五河县甲型病毒性肝炎发病升高原因回顾性与分析

目的　探讨蚌埠市五河县 1999年 1～ 4月份甲型肝炎发病升高原因及防治对策。方法　根据相关疫情资料结合统一调查表 (问卷 )收集的免疫史等甲肝发病信息资料 ,健康人群HAV -IgG抗体水平调查结果 ,进行流行病学回顾性分析。结果　 1998年 10月～ 1999年 4月、1997年 10月～ 1998年 4月甲肝发病均以10岁以下散居儿童为主 ;男性明显高于女性。病例主要分布在水网密集地区和交通相对发达的地区 ;仅 5 .4 1% (34/ 6 2 9)及时隔离治疗 ,乡以下诊断的病例中仅 4 3.77% (130 / 2 97)是通过临床和特异性复合诊断 ;HAV-IgG抗体阳性率有随年龄增长而升高的趋势。结论　五河县甲肝爆发流行与水网密集、交通发达的地理特征引起的爆发和扩散 ,10以下儿童甲肝易感人群积累、传染源管理的失控、误诊等主观因素有关。建议防治中注重根据具体情况采取针对性措施 ,且考虑措施综合性。

Retrospective Analysis on Prevalent Reasons of Hepatitis A in Wuhe County

To know prevalent reasons of hepatitis A from January to April of 1999 in Wuhe County of Bengbu and approach the measures of hepatitis A prevention and control, Prevalent characteristic of hepatitis A was analyzed according to the data from Notifiable Disease Reporting System and a special survey on immunization history of hepatitis A and the surveillance of hepatitis A IgG antibody among healthy people. The results showed hepatitis A mainly occurred in the children aged less than 10 years old during October of 1998 April of 1999 and October of 1997 April of 1998. There were more hepatitis A cases in male people than in female people. Hepatitis A mostly took place in the areas having concentrated water routes and developed highway communication. Only 5.41% cases (34/629) were kept apart and treated timely. 43.77% cases diagnosed at township level were confirmed with combination of clinical experience and specific test. The positive rate of hepatitis A IgG increased with age. Dense water routes and convenient communication, accumulation of vulnerable children aged under 10 years, incorrect management and diagnosis on hepatitis A were responsible for this outbreak of hepatitis A in Wuhe County. We recommend that specific and comprehensive measures should be taken to prevent and control hepatitis A.