2008年安徽省疾控系统流感大流行现场处置能力调查

目的研究安徽省各级疾病预防控制机构流感大流行的现场处理能力,为卫生应急能力和疾病预防控制体系建设提供依据。方法采用问卷和现场考察等方法,对安徽省各级疾病预防控制机构现场处理流感大流行的能力进行调查。结果69.0%疾病预防控制中心制定了流感样病例或流感暴发疫情处理指导方案,94.1%的市级疾控中心对下级疾病预防控制机构或辖区医疗机构的疫情报告定期进行检查。29.4%的市级疾控中心用试剂盒能快速诊断流感,23.5%的市级疾控中心开展了流感病毒核酸快速检测,17.6%的市级疾控中心开展了流感病毒分离鉴定,17家县、区级疾控中心用试剂盒能快速诊断流感。流感样病例暴发疫情网络直报率为23.5%,县区级疾控中心送检流感样病例样本少。部分疾控中心能及时撰写调查报告、总结处理经验和存储资料。结论各级疾病预防控制机构应加大专业人员的培训力度,县级疾控中心应增强流感采样、保存和送检能力,市级疾控中心要加强流感快速诊断能力和核酸检测能力。     

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。     

1起学校诺如病毒急性胃肠炎暴发的病原学检测

目的 对1起学校急性胃肠炎暴发疫情进行病原学检测分析。方法 对该学校暴发疫情的急性胃肠炎病例、厨房工作人员及病例对照采集肛拭子标本,提取核酸RNA,应用实时荧光RT-PCR试剂盒进行诺如病毒、札如病毒、轮状病毒、腺病毒、星状病毒检测,对阳性标本进行核衣壳编码区RT-PCR扩增、序列测定和系统进化分析。结果 21份患者肛拭样本中有16份GII型诺如病毒实时荧光RT-PCR阳性;所有标本的札如病毒、轮状病毒、腺病毒、星状病毒检测阴性。14份诺如病毒核酸阳性标本获得321bp目标片段序列,彼此间核苷酸相似性100%,提示同一来源;GenBank的BLAST结果显示,本次诺如病毒疫情毒株与GⅡ.2的参考株AY134748(Snowmoutain/1976/US)、X81879 (Melksham/1989)同源性最高,进化树上处于同一进化分支,属于GⅡ.2群。结论 该起学校急性胃肠炎暴发疫情是由诺如病毒GⅡ.2感染所致。     

Measles related complications and the role of vitamin A supplementation

Purpose. Measles is associated with high rate of complications and contributes to a major proportion of childhood morbidity and mortality. The role of vitamin A supplementation (VAS) in the case management of measles and prevention of complications is partially understood and not sufficiently supported by epidemiological data. This paper analyses the possible role of vitamin A supplementation in prevention of measles related complications and associated fatality   Methods. A cross sectional study was carried out during an outbreak of measles in Shivpuri, India. A total population of 193,000 was covered by house to house visit and, the caregivers of total 1204 measles cases, including 214 cases with complications, were interviewed using a semi structured interview schedule. The analysis of data was done using Epi Info   Results. The attack rate of 6.7% and rate of complications at 17.8% were found in this investigation. The coverage with routine measles vaccine and the vitamin A supplementation was 18.3% and 28.9% respectively. The management of measles cases was poor with only 15.8% cases receiving therapeutic doses of vit A. Both complications and case fatality rate was higher amongst children who had not received vit A supplementation in previous 6 months (p<0.05). Measles vaccine also found to have preventive effect on development of complications (p<0.05)   Conclusions. Routine vitamin A supplementation and measles vaccination reduces the chances of complications amongst measles cases. The role of VAS becomes more important when the case management is poor. While, measles is frequently associated with complications in Indian setting, there is a need of enhancing the efforts to improve the delivery of vit A supplementation and measles vaccine to the children in rural areas       

厦门市1起非流行季节手足口病爆发疫情的调查处置

目的分析非流行季节手足口病暴发疫情的特点,并对疫情干预效果进行评价。方法对发病儿童和健康儿童进行流行病学调查,并采集标本进行实验室检测核实病原体,查找可能的致病因素。结果本次爆发疫情共11人发病,罹患率为61.1%（11/18）,病原体为CoxA16,危险因素为病例未能及时发现并隔离,班级布局设置不合理。结论厦门地区在冬季也可出现手足口病爆发疫情,在各种综合措施的干预下,疫情可以得到较好的控制。     

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.     

