文章摘要
陆向东,崔亮亮,马焰,祖荣强,申涛,李蒋清,姚建香,单军,谢琪,施超,曾光.一起饮水污染导致埃可病毒3O型脑膜炎暴发的调查[J].中华流行病学杂志,2012,33(10):1067-1071
一起饮水污染导致埃可病毒3O型脑膜炎暴发的调查
A viral meningitis outbreak associated with Ech030 in drinking water
收稿日期:2012-06-25  出版日期:2014-09-03
DOI:
中文关键词: 埃可病毒30型;暴发;病例对照研究;饮水
英文关键词: Eehovirus 30;Disease outbreaks;Case-control studies;Dinking-water
基金项目:
作者单位E-mail
陆向东 江苏省江阴市疾病预防控制中心 214434  
崔亮亮 中国现场流行病学培训项目
山东省济南市疾病预防控制中心 
 
马焰 江苏省江阴市疾病预防控制中心 214434  
祖荣强 江苏省疾病预防控制中心 cdczrq@163.corn 
申涛 中国现场流行病学培训项目  
李蒋清 江苏省江阴市徐霞客医院  
姚建香 江苏省江阴市疾病预防控制中心 214434  
单军 江苏省疾病预防控制中心  
谢琪 江苏省江阴市徐霞客医院  
施超 江苏省无锡市疾病预防控制中心  
曾光 中国现场流行病学培训项目  
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中文摘要:
      目的调查一起学校内多名学生发热伴头晕、头痛,或伴恶心、呕吐的感染原因与影响范围,提出控制措施。方法疑似病例定义为2012年3月1日后L学校师生中?现发热(腋温≥37℃)伴头晕、头痛、恶心、呕吐症状之一者;确诊病例为疑似病例咽拭子或肛拭子肠道通用病毒RT-PCR阳性者。病例搜索通过查阅3月1日后当地4家医院就诊记录和学校师生冈病缺课缺勤记录。采用1:2个体匹配的病例对照研究分析饮水暴露情况。采集27名病例的咽拭子和肛拭子进行肠道通用病毒RT-PCR及序列分析。4月19日采集2份直饮水机温开水样品分析细菌总数和大肠菌群。结果学校学生病例103例,罹患率4.6%(1032255)。77.7%(80/103)病例来自该校综合楼,三年级罹患率最高18.1%(721397)。流行病学曲线为持续同源暴露,饮用直饮水机温开水(OR=18.3,95%CI:2.0~169.5)和饮用生水(OR=15.5,95%CI:1.7~141.8)均是危险冈素。27名病例肠道通用病毒RT-PCR检出率为81.5%(22/27),其中9例PCR序列分析有7例为埃可病毒卸型(Echo 30)。直饮水机温开水细菌总数和大肠菌群检测结果符合标准。结论该次疫情是由Echo 30导致的一起学校内病毒性脑膜炎暴发,饮水是危险因素,不同于以往的人传人模式,值得关注。
英文摘要:
      Objeetive To study the source of infection,the scope of epidemic and controlmeasures in an outbreak involving students having symptoms as fever,dizziness,headache,vomitingand nausea.Methods The suspected-case was defined as fever(armpit temperature≥37 oc)and with one or more of the following symptoms:dizziness,headache,vomiting and nausea,among students and teachers at sch001 from Mar 1.2012.Confirmed-case was among suspected case accompanied by both throat and rectal swabs enterovirus positive by RT-PCR.An the cases werecollected through checking the medical records from 4 hospitals as well as through the absence records of students and teachers.from Mar 1.2012.We conducted a case-control study with ratio of 1:2 anddata on the exposures to water among students and teachers was collected prior to the illness.27 cases’throat and rectal swabs were collected and analyzed bv RT-PCR and PCR sequence methods.2warm-water samples were collected for testing the counts on total bacteria and E eoli.Resultsl 03students’cases were identified in school L.with the attack rate as 4.6%(103/2255).Students fromGrade three had the high attack rate as 18.1%(72/397)and 77.7%(80/103)ofthe cases located in the building with‘multiple-functions’.Epidemic curve of the outbreak showed a paRem with continuouscommon source of infection.It seemed that the exposure to warm-water appeared to be the major risk factor(OR=18.3.95%C,:2.0-169.5)togetherwiththeintake ofan。boiledwater(0尺=15.5,95%CI:1.7-141.8).Specimens from 27 students(81.5%,22/27)were identified enterovirus positive by RTPCR,and 7 of the 9 students were confirmed carrying Echo 30,Bacteria and coli were negative from the 2 warm-water samples.ConclusionThis viral meningitis-outbreak was caused by Echo 30,with drinking water as the major risk factor.
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