Echo30型病毒性脑膜炎爆发的流行病学调查

An epidemiologic study on an outbreak of viral meningitis caused by Echo virus 30

目的探讨2003年江苏省盐城市不明原因无菌性脑膜炎爆发的流行特征、影响因素和病原学病因.方法采用统一的流行病学调查表对病例进行调查,描述临床表现;采用1:1配比病例对照研究的方法分析流行因素;收集部分住院患者的脑脊液及粪便标本进行病原体的分离鉴定.结果报告病例数共计1681例,疫情波及到9个县(市、区),3～6月为发病高峰,主要累及中小学生及学龄前儿童(占总发病数的99%).主要临床表现为发热、头痛、呕吐,预后良好.与发热病例的接触、不洁饮食史、饭前便后不洗手等可能是本次流行的危险因素.从66份患者脑脊液中分离到18株阳性病毒,分离率为27.3%;4份患者粪便标本分离病毒全部阳性.22株分离株病毒经鉴定均为Echo30型肠道病毒.结论2003年江苏省盐城市无菌性脑膜炎爆发的病原体为Echo30型肠道病毒,不良个人卫生习惯可能是本次流行的危险因素.

Objective To explore the epidemiological characteristics, risk factors and etiology of an unknown viral meningitis outbreak in Yancheng city, Jiangsu province in 2003. Methods The uniform epidemiolegical questionnaire was used to collect data and describe disease distribution. 1 ： 1 matched case-control study was carried out with cerebrospindal fluid （CSF） and fecal samples collected for pathogens＇ isolation and identification. Results A total of 1681 cases were involved, and most of them were students and children under school age. The epidemic spread 9 counties and the peak time was from March to June. The principal clinical manifestations were fever, headache and vomiting, while the prog- nosis were good. History of unsanitary food, not washing hands before dining and after excretion could be risk factors of this epidemic. 18 positive virus strains were isolated from 66 CSF specimens （isolation rate was 27.3 % ） and all 4 fecal samples were positive on virus isolation as well. Conclusions Echo virus 30 should be responsible for the unknown outbreak of viral meningitis in Jiangsu province in 2003. Unsanitary habits could be the risk factor of this epidemic.