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[目的 ]分析 N市三起介水腹泻病暴发的成因 ,探讨减少二次供水污染事故的对策。 [方法 ]流行病学调查 ;检验饮用水微生物污染的程度及致病原 ;比较污染水 (暴露组 )和非污染水 (对照组 )供水范围内居民同期腹泻病发病率 ,计算相关危险度 (RR)和归因危险度 (AR)。 [结果 ]腹泻病患者的住宅楼二次供水设施存在明显的卫生设计隐患 ,且日常性卫生管理松懈 ,蓄水池受到生活污水污染 ;发病居民饮用的受污染水感官指标异常、菌落总数分别为 1.1× 10 3、 1.1× 10 3、 1.8× 10 3CFU/ m L,总大肠菌群分别为 1.6× 10 4、 1.6× 10 4、 >2 30 MPN/ L,检出豚鼠气单胞菌、河弧菌、温和气单胞菌、嗜水气单胞菌 (菌量大于 10 3CFU / m L ) ,部分菌株检出耐热性肠毒素 ST;三起介水腹泻病暴发的 RR值分别为 6 3.7、 17.3、 33.8,AR值分别为 30 .4、 12 .2、 2 0 .0。 [结论 ]三起腹泻病暴发的主要原因与相关住宅楼二次供水严重污染有高度关联。
[Objective] To analyze the causes of three outbreaks of water-borne diarrhea in N City and discuss the countermeasures to reduce the pollution of secondary water supply. [Methods] Epidemiological investigation was carried out. The degree and pathogenicity of microbial contamination in drinking water were tested. The incidence of diarrheal disease in residents over the same period was compared between contaminated water (exposed group) and non-contaminated water (control group) RR) and attributable risk (AR). [Results] The secondary water supply facilities in residential buildings of diarrheal patients had obvious health design problems, and the routine health management was lax. The reservoirs were polluted by domestic sewage. The sensory indexes of polluted water consumed by residents were abnormal. The total number of colonies were 1.1 × 10 3, 1.1 × 10 3 and 1.8 × 10 3 CFU / m L, respectively. The total coliforms were 1.6 × 10 4, 1.6 × 10 4 and> 230 MPN / L, respectively. Aeromonas caviae Vibrio, Aeromonas sobria, Aeromonas hydrophila (bacteria more than 10 3CFU / m L), some strains detected heat-tolerant enterotoxin ST; three water-borne diarrhea disease outbreak RR values were 6 3.7, 17.3, 33.8, AR values were 30.4, 12.2, 20.0 respectively. [Conclusion] The main causes of the three outbreaks of diarrheal diseases are highly correlated with the serious pollution caused by the secondary water supply in residential buildings.