论文部分内容阅读
目的通过对不明原因脑炎病例的现场调查,分析确认疫情的性质和原因。方法通过规范的现场流行病学调查,对收集到的实验室检测、临床表现和流行病学资料进行综合分析。结果2003年5月8日~6月2日,某市“不明原因脑炎”发病34例,罹患率2.03/10万;死亡4例,病死率11.76%。发生不明原因脑炎病例疫情的乡(镇),1~4月应种儿童(1~15岁)流行性乙型脑炎(乙脑)疫苗的接种率仅为21.82%。当地卫生环境较差,蚊虫孳生严重,未开展有效的预防,三带喙库蚊是当地优势蚊种。病例皆急起发热,体温≥38.5℃,伴嗜睡、抽搐、喷射状呕吐等症状。实验室检测患者的脑脊液压力增高,检测的标本数占病例数的67.65%(23/34),标本中乙脑IgM阳性率82%(19/23)。结论这次“不明原因脑炎”疫情最终确认为一起乙脑疫情。疫情发生的主要原因是2003年5月以前乙脑疫苗接种率低。敏感和质量可靠的诊断试剂,对于这次疫情的判定起了重要作用。
Objective To investigate the nature and causes of epidemic situation by field investigation of cases of unexplained encephalitis. Methods Through the standardized on-site epidemiological investigation, the collected laboratory tests, clinical manifestations and epidemiological data were analyzed comprehensively. Results From May 8 to June 2, 2003, 34 cases of “unexplained encephalitis” were found in a city with an attack rate of 2.03 / 100,000; 4 died and the case fatality rate was 11.76%. The incidence of encephalitis cases in rural areas (towns), from January to April should be the kind of children (1 to 15 years old) Japanese encephalitis (JE) vaccination rate was only 21.82%. The local health environment is poor, mosquitoes breed seriously, did not carry out effective prevention, Culex tritaeniorhynchus is the local dominant mosquito species. Cases are acute fever, body temperature ≥ 38.5 ℃, with lethargy, convulsions, jet-like vomiting and other symptoms. Cerebrospinal fluid pressure increased in laboratory tests. The number of specimens detected was 67.65% (23/34) of the cases, and the positive rate of IgM in samples was 82% (19/23). Conclusion This “unknown cause encephalitis” epidemic finally confirmed as a JE epidemic. The main reason for the outbreak was the low vaccination rate of JE before May 2003. Sensitive and reliable quality diagnostic reagents, for the determination of the epidemic played an important role.