苏州市人感染H7N9禽流感流行病学特征及外环境监测结果

目的分析苏州市人感染H7N9禽流感病例流行病学特征及外环境H7N9病毒感染情况。方法以2013年以来苏州市报告的确诊H7N9禽流感病例为研究对象,描述病例的三间分布特征;分析2014—2015年度外环境H7N9阳性率季度变化。结果截至2016年5月31日,共确诊人感染H7N9禽流感病例26例,死亡13例,病死率50.0%;男女性别比为3.3∶1,年龄中位数为59岁。病例最多的为1月份(9例),其次12月(6例),再次3和4月(各5例);主城区姑苏区病例最多,有8例,其次吴江区,有6例;外环境H7N9阳性率最高的为1月份(27.6%),其次12月份(27.1%),再次2月份(17.1%)。结论感染人群男性多于女性,以老年人为主,发病季节主要为冬春季,空间上有一定的聚集性。外环境冬春季H7N9阳性率较高,夏秋季较低。     

2013 - 2018年合肥市22例人感染H7N9禽流感流行特征

目的 分析合肥市人感染H7N9禽流感的流行特征和外环境监测结果,为人感染H7N9禽流感的防控提供参考。方法 采用描述流行病学方法对2013 - 2018年合肥市本地感染的22例人感染H7N9禽流感病例的流行病学资料和全市外环境监测资料进行分析。结果 2013 - 2018年合肥市共确诊本地感染病例22例,中位年龄62.50岁,男女比例2.67∶1;病死率为54.55%,治愈组和死亡组在患有基础性疾病之间分布差异有统计学意义（P = 0.027）;85.00%的患者发病前10 d有禽类接触或活禽市场暴露史。历年人感染H7N9禽流感发病例数与应急监测标本阳性率之间有相关性(r = 0.997,P = 0.003),与常规监测标本阳性率之间无相关性(r = - 0.385,P = 0.451)。结论 老年男性是感染H7N9禽流感病毒的主要人群,基础性疾病可能是人感染H7N9禽流感患者死亡的危险因素,现有监测方案监测敏感性较差,需要进一步完善。     

一起家庭聚集性人感染H7N9禽流感事件调查

目的分析报告湖南省1起家庭聚集性人感染H7N9禽流感疫情,为今后防控工作提供科学依据 方法按照《人感染H7N9禽流感诊疗方案(2014年版) 》进行病例诊断,由疾病预防控制中心专业人员按照《人感染H7N9禽流感流行病学调查方案（2013年版）》进行调查,采用real-time PCR对病例和环境标本进行检测和病毒培养,并对分离出到病毒进行全基因组序列测定和分析。结果2014年2月湖南双峰县发生一起人感染H7N9禽流感家庭聚集性疫情,报告病例2例,二者系夫妻关系;妻子为首发病例,发病前多日居住在有活禽活动的农村家中,发病后7天确诊;丈夫比妻子晚发病9天,与妻子密切接触,发生人传人的可能性大,发病后次日确诊;自丈夫标本中分离到H7N9亚型病毒,该病毒基因序列分析与既往报道病毒相似;自病例居家鸡舍表面和鸡毛涂抹标本各1份H7N9禽流感病毒核酸阳性,该县城主要集市活禽交易店3份环境标本H7N9禽流感病毒核酸阳性。结论两例病例系人感染H7N9禽流感家庭聚集性病例,首发病例系禽类暴露感染,续发病例系密切接触首发病例感染可能性大, H7N9禽流感病毒具有有限的人传人传播能力,对人感染H7N9禽流感病例的密切接触者实施医学观察很有必要。     

安徽省2019年1月法定报告传染病疫情

2019年1月(2019年1月1日0时至1月31日24时),全省共报告法定传染病23种43197例。无甲类传染病发病、死亡报告。乙类传染病中除新生儿破伤风、炭疽、人感染高致病性禽流感、人感染H7N9禽流感、流行性乙型脑炎、脊髓灰质炎、钩端螺旋体病、传染性非典型肺炎、白喉9种无发病、死亡病例报告外,其余17种乙类传染病共报告14489例,死亡41例。     

杭州市五波人感染H7N9禽流感疫情流行特征分析

目的对杭州市五波人感染H7N9禽流感疫情的流行特征进行分析,为H7N9禽流感的预防控制提供依据。方法收集2013年以来杭州市人感染H7N9禽流感病例的相关资料,利用Excel 2007软件对数据进行统计学分析,描述其三间分布、暴露史、聚集性等特征。结果截至2017年6月30日,杭州市共确诊人感染H7N9病例96例,死亡33例,病死率为34.38%。发病集中在冬春季节,90.62%病例有禽类或活禽交易市场暴露史;外环境监测样本阳性率与病例发病时间分布基本一致。五波疫情病例在居住地分布及发病至首诊时间间隔差异有统计学意义(P0.05)。结论五波疫情呈散发态势,外环境监测阳性率与发病趋势基本吻合,应重视农村地区散养活禽暴露情况。     

如何预防H7N9禽流感?

