广西5年间霍乱的流行特征与监测结果

ANALYSIS OF EPIDEMIOLOGIC CHARACTERISTICS AND SURVEILLANCE OF CHOLERA IN GUANGXI

目的:对1999～2 0 0 3年广西霍乱流行病学特点及监测结果进行分析。方法:对收集的疫情报告、个案、疫点处理、实验室检测和监测月报表等资料进行统计和流行病学分析。结果:1999～2 0 0 3年5年间广西共报告霍乱病例133例,年均发病率0 . 0 6 / 10万,病死3例,病死率2 .2 6 % ,检出带菌者81例;地区分布呈现沿海与内陆并存的格局,流行高峰在7～9月份,病例年龄有老龄化的倾向,职业分布以农民和渔船民为主;流行的优势菌型1999年和2 0 0 0年以O1群小川型为主,2 0 0 1年转变为稻叶型,首次发现O139群霍乱病例和外环境株;分离的小川和稻叶型菌株对复方新诺明、痢特灵等常用抗生素耐药严重,O139群菌株更显严重的多重耐药现象;传播途径以食物和水为主;5年来3类监测地区采集标本的总阳性率为0 . 77‰,阳性标本均出现在疫区,标本阳性率以2 0 0 0年(1. 96‰)为高、以3类地区为最高(1 .34‰) ,各类标本中以疑似病例粪便标本为最高(9 .17‰)。结论:广西霍乱流行强度近年呈逐年下降态势;霍乱监测取得较好的效果,我区霍乱防治工作仍需加强监测。

Objective:To characterize the epidemiologic features and surveillance profiles of Cholera in Guangxi from 1999 to 2003Methods:Data was collected from disease notification systems,case-reports,outbreak field sites,laboratories and monthly surveillance report and was statistically analyzedResults:A total of 133 cases of Cholera were reported in Guangxi between 1999 and 2003The annual incidence rate was 006 per 100,000 and 3 patients died,yielding a case-fatality rate of 226%In addition 81 carriers were observedCholera cases were found in both littoral and inland,with a seasonal cluster from July to SeptemberThe elders experienced the highest proportion of all casesPeasantry and fishing population were predominant compared with other populationOgawa was the dominant serotype that caused epidemics from 1999 to 2000,however,Inaba became the most important serotype in 2001The cases caused by Vibrio cholerae O139 and environmental strains were first found in GuangxiVibrio cholerae serotype Ogawa and Inaba were highly resistant to frequently used antibiotics,such as sulfamethoxazole-trimethoprom and furazolidoneIt is more important that antibiotic multi-resistance were found in O139 CholeraeIn Guangxi,Cholera mainly spread by contaminating water and foodA total culture-positive rate of 077‰ was observed in all three categories of surveillance areas during the passed five yearsAll strains were isolated from endemic areas,but none from non-endemic areasThe highest culture-positive rates were found in category 3 surveillance areas(134‰)as well as in the year of 2000(196‰)Compared with other cases categories,suspected patients had a higher culture-positive rate on stool samples(917‰)Conclusion:In Guangxi,epidemic intensity of Cholera has declined graduallyThe surveillance system is considered effective which is important for prevention of CholeraEven so,the surveillance will need to be strengthened