标本（共3份）,未采集到脑脊液标本的5例患儿中4例采集了血清标本（共4份）。对标本进行病毒分离和肠道病毒(EV)组合血清鉴定,对阳性分离物采用逆转录PCR方法扩增VP1区基因、测定核苷酸序列并进行亲缘进化分析。结果 采集的脑脊液、血清、粪便标本共15份,荧光定量PCR检测结果显示,11份标本EV通用检测阳性,其中2份粪便标本分离到2株病毒毒株,EV组合血清鉴定血清型别均为柯萨奇病毒(Cox)阳性,VP1区全长基因序列均为849 bp,与Cox B5的核苷酸相似性为77.1％～96.9％,氨基酸相似性为95.8％ ～ 100％,遗传发育树分析与D基因型属同一分支。结论 CoxB5是引起本次河南省平顶山市鲁山县病毒性脑炎暴发的病原体,其基因型为D基因型。     

A community-based survey on influenza and vaccination knowledge,perceptions and practices in Peru

BackgroundAlthough Peru provides safe and effective influenza vaccines free-of-charge, coverage among vaccine target groups like pregnant women and older adults remains low. To improve risk communication messages and vaccine uptake, we explored knowledge, perceptions and practices about influenza illness and vaccination.MethodsA cross-sectional, community-based survey with a three-stage cluster sampling design was conducted in three cities in Peru. We included mothers of young children, pregnant women and persons ≥65 years. Participants completed a questionnaire about knowledge, perceptions and practices about influenza illness and vaccination against influenza during the past year. Generalized linear models were used to explore factors associated with vaccination in the past year.Results624/645 (97%) mothers, 54/55 (98%) pregnant women and 622/673 (92%) older adults approached provided informed consent and were surveyed. While most mothers, pregnant women and older adults (94%, 96% and 91%, respectively) perceived influenza as a potentially serious illness, few pregnant women (13%) and older adults (34%) self-identified themselves as a target group for influenza vaccination. Only 28% of mothers, 19% pregnant women, and 27% older adults were vaccinated against influenza during the previous year. Among the participants that did not get vaccinated against influenza in the previous year, “being afraid of vaccination and its effects” was the most commonly cited barrier. Knowledge of the recommendation for annual vaccination was significantly associated with vaccination status among pregnant women (p = 0.048) and older adults (p = 0.004).ConclusionDespite a government subsidized vaccine program, vaccine utilization remained low among pregnant women and older adults, who seemed typically unaware of their status as high-risk groups targeted for vaccination. Those aware of the recommendations for annual vaccination were more likely to be vaccinated. Information campaigns addressing fears and highlighting populations at risk for severe influenza illness that are targeted for vaccination might increase vaccine coverage in Peru.     

Public opinion about condoms for HIV and STD prevention: a Midwestern state telephone survey

CONTEXT: Public opinion is important in determining condom and condom education policies in public high schools.
METHODS: A random telephone survey of 517 Indiana residents was conducted from July through October 2003 to assess public opinion about education on correct condom use for HIV and STD prevention; condom availability in Indiana public high schools; and issues related to condom use, effectiveness and promotion. Data were analyzed using bivariate and linear regression techniques.
RESULTS: A majority of respondents strongly or somewhat agreed that instruction on correct condom use for HIV and STD prevention should be provided in public high schools (77%), classroom instruction should include condoms (71%), only medically accurate information about condoms should being given (94%) and the federal government should promote condoms (70%). Fewer than half (48%) strongly or somewhat agreed that condoms should be made available to teenagers in public high schools without parental permission. Nearly all (92%) considered condoms at least somewhat effective in preventing HIV and other STDs. Non-Republican party affiliation, younger age and condom use within the previous five years were each significantly associated with having positive opinions on many of the condom-related statements.
CONCLUSIONS: Public opinion appears to support the provision of correct condom use information in Indiana public schools. Schools should consider providing only medically accurate information about condoms and including condoms in instruction so students can see and touch them.