贵州省紫云县伤寒副伤寒潜在流行因素研究

目的探讨紫云县城区伤寒副伤寒流行的潜在传染源和可能的传播途径,为当地伤寒防制和监测提供依据。方法采集大便(饮食服务人员、患者和其密切接触者)、凉拌食品和排污沟水等标本检测伤寒等肠道致病菌,并用个案调查表调查饮食等服务人员、患者及其密切接触者的个人行为卫生习惯和危险因素,用Excel 2000统计分析。结果从141例饮食服务人员的大便中检出丙型副伤寒杆菌1株,检出率0.71%;17份血培养阳性愈后患者的大便分离到1株甲副。饮食等服务人员、患者和其密切接触者均有不同程度的不良卫生习惯。患者中25%就诊前自购药物,66.67%未及时就诊;67.86%未住院治疗,住院者平均住院6.17d,平均用药时间为8.26d。结论患者不规范治疗所致带菌、从业人员的健康带菌是伤寒副伤寒传播流行的潜在传染源。个人不良卫生习惯是伤寒副伤寒等肠道传染病发生、传播、流行的高危行为。

Latent Epidemic Factors of Typhoid and Paratyphoid in Ziyun County, Guizhou Province

Objective To explore the latent source of infection and possible route of transmission of typhoid and paratyphoid epidemic in Ziyun County,and to offer the information for prevention and monitoring of typhoid fever in the area.Methods Salmonella typhi etc.intestinal pathogen were isolated from 141 stool specimens collected from food and drink servers,patients and people close contact with the patients.Hygiene habits and risk factors were also investigated among them.Results 1 strain of Bacillus paratyphosus C was isolated from 141 stool specimens(0.71%).1 strain of Bacillus paratyphosus A were isolated from 17 patients with positive blood culture.All the persons investigated were of inadequate hygiene habits to some extent.25%patients purchased drugs by themselves before to see a doctor,66.67% patients had not diagnosed timely,67.86% patients did not hospitalize for treatment,and the patients hospitalized 6.17 days in average.The drug administration period was 8.26 days in average.Conclusion The healthy carriers in food and drink servers and carriers caused by nonstandard treatment are the lalent source of infection of the typhoid or paratyphoid epidemic.Inadequate hygiene habits is very dangerous behavior to the origination,transmission and epidemic of the disease.