Surveillance for dracunculiasis, 1981-1991.

In 1986 the World Health Organization (WHO) designated dracunculiasis (guinea worm disease) as the next disease scheduled to be eradicated (by 1995) after smallpox. Dramatic improvement in national and international surveillance has played a key role in the global eradication campaign, which was initiated at CDC in 1980. About 3 million persons are still affected by the disease annually, with adverse effects on their health as well as on agricultural production and education. Over 100 million persons are at risk of having the disease in more than 20,000 villages in India, Pakistan, and 17 African countries. At least one nationwide, village-by-village search to detect all villages with endemic dracunculiasis and count cases is recommended at the outset of each national campaign, followed by monthly reporting by village-based health workers in the targeted villages during the implementation phase. Rapid dissemination of the results of the surveillance is critical. Intensive case detection and containment--with rewards for reporting of cases--are most appropriate near the end of each campaign. Cameroon, Ghana, India, Nigeria, and Pakistan have pioneered the various surveillance methods for this disease in recent years. Methods for conducting surveillance of dracunculiasis and other important diseases must continue to be developed and improved as countries now believed to be free of dracunculiasis prepare to apply to WHO for certification of elimination of dracunculiasis.     

Surveillance for measles--New Zealand, 1991.

To monitor the extent and spread of the epidemic of measles that began in New Zealand in 1991, a special surveillance system was established. Reports from 13 area health boards were received on a weekly basis; the Bay of Plenty Area Health Board provided data aggregated over several weeks on a less frequent schedule. Nine thousand two hundred thirty-nine measles cases were reported during the 6-month period July-December 1991, with the highest incidence being reported from the Tairawhiti (1,027 cases/100,000 population) and Taranaki (558/100,000) Area Health Boards; South Island areas reported rates that were all below the national average of 280/100,000. Of the 8,684 cases for which information on age was obtained, over one-third (2,957, or 34%) occurred among children less than 5 years of age, most of whom had not been vaccinated. The failure to vaccinate a sufficiently high percentage of children against measles is the major factor that contributed to this epidemic.     

Malignant Mesothelioma Registry from Piedmont. Incidence in 1990-1995

This paper describes methods and results of the Piedmont Malignant Mesothelioma Registry. The Registry is active since 1990 and collects all histologically confirmed incident cases of malignant mesothelioma (m.m.) occurring in the residents of Piedmont. In the period 1990-95, 346 cases of pleural m.m. (211 males and 135 females) and 41 (28 males and 13 females) of peritoneal m.m. have been observed. Amongst the inhabitants of the Local Health Authority of Casale Monferrato, where manufacturing of cement asbestos has determined serious asbestos exposures both in the work place and general environment, there have been 105 pleural m.m. and 17 peritoneal m.m. (incidence rate were 15.6 for men and 13.0 for women and 3.6 for men and 0.6 for women respectively). Leaving out the Local Health Authority (LHA) of Casale Monferrato, the annual incidence rate in Piedmont (for 10(5) person-years, age standardised on the 1981 Italian population), has been 1.0 in men and 0.6 in women for the pleural m.m. (respectively 154 and 87 cases) and 0.09 and 0.06 for peritoneal m.m. (14 and 10 cases). Possible cases of m.m. (cytological and/or x-ray diagnosis) have been searched in the file of hospital admission and discharges (SDO) in 1994-95: 46 additional cases were found, with a 25% increase in incidence rates. The analysis of incidence according to geographical aggregations (defined according to the LHA borders) has identified, besides some already known important sources of exposures, as Casale Monferrato and the LHA of Lanzo (Balangero mine), other areas with excess of incidence as the LHA's of Galliate and Caluso which show an increased incidence of pleural m.m. in men or Vercelli and Chieri with increased incidence of pleural m.m. in women. These observation deserves further analysis.     

