石家庄市急性脑炎、脑膜炎病例监测结果分析

[目的]了解急性脑炎/脑膜炎的流行特征与病原谱,为全国范围内开展类似研究提供重要的现场依据。[方法]随机选取石家庄市5个县为项目县,选择其中的6所医院为监测试点医院,开展疑似脑炎/脑膜炎病例报告、登记工作、个案调查、实验室检测工作。[结果]2007年5月～2010年3月累计报告急性脑炎/脑膜炎患者631例,年发病率为9.87/10万,年病死率为0.22%。病例的男女性别比为1.51:1,平均年龄11.71岁,81.62%的病例小于15岁,城乡分布比为1:1.74,各月都有病例发生,但3～11月相对较多。38.99%病例接种过乙脑、流脑、Hib疫苗中的一种或一种以上,78.92%的病例在标本采集前使用了抗生素。82.52%的实验室确诊监测病例为病毒性脑炎/脑膜炎,病原谱的前5位依次为肠道病毒、乙脑病毒、流行性腮腺炎病毒、水痘带状疱疹病毒、单纯疱疹病毒。检出实验室确诊的细菌性脑炎/脑膜炎病例的主要病原为肺炎链球菌、Hib、奈瑟氏球菌,其中Hib导致的脑膜炎首次在河北省检出。新型隐球菌是真菌性脑炎/脑膜炎的主要致病菌。[结论初步了解了急性脑炎/脑膜炎的流行特征与病原谱。对于进一步研究急性脑炎/脑膜炎及其他症状群的流行病学监测具有一定的借鉴作用,为全国的疾病症状监测及相应疾病的预防控制提供了重要依据。

EPIDEMIOLOGY SURVEILLANCE OF ACUTE MENINGITIS AND ENCEPHALITIS IN SHIJIAZHUANG

[Objective]To understand epidemic characteristic and pathogeny spectrum of acute meningitis and encephalitis.[Methods]Meningigis and encephalitis syndrome surveillance system was established with 5 counties and 6 sentinel hospitals selected randomly.Sentinel hospitals were in charge of case finding and reporting.County CDC did active surveillance routinely,did case investigation when receiving case report,and collected blood sample and CSF sample from surveillance cases.Lab test was done by sentinel hospitals and CDC.[Results]During the 35-month surveillance period,631 local cases were reported and investigated.The incident rate and the fatality rate was respectively 9.87/lakh and 0.22% in Shijianzhuang.The average age of cases was 11.71 years old.81.62% of cases were under 15 years old.The male-to-female sex ratio was 1.51︰1.The ratio of town against country was 1︰1.74.The cases were found in each month,most of the cases concentrated in summer,autumn and winter.38.99% of cases were vaccinated one of vaccines of encephalitis vaccine,meningococcal vaccine and Hib vaccine.78.92% of cases used the antibiotics before the collection of sample.Viral pathogen was the main causative agents of acute meningitis/encephalitis,the top five were enterovirus,encephalitis B virus,mumps virus,varicella-zoster virus,herpes simplex virus.Laboratory-confirmed bacterial meningitis/encephalitis cases were less than viral meningitis/encephalitis.Streptococcus pneumoniae,Hib,neisseria catarrhalis were the main bacterial pathogens.Meningitis/encephalitis caused by Hib was found for the first time in Hebei Province.Cryptococcus neoformans was the main fungal infection.[Conclusion]It preliminarily gets the epidemic characteristic and pathogeny spectrum.It may provide the experience for the national acute meningitis and encephalitis surveillance.