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Background: Encephalitis caused by ECHO virus 30 enterovirus had been reported in 2003.On May 20th, 2011, health center in F town reported that many children were diagnosed as viral encephalitis since May 10th.We undertook an investigation to indentify the dimension, pathogen, and risk factors of the event, and recommend control measures.Methods: A case was defined as onset of fever (≧37.5 ℃), headache, and one of following: nausea, meningismus, abnormal electroencephalogram from January through May.We search for cases through checking medical records from 2004 to 2011 in main hospitals of Yancheng Prefecture and health center of F town.In a case-control design we used questionnaires about exposures in the primary school with highest number of cases.We collected environmental samples and from cases, throat swab, spinal fluid, and stool.Results: Cases of first 5 months of 2011 exceed 2004-2010 background by 8 times.88 cases (11 confirmed) were registered in May 2011 in F town, and peak date was Mid-May.Attack rate of 7-14 year old children (2.1%)was 3.7 times greater than in ≤ 6 year old children (0.57%).Attack rate in boys (1.7%) was 1.8 times higher than in girls (0.93%).Case-patients did not cluster geographically by residence.The pathogen had 96% homology with ECHO virus 19 enterovirus.Case-patients did not always wash hands 74% before meals compared to 19% of control-students (OR =10; 95% CI=3.5-29), and shared hand towels 48% compared to 11% of control-students (OR=5.7; 95% CI=1.8-18).Conclusions: This viral meningitis outbreak was caused by ECHO virus 19 and was mainly transmitted person to person among children with poor personal hygiene.We proposed surveillance and measures to improve personal hygiene.