浙江省1990-2005年钩端螺旋体病监测研究

目的通过对浙江省钩端螺旋体病监测资料的分析，了解人群和宿主动物钩体菌群分布和变动情况，为浙江省研究钩体病流行规律，制定预防和控制措施提供依据。方法用显微镜凝集实验，对临床确诊病人和宿主动物血清进行抗体测定。采集鼠、蛙、猪、水鸭肾脏和牛中段尿，进行病原体分离培养。结果1990—2005年全省累计发生钩体病例5653例，死亡68例，各地市除舟山外，其余各地均有病例报告。病人血清抗体对应菌群以黄疸出血群和七日热群为主。宿主动物感染秋季群的构成比2000年以后较1990—2005年有较显著的上升，秋季群和黄疸出血群一起成为主要菌群。继1996—1997年龙游县赛罗群钩体病疫情暴发后，2002年浙江省又在蛙血清中检测到赛罗群抗体阳性。结论宿主动物携带钩体菌群发生变化，其带菌情况与病人带菌血清学检测对应的菌群不完全一致。因此，钩体病监测仍不能放松，尤其在洪涝灾害后应列为防制重点。     

云南省昭通市1990～2004年艾滋病监测结果分析

昭通市位于云南省东北部,滇、川、黔三省交界处;全市面积2．3万km^2,辖1区10县,2004年末总人口524万人,有彝、苗、回等23个少数民族定居。同时也是云南东北部进人内地的主要通道,近年来沿线毒品交易猖獗。按照云南省艾滋病哨点监测方案,昭通市从1990年开始对高危人群进行艾滋病哨点监测工作。现将监测结果报告如下。     

山东省1991~1994年脊髓灰质炎监测报告

在１９８８－１９９０年脊灰爆发流行之后山东省通过采取综合性措施，１９９１－１９９４年脊髓灰质炎病例分别降至９５例，２５例，２２例和１７８例，发病分散且无季节性高峰，未发现野病毒所致病例。１５岁以下非脊灰ＡＦＰ病例的报告发病率逐步提高，１９９３－１９９４年已达到１／１０万的要求。     

1990、1991年广东国境口岸重点人群艾滋病监测报告

本文报告了１９９０至１９９１年广东各卫生检疫机构对国境口岸九类重点人群２６０１１２份血清的艾滋病监测情况，共发现１６名ＨＩＶ抗体阳性者（含１例艾滋病病人），其中外籍入境者６名；我国回归人１０名。笔者对监测情况进行了讨论并提出相应的建议。     

南京市1 990～2000年围生儿出生缺陷监测结果分析

目的 为了解南京市围生儿出生缺陷的发生种类及分布情况,寻找影响出生缺陷的相关因素。方法 1990年1月-2000年12月监测南京市11所医院住院分娩孕28周-产后7 d的围生儿。按全国出生缺陷监测统一标准要求,由医院逐月上报《围生儿数月报表》、《出生缺陷登记卡》至市妇女保健所。结果 围生儿出生缺陷发生率7.95‰(1 254/157 637),唇腭裂,畸指(趾),神经管畸形是南京市围生儿出生缺陷前3位高发种类;男性出生缺陷发生率为8.75‰(721/82 432)高于女性6.86‰(516/75 188);产母年龄≥35岁是出生缺陷的高发风险因素。结论 进一步开展婚前生殖健康教育和医学检查,指导新婚妇女服用小剂量叶酸预防神经管畸形,孕期开展产前诊断、遗传咨询、Down综合征筛查和新生儿疾病筛查工作,降低出生缺陷的发生率。     

Washing our hands of the congenital cytomegalovirus disease epidemic

Background  

Each year in the United States, an estimated 40,000 children are born with congenital cytomegalovirus (CMV) infection, causing an estimated 400 deaths and leaving approximately 8000 children with permanent disabilities such as hearing or vision loss, or mental retardation. More children are affected by serious CMV-related disabilities than by several better-known childhood maladies, including Down syndrome, fetal alcohol syndrome, and spina bifida.     

