陕西省三地区2005-2006年度病毒性脑炎病例监测分析

目的 监测陕西省安康、宝鸡、渭南3个地区病毒性脑炎,了解流行病学特征和发病情况.方法 2005年6月至2007年5月对监测医院报告的所有病毒性脑炎病例开展个案调查,同时采集血和/或脑脊液标本,用ELISA检测流行性乙型脑炎(乙脑)IgM抗体;用Epi Data和Excel软件进行分析.结果监测病毒性脑炎1097例,对其中1053例(96.0%)检测乙脑IgM,阳性311例(29.5%).监测的两年度内病毒性脑炎、乙脑病例均在7、8月份出现高峰,病毒性脑炎发病趋势与乙脑lgM阳性病例趋势基本一致;宝鸡、渭南和安康地区14岁以下年龄组人群乙脑IgM阳性病例分别为33.7%、43.9%～1188.3%,其他病毒性脑炎在3个地区均是5～14岁组所占比例较高(53.3%);乙脑IgM阳性病例中散居儿童、农民和学生占85.2%,其他病毒性脑炎病例学生所占比例较高(51.0%);病例出院时398例中,乙脑IgM阳性病例和其他病毒性脑炎治愈比例分别为67.1%、83.7%,病死率分别为9.2%、3.1%.578例出院90 d后随访,乙脑IgM阳性病例和其他病毒性脑炎治愈比例分别为69.6%、90.2%,病死率分别为13.6%、3.6%,留后遗症比例分别为10.0%、4.5%.结论病毒性脑炎的高发季节和乙脑一致,临床报告的乙脑病例中乙脑IgM阴性病例占45.6%,提示对临床报告的乙脑/病毒性脑炎病例进行乙脑实验室检测是非常必要的;不同地区乙脑高发人群存在差异,在预防控制中应引起重视.

Analysis on data from the clinical acute viral encephalitis surveillance system in three prefectures in shaanxi during 2005-2006

Objective To describe the epidemiologieal features of viral encephalitis and burden of Japanese encephalitis (JE),and to identify potential strategies for effective JE control measures,using data from the Viral Encephalitis Surveillance Program (VESP) launched in Ankang,Baoji,and Weinan prefectures,Shaanxi province.Methods Data was gathered from sentinel hospitals reporting system on all the viral encephalitis (VE) eases identified between June 2005 and May 2007.County Center for Disease Control and Prevention (CDC) investigated the cases,drawing blood and cerebrospinal fluid (CSF) samples from the hospitals,and testing IgM antibody against JE using ELISA.We used Epi Data and Excel for data entry and analysis.Results A total of 1097 VEs were reported and 1053 (96.0%) had blood or CSF samples collected and tested for IgM antibody against JE.Three hundred and eleven cases (29.5%) showed JE antibody positive (JE confirmed case).Among the JE confirmed cases,numbers of those under 15 year of age accounted for 33.7%,43.9%and 88.3%in Baoji,Weinan and Ankang prefectures respectively.The rest were mainly children aged 5-14 years old (53.3%).Toddlers,farmers and children accounted for 85.2%in JE confirmed cases.About half of other VE cases (51.0%) were students of all age.Data an investigation on 398 reported VE cases at discharge,showed that 67.1%of JE confirmed cases recovered while 83.7%of the other VE cases fully recovered.The case fatality rates were 9.2%for JE confirmed cases and 3.1%for other VE cases.578 cases were followed up at 90-days after discharge,69.6%of JE confirmed cases and 90.2%of other VE cases recovered,with case fatality rates were 13.6%and 3.6%for JE confirmed cases and for other VE cases,respectively.The sequelae rates were 10.0%for JE confirmed cases and 4.5%for other VE cases.Conclusion The peak of the VE season was the sameas that of JE.There were 45.6%of reported JE cases with negative JE IgM,suggesting that it is necessary to carry out laboratory testing for clinical diagnosis cases.The fact that high risk population was different at prefectures levels suggested that more attention be paid in JE control and prevention.