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目的了解漳州地区霍乱流行规律和趋势,为制定防治对策提供依据。方法收集漳州地区1962~2008年霍乱发病、科研及外环境监测资料,应用描述流行病学方法进行统计分析。结果霍乱传入漳州市已40多年,疫情起伏不定,先后发生过3次较大流行。至2008年底有17年发生霍乱疫情,疫情波及11个县(市、区),共发生霍乱3 646例,死亡81例,健康带菌者1 332例,1998年发现首例O139病例后出现2群霍乱同时流行;病例主要分布于沿海50 km内的地区,波及范围广,发病率高,发病早,持续时间长,且与泥土的pH和钾含量及水的pH、氯化物含量有关;霍乱流行有明显季节性,每年的7~11月份为流行高峰期,气温在20℃以上时,霍乱病例增多,处于流行状态,在流行后期,气温降至20℃以下时,经过一个最长潜伏期后病例显著减少;60岁以上年龄组人群发病率较高,发病以农民为主,密切接触者带菌率高;第一次流行小川型1a患者轻、中、重型各占一定比例;第二次流行稻叶1d以轻型为主,占71.64%;第三次流行小川1b和O139型以中、轻型为主,占84.67%;霍乱主要经水和食物传播;流行优势菌株第一次流行以小川型1a为主,第二次流行以稻叶型1d为主,第三次流行以小川型1b为主,1999~2002年优势菌群改以O139群为主;霍乱弧菌耐药谱呈现一定的变化,对氟哌酸、庆大霉素、卡那霉素、先锋霉素、利福平高度敏感,对四环素不敏感。结论霍乱的发生和流行主要取决于自然因素和社会因素。目前漳州市霍乱流行因素依然存在。
Objective To understand the prevalence and trend of cholera in Zhangzhou and provide evidence for prevention and control measures. Methods The data of epidemics, scientific researches and environmental monitoring of cholera from 1962 to 2008 in Zhangzhou area were collected and used to describe the epidemiological analysis. Results Cholera was introduced into Zhangzhou City for more than 40 years. The outbreak of epidemics fluctuated. There were 3 major epidemic occurrences successively. By the end of 2008, there was a cholera outbreak in 17 years. The outbreak spread to 11 counties (cities and districts). There were 3,646 cholera cases, 81 deaths and 1 332 healthy carriers. In 1998, there were 2 outbreaks of O139 cases Cholera is epidemic at the same time; the cases are mainly distributed in the area within 50 km along the coast, with wide spread, high incidence, early onset and long duration, and are related to soil pH and potassium content and water pH and chloride content; cholera prevalence There are obvious seasonal, annual peak from July to November, when the temperature is above 20 ℃, cholera cases increased, in a state of epidemic, late in the epidemic, the temperature dropped to below 20 ℃, after a case of the longest incubation period The prevalence rate was higher in peasants aged 60 and over, with the incidence of peasants being the main factor, and the rate of carrier with close contacts being high. The prevalence of light, medium and heavy type in the first epidemic Ogawa-type la patients was a certain proportion. The second epidemic rice Leaf 1d mainly light, accounting for 71.64%; the third epidemic Ogawa 1b and O139 type in light and light, accounting for 84.67%; cholera mainly by water and food transmission; prevalence strains first epidemic Ogawa type 1a Based, the second popular to rice-based 1d-based, the third popular Chuan-1b-based, dominant bacteria in 1999 ~ 2002 changed to O139 group; Vibrio cholerae resistance spectrum showed some changes, norfloxacin, gentamicin, kanamycin, cephalosporins, Rifampicin is highly sensitive and insensitive to tetracycline. Conclusions The occurrence and prevalence of cholera mainly depend on natural factors and social factors. At present, the prevalence of cholera in Zhangzhou still exists.