广东省2008-2015年诺如病毒感染暴发的危险因素分析

目的 研究2008-2015年广东省诺如病毒感染暴发疫情的危险因素,为诺如病毒感染的预防控制工作提供参考依据。方法 通过"突发公共卫生事件报告管理信息系统"收集2008年1月1日至2015年12月31日广东省报告的诺如病毒感染暴发疫情资料,并进行流行病学分析。采用RT-PCR 方法对2012-2015年73起诺如病毒感染暴发疫情的372份阳性标本进行基因测序亚型分析。结果 2008-2015年广东省共报告96起诺如病毒感染暴发疫情,其中2013-2015年共报告80起（占83.3%,80/96）。暴发地点在学校的占全部疫情的85.4%（82/96）;传播途径为食源性传播占40.6%（39/96）,接触传播占24.0%（23/96）,水源性传播占7.3%（8/96）。基因测序亚型分析显示, 2012-2013年的暴发主要由GⅡ.4/Sydney2012型诺如病毒感染引起（占30.0%,6/20）,2014-2015年的暴发主要由GⅡ.17型诺如病毒感染引起（占62.3%,33/53）。结论 食源性和接触传播及新出现的2种诺如病毒变异株GⅡ.4/Sydney2012变异株和GⅡ.17是引起广东省诺如病毒感染暴发的主要原因。     

Distributions of antibody titers to Mycoplasma pneumoniae in Korean children in 2000-2003

The aim of study was to describe Mycoplasma pneumoniae epidemics in a hospital-based population. Special attention was paid to the relationship between antibody titer to M. pneumoniae and sex, age, and atopy. During the eight 6-month periods between January 2000 and December 2003, serum samples were obtained from 1,319 Korean children who presented with respiratory symptoms, and were examined for antibodies to M. pneumoniae using the indirect particle agglutination test. Geometric mean antibody titers peaked in the second half of 2000 and then decreased gradually, a second peak occurred in the second half of 2003. Likewise, the frequency of high antibody titers (> or =1:640) also peaked during these two periods. Antibody titers in children aged 0-3 yr were lower than in older children during both peak periods and for 2 yr after the first peak. Sex and atopy had no effect on antibody titers. During the years 2000-2003, geometric mean antibody titers and the frequencies of high antibody titers varied with time. These changes suggest a cyclic pattern of M. pneumoniae infection, with two epidemic peaks separated by 3 yr.     

A sporadic outbreak of human brucellosis in Korea

Eleven cases of human brucellosis occurred among livestock workers and a veterinarian who lived and worked in a rural area around Jeongeup City, Jeollabuk-Do, Korea from February 2003 to August 2003. Eight of the patients had taken care of Korean native cattle that were infected with bovine brucellosis and had already been slaughtered. Two of the patients had taken care of dairy cattle, and one case was a veterinarian who acquired the disease through an accidental contact with infected cattle while assisting in calf delivery. Eleven cases were identified by serologic work ups and four cases were identified via positive blood cultures. This study shows that the Republic of Korea is no longer free of human brucellosis, Brucella abortus biotype 1. We reviewed the patients' characteristics and serologic data during the one-year follow up period, and we also discuss on the efficacy and side effects of the rifampin and doxycyline regimen used for the treatment of human brucellosis.     

Hospitalization and antimicrobial resistance in Salmonella outbreaks, 1984-2002

Few studies have evaluated the health consequences of antimicrobial-resistant Salmonella strains associated with outbreaks. Among 32 outbreaks occurring in the United States from 1984 to 2002, 22% of 13,286 persons in 10 Salmonella-resistant outbreaks were hospitalized, compared with 8% of 2,194 persons in 22 outbreaks caused by pansusceptible Salmonella strains (p<0.01).