2009年深圳市福田区学校与托幼机构传染病爆发疫情分析报告

目的分析2009年深圳市福田区学校传染病爆发疫情的流行病学特征。方法应用描述流行病学方法对深圳市福田区2009年学校传染病爆发疫情进行分析。结果深圳市福田区学校及托幼机构共报告6种传染病爆发疫情,累计报告疫情84起,呈现逐年上升趋势,其中流感、甲型H1N1流感疫情占76%,为全年爆发疫情之最,其中以小学最为常见,占事件的50%;2009年学校传染病爆发疫情以3—6月和9—11月为多,占全部爆发疫情的75%以上;经呼吸道传播的占85.7%,其次为经肠道传播占13.1%,学校及托幼机构传染病疫情中呼吸道传染病和肠道传染病的差异有统计学意义(χ2=19.79,P<0.01)。结论 2009年深圳市福田区学校传染病爆发疫情以在中小学人群传播的流感、甲流等冬春季呼吸道传染病为主,为今后疫情防控的重点。     

2016 - 2018无锡市腹泻病疫情中诺如病毒的分子流行病学特征

目的 鉴定无锡市2016年3月 - 2018年3月急性腹泻病突发疫情中诺如病毒的感染流行情况,并对病原体进行分子特征研究。方法 对疫情上送的暴发急性病例标本,采用荧光PCR初步判定病原体,常规RT - PCR检测诺如病毒RNA聚合酶和衣壳蛋白基因片段,并进行序列测定和分子特征分析。结果 在30起暴发疫情中共有162份标本经荧光PCR检测均为诺如病毒核酸阳性,其中154份标本RT - PCR检测判为GII型诺如病毒,120份标本成功测序。测序结果显示,2016 - 2018年突发疫情中有5种基因型,分别是GII.P16 - GII.2、GII.P17 - GII.17、GII.4_Sydney2012、GII.4_NewOrleans和GI.6,2017年之前以GII.17病毒株流行为主,2017之后新的GII.P16 - GII.2重组株成为无锡市病毒性腹泻疫情中的绝对优势株。结论 诺如病毒是无锡市腹泻病疫情的最常见病原体,其最新的优势流行株是GII.P16 - GII.2重组株,和全国趋势一致。     

The risk of hepatitis A infection among healthcare workers: a review of reported outbreaks and sero-epidemiologic studies

All reports of hepatitis A (HA) outbreaks in healthcare settings published between 1975 and 2003 were studied to determine the background immunity or susceptibility of healthcare workers (HCWs) to HA. Twenty-six reports were found. The number of infected personnel ranged from one to 66 and, in most outbreaks, nurses accounted for the majority of personnel infected, reflecting high attack rates reaching 15-41%. In addition, we found 23 sero-epidemiological studies for HA among HCWs that had been performed in 13 different countries. Seroprevalence rates of HCWs with anti-HA antibody ranged between 4% among paramedical workers in Germany to 88% among hospital maintenance workers in Portugal. Effective infection control of HA outbreaks in hospitals demands early recognition, including awareness of atypical presentations of the infection, and strict adherence to universal infection control measures. Education programmes are of special importance for HCWs in neonatal, paediatric and intensive care units. The findings of the current study suggest that a pre-employment screening policy and administration of active vaccination to susceptible HCWs, particularly nurses, should be seriously considered in high-risk settings.     

广州大学城某高校一合唱团甲型H1N1流感暴发疫情分析

目的对广州市大学城某高校合唱团甲型H1N1流感暴发疫情进行分析,探讨流行特征及采取的防制措施,为控制暴发提供科学依据。方法设计统一调查表,对甲型H1N1流感暴发疫情进行现场调查,采集病例咽拭子标本以及血清标本进行甲型H1N1流感病毒核酸检测以及血清抗体检测,采用excell录入数据,Spss10.0软件进行统计分析。结果该起疫情累计确诊甲型H1N1流感病例36例,罹患率为60%(36/60)。36例病例中,男21例,女15例,罹患率分别为61.76%(21/34)和57.69%(15/26),χ2=0.102,P=0.750。从9月4日至疫情结案后7d,合唱团所在学校门诊流感样病例就诊比例为4.32%～11.67%,平均为8.77%,大学城10所高校为4.9%～12.09%,平均为9.08%。相关系数R=0.699(P=0.00)。结论早报告、加强发热病例的隔离治疗以及密切接触者的医学观察,是控制甲型H1N1流感疫情的有效措施。不能忽视甲型H1N1流感隐性感染者,在密切接触者病例排查中除了采集咽拭子标本外,尽可能采集双份血清标本,从而全面评估疫情态势。     

