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2010年9月28日,江西省于都县黄坑村发生25例疑似伤寒病例。为查明病因和传播途径,开展了本次调查,结果黄坑村共搜索到40例病例(疑似病例25例,确诊病例15例),39例(98%)在沉坑组居住,沉坑组罹患率(34%)明显高于其他村民组(0.34%)(RR=983,95%CI:136～7096)。沉坑组居民中使用沉坑山水源村民的罹患率(42%)显著高于使用其他水源村民的罹患率(4%)(RR=11,95%CI:2.1～160)。对使用沉坑山水源村民的队列研究显示,饮用生水者发病风险高于饮开水或桶装水者(RR=2.5,95%CI:1.1～7.9)。饮用生水者中,饮水剂量与发病风险呈现剂量反应关系(线性趋势χ2=5.7,P=0.016)。环境卫生调查发现,沉坑山水源为山渗水,无任何安全保护措施,6份水源水样标本检测总大肠菌群和粪大肠菌群均超标。15例病例Tubex检测伤寒IgM均阳性。本次伤寒暴发的危险因素是饮用受污染山渗水的生水。
On September 28, 2010, 25 cases of suspected typhoid fever occurred in Huangkeng Village, Yudu County, Jiangxi Province. In order to find out the etiology and route of transmission, the survey was conducted. Results A total of 40 cases (25 cases of suspected cases and 15 confirmed cases) were found in Huangkeng Village and 39 cases (98% The group attack rate (34%) was significantly higher than that of other villagers (0.34%) (RR = 983, 95% CI: 136-7096). The attack rate (42%) of residents in Shenkeng Mountain who inhabit Shenkengshan source was significantly higher than that of other villagers (RR = 11,95% CI: 2.1 ~ 160). A cohort study of villagers using Shenkeng Mountain water sources showed that those who consumed raw water had a higher risk of developing disease than those who drank water or bottled water (RR = 2.5, 95% CI: 1.1 to 7.9). Drinking water, drinking water dose and risk of developing dose-response relationship (linear trend χ2 = 5.7, P = 0.016). Environmental health survey found that Shen pit mountain water seepage, without any safety protection measures, six water samples of total coliform and fecal coliform were detected. Tubex test in 15 cases was positive for typhoid IgM. The risk factor for this outbreak of typhoid fever is drinking raw water seepage from polluted hills.