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[目的 ]调查处理某中学水传伤寒暴发流行疫情 ,为今后突发事件处理提供借鉴。[方法 ]采用卫生学调查、病例对照 ( 1∶1至 1∶3 )调查、临床观察和实验室检验等方法 ,查明暴发原因与危险因素 ,控制疫情。[结果 ]暴发流行系水传引起 ,罹患率 8 2 %( 115 / 14 0 0 )。从末梢水与患者血培养中分离出伤寒菌 ,患者肥达氏反应阳性。“经常饮生水”与“不经常洗手”是主要危险因素 (OR值 11～ 12倍 )。通过健康教育、停用污染水源、专人供开水、预防服药、隔离治疗、应急接种等措施控制了疫情。[结论 ]乡村学校自行集中供水者 ,要严格选择水源 ,做好防护 ,保证开水供应 ,开展健康教育 ,做到不饮生水 ,饭前便后要洗手 ,才能防止伤寒等肠道传染病流行
[Objective] To investigate and deal with a epidemic of water-transmitted typhoid fever in a middle school and provide references for handling emergencies in the future. [Methods] The methods of hygiene investigation, case control (1: 1 to 1: 3) investigation, clinical observation and laboratory test were used to identify the causes and risk factors of outbreak and control the epidemic. [Results] Outbreaks were caused by water transport, with an attack rate of 82% (115/140). Typhoid bacteria were isolated from the peripheral water and blood cultures of patients, and patients were positive for Widal reaction. “Regular drinking water” and “not wash your hands frequently” are the main risk factors (OR 11 ~ 12 times). Outbreaks were controlled through health education, the decontamination of polluted water sources, the special supply of boiling water, preventive medication, isolation treatment and emergency inoculation. [Conclusion] Rural schools should concentrate their water supply on their own by strictly selecting sources of water, protecting them, ensuring the supply of boiling water and carrying out health education so as to prevent from drinking water and wash hands before and after meals to prevent the spread of enteric diseases such as typhoid fever