Use of immunization as strategy for outbreak control of varicella zoster in an institutional setting

Background

Outbreaks of varicella gets reported often in India. However, outbreak in health care providers living in closed institutional setting and role of vaccination as post exposure prophylaxis for control of outbreak has not been studied extensively. This paper presents epidemiological investigation and control strategy undertaken in such scenario.

Methods

This is an epidemiological investigation of chickenpox in nursing students which highlights role of early identification and appropriate control strategy to prevent explosive outbreak in high risk vulnerable population. Vaccination of all susceptible in addition to isolation of cases, quarantine of suspects and proper screening for new cases was the major control strategy adopted.

Results

The index case was imported and all eight cases occurred within the incubation period of the case. Two cases occurred in students previously vaccinated for chickenpox. No second or third wave of infection occurred showing vaccination as effective tool in outbreak control strategy.

Conclusion

Early identification of cases and vaccination of all susceptible contributed to effective control of the outbreak.     

Whole-genome sequencing of Campylobacter jejuni isolated from Danish routine human stool samples reveals surprising degree of clustering

ObjectivesOutbreaks of Campylobacter are traditionally considered to be rare; however, rather than being the true nature of the disease, this may reflect our present inability to detect them. The aim of this study was to determine the genetic and epidemiological degree of clustering among Campylobacter jejuni isolates from Danish patients.MethodsWhole-genome sequencing (WGS) was applied to 245 C. jejuni isolates from patients with domestically acquired infection over a 9-month period in 2015 and 2016.ResultsWGS demonstrated that 62 of the 245 isolates (25%) clustered genetically. In total, 21 genetic clusters were identified of which four (18%) consisted of five isolates or more. Seventeen (81%) of the 21 genetic clusters were clustered in space and/or time. Of the 245 isolates, 49 (20%) were part of a temporal and/or geographical cluster. The identified clusters included two outbreaks; one which had not been identified through the existing surveillance system.ConclusionsUsing WGS, we show that Campylobacter case clustering and even outbreaks appear to occur more often than previously assumed, providing important new insight into the relatively poorly understood epidemiology of the most important cause of bacterial gastroenteritis in the industrialized world.     

Cambios en la epidemiología de la hepatitis A: repercusiones clínicas y preventivas

Introduction and objectivesHepatitis A Virus Infection (HAI) has been related to the hygienic-sanitary situation of an area, the changes in the epidemiology of HAI in the province of Guadalajara between 1991 and 2017 are analyzed.Materials and methodsCases of HAI declared between 1991 and 2017 in Guadalajara were included. The variables analyzed were age, sex, environment, risk factors for HAI and need for hospitalization. The incidence was compared in three periods: 1991–1999, 2000–2008 and 2009–2017.ResultsTwo hundred and thirty-three cases of HAI were declared, the average incidence rate was 4.27 cases/100,000 inhabitants, highest between 1991 and 1999 (6.93) and lowest between 2009 and 2017 (1.92), with an increment in 2017 (5.5). The median age was 16 years (IR: 8.5-28.5 years), 58.4% were male, and the highest incidence occurred between 5 and 14 years in both sexes. The most frequent risk factors were family and non-family contact and trips to endemic areas (18.6%, 17.3% and 18.2%, respectively). The last risk factor increased after 2000 (P=.001), as did the incidence in urban areas. The MSM group showed an increase in the last period (P<.001). Hospital admissions increased progressively from the first to the third period studied (P=.001).ConclusionsHAI has a low incidence in our area. More cases related to travel or sexual practices are observed. This should be considered when establishing prevention policies, including vaccination of the most exposed people.