广东省1991-2004年乙型流感监测结果分析

[目的]分析1991—2004年广东省乙型流感病毒抗原变异和流行情况。[方法]用9~11日龄鸡胚和(或)MDCK细胞分离流感病毒,病毒鉴定用常量红细胞凝集抑制法(HI);人血清流感抗体检测用微量半加敏红细胞凝集抑制法。[结果]广东省一直有乙型流感流行,并从人群中分离到流感病毒2 916株,乙型流感病毒占23.3%。乙型流感病毒两大谱系交替为优势株,除1994、1997及2002年以Victoria系为主外,其余各年以Yamagata系为主。乙型流感病毒抗原性不断发生漂移,历年一般人群血清乙型流感抗体检测阳性率在28.3%~73.9%。[结论]1991—2004年广东省乙型流感病毒存在差异较大的两个谱系,病毒谱系的轮换和抗原漂移导致乙型流感不断流行。     

Avoidable mortality in Lithuania: 1991-199 compared with 1970-1990

This paper assesses the changes in avoidable mortality in Lithuania in 1991-1999 compared with 1970-1990. Causes of death were disaggregated into causes most amenable to treatment and those amenable to prevention. Trends in age-standardised death rates were calculated. In 1970-1990, avoidable causes of death accounted for 26.3% of all deaths. By 1991-1999 this figure had decreased slightly to 24.6%. At the same time, age-standardised death rates from avoidable causes increased by 8%, from 118.1 per 100000 in 1970-1990 to 127.9 in 1991-1999. Avoidable mortality among men was considerably higher than for women in both periods. There was considerable fluctuation in both treatable and preventable mortality during the 1990s, reflecting diversity in trends in different causes of death. Increases occurred in death rates from tuberculosis, cervical cancer and liver cirrhosis and, immediately after independence, also in hypertensive and cerebrovascular diseases and, among men, lung cancer, followed by subsequent declines. Deaths from chronic rheumatic heart disease, asthma and other respiratory diseases, appendicitis, abdominal hernia, cholelithiasis and maternal mortality consistently declined. In conclusion, avoidable mortality declined as a proportion of total mortality in Lithuania during 1991-1999 compared with 1970-1990. This reflected the combined impact of an initial rise in death rates from treatable and, to a lesser extent, preventable causes, followed by subsequent declines. While this indicates some success in the development of medical care, it emphasises the need for more effective public health policies directed at the major determinants of health.     

Norovirus and foodborne disease, United States, 1991-2000

Efforts to prevent foodborne illness target bacterial pathogens, yet noroviruses (NoV) are suspected to be the most common cause of gastroenteritis. New molecular assays allow for better estimation of the role of NoV in foodborne illness. We analyzed 8,271 foodborne outbreaks reported to the Centers for Disease Control and Prevention from 1991 to 2000 and additional data from 6 states. The proportion of NoV-confirmed outbreaks increased from 1% in 1991 to 12% in 2000. However, from 1998 to 2000, 76% of NoV outbreaks were reported by only 11 states. In 2000, an estimated 50% of foodborne outbreaks in 6 states were attributable to NoV. NoV outbreaks were larger than bacterial outbreaks (median persons affected: 25 versus 15), and 10% of affected persons sought medical care; 1% were hospitalized. More widespread use of molecular assays will permit better estimates of the role of NoV illness and help direct efforts to control foodborne illness.     

厦门市2013-2018年围产儿出生缺陷监测情况分析

目的 分析厦门市围产儿出生缺陷发生情况及主要特征分布情况。方法 监测2013年1月1日至2018年12月31日厦门市34所开展助产技术服务的医疗机构出生的孕28周至生后7天的所有围产儿的出生缺陷情况。结果 2013-2018年厦门34所开展助产技术服务的医疗机构共住院分娩围产儿481262名,出生缺陷总发生率为129.97/万,出生缺陷发生率逐年提高。前5位出生缺陷类型为先天性心脏病(41.00/万)、多指（趾）(18.53/万)、耳畸形(7.58/万)、并指（趾）(5.57/万)、尿道下裂(4.68/万)。男性出生缺陷发生率(148.12/万)高于女性(107.39/万)（P＜0.001）,出生缺陷发生率呈现随产妇年龄增大而逐渐升高的趋势（P＜0.001）。城镇产妇所生围产儿出生缺陷总发生率(179.21/万)高于乡村(78.09/万)（P＜0.001）。结论 厦门市出生缺陷发生率低于全国水平,但近几年呈现逐年升高的趋势,出生缺陷存在性别、年龄、城乡差异。