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目的分析2005年安徽省六安市一起埃可病毒6型(Echo6)脑膜炎暴发疫情的流行病学、临床、实验室特征。方法对所有病例进行流行病学、临床特征分析,通过病例对照调查危险因素。采用病毒分离方法确定病原,运用分子生物学检测进一步确证,利用血清学检测分析隐性感染情况。结果105例病例分布在金寨县30个乡镇中的17个,41.0%病例集中在斑竹园镇,该镇罹病率为203/10万,具有学校和班级聚集性。发病年龄在3～15岁之间,以6～10岁小学生为主,平均年龄7.8岁,罹病率为10.9/10万,男性和女性的罹病率分别为24.2/10万和8.4/10万。大部分患者主要临床表现为发热、头痛、呕吐。从72例患者脑脊液中分离出25份Echo6,占35%。病例组与对照组比较,喝饮料OR=4.1,95% CI:1.4～12.0;尤其喝袋装饮料OR=3.3,95%CI:1.3～8.8。在生产袋装饮料的7名职工中有6人粪便检出Echo6。100名7～14岁健康人血清中和抗体阳性46人,阳性率46.0%,与病例组阳性率73.5%相比差异有统计学意义(χ~2=12.526,P=0.000)。结论为一起主要由Echo6感染所致的病毒性脑膜炎的疫情,病例组喝饮料尤其袋装饮料的比例明显高于对照组。
Objective To analyze the epidemiological, clinical and laboratory features of an outbreak of Echo6 (meningitis) in China in 2005 in Lu’an City, Anhui Province. Methods All cases were analyzed by epidemiology and clinical features, and risk factors were investigated by case control. Viruses were used to determine the pathogen, using molecular biology tests to further confirm the use of serological tests to detect latent infection. Results 105 cases were distributed in 17 villages and towns in Jinzhai County, 41.0% of which were concentrated in Banzhuanyuan Town. The prevalence of the disease was 203 / 100,000 in Jinzhai County, with the school and class aggregation. The age of onset was between 3 and 15 years. The average age was 7.8 years. The prevalence rate was 10.9 / 100,000. The morbidity rates of males and females were 24.2 / 100 000 and 8.4 / 100 000 respectively. Most of the main clinical manifestations of patients with fever, headache, vomiting. Echo6 was isolated from cerebrospinal fluid in 72 patients (35%). Case group and control group, drink OR = 4.1,95% CI: 1.4 ~ 12.0; especially drink packaged drinks OR = 3.3,95% CI: 1.3 ~ 8.8. Six of the seven workers who produced sachets of packaged foods were found to have Echo6.100 positive serum neutralizing antibodies (46.0%) positive for healthy people aged 7-14 years, with a positive rate of 73.5% Statistical significance (χ ~ 2 = 12.526, P = 0.000). The conclusion was that of an epidemic of viral meningitis mainly caused by Echo6 infection, and the proportion of cases receiving drinkable beverages, especially sachets, was significantly higher than that of the control group.