核心提示:新型H7N9禽流感慢慢肆虐开来,2013年4月19日16时至4月20日16时,全国报告新增人感染H7N9禽流感病例5例。其中,上海市1例,江苏省1例,浙江省3例。截至目前,全国共报告96例确诊病例,其中死亡18人,9人康复,其余69人正在各定点医疗单位接受救治。病例分布于北京(1例)、上海(33例,死亡11例)、江苏(23例,死亡3例)、浙江(33例,死亡3例)、安徽(3例,死亡1例)、河南(3例)6省市。     

浙江省三波人感染H7N9禽流感疫情流行特征与趋势分析

目的分析浙江省2013年以来三波人感染H7N9禽流感疫情流行特点,探讨流行趋势,为其防控提供依据。方法通过个案调查的方法收集人感染H7N9禽流感患者的相关资料,应用SAS 9.2统计软件,采用χ2检验、秩和检验分析三波疫情流行特征的变化,P0.05为差异有统计学意义。结果截至2015年7月2日,浙江省共确诊人感染H7N9禽流感患者184例,死亡73例。外环境监测表明,H7样本阳性率(r=0.45,P=0.02)和场所阳性率(r=0.50,P=0.01)在11月至次年2月最高,与发病时间分布一致。三波疫情中,患者在病死率(χ2=9.36,P=0.01),地区分布(χ2=6.71,P=0.03),活禽市场暴露(χ2=6.13,P=0.046),宰杀禽暴露(χ2=7.85,P=0.02),饲养禽暴露(χ2=13.69,P=0.00),职业暴露(χ2=8.73,P=0.01),发病至抗病毒治疗时间(H=9.99,P=0.01)上差异均有统计学意义,而在年龄(t=1.79,P=0.41),性别(χ2=0.47,P=0.79),职业(χ2=2.90,P=0.23),基础性疾病患病高血压(χ2=0.34,P=0.84)、糖尿病(χ2=3.01,P=0.22),直接接触禽类暴露(χ2=5.60,P=0.06),购买禽暴露(χ2=4.78,P=0.09),发病至就诊时间(H=4.45,P=0.11),发病至确诊时间(H=0.28,P=0.87),发病至住院时间(H=1.62,P=0.44)上差异均无统计学意义。结论由于外环境H7阳性持续存在,人感染H7N9禽流感患者将持续散发,应进一步加强城市地区活禽市场关闭的管理并重视农村地区活禽暴露和患者的救治问题。     

2020年1月全国法定传染病疫情概况

2020年1月(2020年1月1日0时至1月31日24时),全国(不含香港、澳门特别行政区和台湾地区,下同)共报告法定传染病1414630例,死亡1629人。其中,甲类传染病无发病报告,鼠疫报告1例死亡。乙类传染病中传染性非典型肺炎、脊髓灰质炎、人感染高致病性禽流感、白喉和人感染H7N9禽流感无发病、死亡报告,其余22...     

湖南省人感染H7N9禽流感患者流行病学调查研究

目的描述人感染H7N9禽流感患者的流行病学特征,分析人感染H7N9禽流感患者预后的影响因素。方法从"中国疾病预防控制信息系统"收集湖南省2013年3月30日至2016年3月30日报告的人感染H7N9禽流感确诊患者35例,描述流行病学及临床特征,利用logistic回归分析评估人感染H7N9禽流感患者预后的影响因素。结果35例确诊患者中,死亡16例(45.71%),具有禽类暴露史31例(88.57%)。症状起始至入院时间中位数5(3~7)d,症状起始至诊断时间中位数7(6~10)d,症状起始至死亡时间中位数14(10~26)d。多因素logistic回归分析显示,女性患者发生死亡风险是男性患者的12.877(95%CI:1.156~143.450)倍,肾功能不全患者发生死亡的风险是肾功能正常的30.636(95%CI:3.180~295.179)倍。生存分析结果显示,女性和肾功能不全患者的总生存率低于男性和肾功能正常的患者(P0.05)。结论女性和肾功能不全可能是影响人感染H7N9禽流感患者预后的主要影响因素,建议针对女性和肾功能不全患者采取有效的治疗措施和重点护理。     

南昌市人感染禽流感死亡病例的发病特征与防控效果

目的 分析南昌市人感染 H7N9/H10N8 禽流感死亡病例的发病特点和感染来源,探讨防控对策。方法 收集 2013年4月 - 2018年3月 南昌市人感染禽流感确诊死亡病例的流行病学个案调查资料、患者相关标本和活禽交易场所及活禽相关样本检测结果,进行描述性流行病学分析。结果 南昌市2013年4月 - 2018年3月年报告人感染H7N9/H10N8 禽流感死亡病例 8 例,男女比例 5∶3;发病年龄中位数为 72.5 岁,并以有基础性疾病者为主;＞ 65 岁 7 例;均在春节期间及春节前后发病。无病例在发病当天就诊,病例发病至确诊时间和服用磷酸奥司他韦（达菲）时间间隔长。7 例有明确禽类暴露史;密切接触者观察期内流感病毒核酸检测均为阴性,病例可疑暴露环境相关标本中H7N9/H10N8禽流感病毒核酸检测阳性率为 15.75%;落实各项防控措施后,暂无新发病例。结论 南昌市人禽流感死亡病例特征明显,主要为大于 65 岁,合并基础疾病、诊疗不及时和禽类暴露。春节期间及春节前后,应加强民众禽流感宣教,切实加强推进关闭活禽交易市场等有效防控措施。     

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.     

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.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.