广西壮族自治区14起学校重大伤寒、副伤寒疫情分析

Investigation of 14 Epidemic Outbreaks of Typhoid and Paratyphoid Fever at Schools in Guangxi

目的了解学校发生伤寒、副伤寒重大疫情的原因及其流行因素,为控制疾病提供依据.方法收集、统计和分析广西壮族自治区和各地、市、县疾病预防控制机构疫情报告和学校重大伤寒、副伤寒疫情调查处理报告.结果1996～2002年广西共发生14起学校内重大伤寒、副伤寒疫情,其中甲型副伤寒11起,伤寒2起,甲型副伤寒和伤寒混合流行1起;发生在大专院校3起,高级中学3起,初级中学8起;农村10起,城市4起.各学校学生罹患率1.9%～31.1%,平均10.3%,教职工平均1.6%,差异有显著性(P＜0.01);流行时间最短15 d,最长115 d;传播途径水型11起,食物型3起.每年5～6月和10～11月为流行高峰期.学校饮用水卫生、食品卫生状况恶劣,粪便无害化处理率低,疫情迟报、误诊和缺乏预警机制是疫情发生的重要原因.结论伤寒、副伤寒已成为广西各级学校尤其是农村中学的公共卫生问题,必须采取标本兼治和针对性措施加以防范和控制.

Objective To know the causes and epidemic factors for outbreaks of typhoid and paratyphoid fever at schools, to provide basis for the control of epidemic diseases. Methods Data were analyzed, which were collected from the investigation and disposal reports of typhoid and paratyphoid outbreaks at schools. Results From 1996 to 2002, 14 serious epidemic outbreaks of typhoid and paratyphoid at school were reported in Guangxi province. A-mong which, 11 were s.paratyphoid, 2 typhoid and 1 dual infection ofs.paratyphoid and. typhoid; 3 occurred in universities and colleges, 3 in senior high schools, 8 in junior high schools, 10 in rural schools and 4 in urban schools. The prevalence rate among all the schools was 1.9% -31.1%. The average prevalence rate of the students (10.3%) was significantly different from that of school staff (1.6%). The shortest epidemic duration was 15 days and the longest 115 days. As far as the transmission way was concerned, among the 14 outbreaks, 11 were through water, the rest through food. The peak months were May - June and October- November. The major causes of the epidemic outbreaks were: unhygienic drinking water and food supplies, low innocuous treatment rate of dejecta, reporting delay, misdiagnosis and the lack of pre-alerting system. Conclusion Typhoid and paratyphoid have already become a major public health problem among schools, especially rural schools in Guangxi province. Pertinent measures should be taken to prevent and control the diseases.