论文部分内容阅读
目的探讨2003年江苏省盐城市不明原因无菌性脑膜炎爆发的流行特征、影响因素和病原学病因。方法采用统一的流行病学调查表对病例进行调查,描述临床表现;采用1∶1配比病例对照研究的方法分析流行因素;收集部分住院患者的脑脊液及粪便标本进行病原体的分离鉴定。结果报告病例数共计1 681例,疫情波及到9个县(市、区),3~6月为发病高峰,主要累及中小学生及学龄前儿童(占总发病数的99%)。主要临床表现为发热、头痛、呕吐,预后良好。与发热病例的接触、不洁饮食史、饭前便后不洗手等可能是本次流行的危险因素。从66份患者脑脊液中分离到18株阳性病毒,分离率为27.3%;4份患者粪便标本分离病毒全部阳性。22株分离株病毒经鉴定均为Echo30型肠道病毒。结论2003年江苏省盐城市无菌性脑膜炎爆发的病原体为Echo30型肠道病毒,不良个人卫生习惯可能是本次流行的危险因素。
Objective To explore the epidemiological characteristics, influencing factors and etiological factors of unexplained aseptic meningitis in Yancheng City, Jiangsu Province in 2003. Methods Uniform epidemiological questionnaires were used to investigate the cases and describe the clinical manifestations. The epidemiological factors were analyzed by a 1: 1 ratio-matched case-control study. Cerebrospinal fluid (CSF) and stool samples were collected from some in-patients for identification of pathogens. Results A total of 1 681 cases were reported. The outbreaks spread to 9 counties (cities and districts). The incidence peaked from March to June, mainly involving primary and secondary school students and preschool children (accounting for 99% of the total number of cases). The main clinical manifestations of fever, headache, vomiting, the prognosis is good. Contact with febrile cases, unclean diet history, not wash hands before and after meals may be the risk factors of this epidemic. 18 positive isolates were isolated from cerebrospinal fluid of 66 patients, with a separation rate of 27.3%. All four fecal specimens were positive for virus isolation. Twenty-two isolates were identified as Echo30 enterovirus. Conclusion The pathogen of aseptic meningitis outbreak in Yancheng City of Jiangsu Province in 2003 was Echo30 type enterovirus. The bad personal hygiene habits may be the risk factors of this epidemic.