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目的查明2003年章丘市一起无菌性脑膜炎爆发的流行病学特征及病原。方法开展现场流行病学调查和病原学检测,对流行病学特征和流行因素进行分析。结果共发病1 743例,罹患率为1.81‰。发病集中在7~8月,以<15岁儿童为主,5~9岁儿童占全部病例数的55.08%,男女性别比1.57∶1。此次爆发以明水镇为中心,向东呈扇形分布。病原学检测确定为埃可病毒30型(ECHO30)所致的无菌性脑膜炎爆发。此次爆发与以下因素有关:该地区多年未曾有过ECHO30所致疾病的流行,易感人群累积较多;ECHO30亚型发生了核苷酸变异,形成了新的基因型,耐酸试验显示分离株病毒具有“D”特征,其毒力较强;当地的自然地理条件和饮食习惯,成为此次爆发的客观条件。结论此次无菌性脑膜炎爆发是由ECHO30新基因型广泛感染所致。今后应加强非脊髓灰质炎肠道病毒所致疾病的监测和控制工作。
Objective To identify the epidemiological features and pathogens of aseptic meningitis in 2003 in Zhangqiu City. Methods To carry out on-site epidemiological investigation and etiological test to analyze epidemiological characteristics and epidemiological factors. Results A total of 1 743 cases of attack, the attack rate of 1.81 ‰. The incidence concentrated in July to August, mainly children <15 years old, 5 to 9 years old children accounted for 55.08% of the total number of cases, male to female ratio of 1.57: 1. The outbreak to Mingshui town as the center, was fan-shaped distribution. Etiologic testing identified aseptic meningitis outbreaks caused by ECHO30. The outbreak was linked to the following factors: There have been no epidemics of ECHO30-induced disease in the area for many years, with more susceptible populations accumulating. Nucleotide mutations in ECHO30 subtypes have led to the formation of new genotypes, and acid-tolerant tests have shown that the isolated virus Has the “D” characteristics, its virulence is strong; the local natural geographical conditions and eating habits, as the objective conditions of the outbreak. Conclusion The aseptic meningitis outbreak is caused by the widespread infection of the new genotype ECHO30. In the future, the surveillance and control of non-polio enterovirus-induced diseases should be strengthened.