四川省1950～1995年伤寒流行病学分析

Epidemic Analysis of Typhoid Fever From 1950 to 1995 in Sichuan Province

四川省１９５０～１９９５年共发生伤寒１１７２９５例，死亡２１７４人，年平均发病率为３３２／１０万。１９５２年及１９６１年为流行高峰年，发病率各为１０７９／１０万和１５１０／１０万；６～９月发病最多；７０年代后发病两个波峰特征已不复存在。边远山区和少数民族地区为高发区。１０～３９岁发病占７１６０％，各年龄组发病专率有显著性差异；发病男与女之比为１３９∶１；发病以农民为主占４８２２％，次为工人及学生，各占１５７２％和１４８６％。传播方式以日常生活接触为主占６４５２％，食物型占１９３５％，水型占１６１３％；爆发流行病例数占总病例数的１８３０％；临床症状呈现明显轻症化趋向。伤寒沙门氏菌已成为现今流行的单一菌型；大多数菌株对复方新诺明及四环素出现耐药性；ｖｉ噬菌体分型Ｄ２占３４９０％，而近年Ｍ１型有增加之势。并分析了引起伤寒流行的主要因素，对伤寒防制策略作了初步探讨。

There were 117,295 typhoid fever cases in Sichuan Province from 1950 to 1995,2,174 patients died of the disease; the morbidity is 3.32/100 million. Peak prevalent years were 1952 and 1961, with morbidities of 10.79/100 million and 15.10/100 million, most cases found from June to September, the characteristic of two wave crests of the occurrence no longer existing since niniteen-seventies. The remote mountainous districts and the minority nationality regions were the focuses areas of the disease. Of all the cases, people from ten to thirty nine years old were 71.60%; the morbidities of different age groups had distinct differences; the occurring proportion between men and women is 1.39:1; the majority of the cases were farmers with the percentage of 48 22%; second were the workers and students with the percentage of 15 72% and 14 86%. The spread mainly achieved through the daily living contacts which accounts for 64 32%, and the food-pattern 19 35%, the water-pattern 16 13%; the cases of outbreaks account for 18 30%; the clinical syptoms tend to become slight. Salmonella typhi has become the only bacterio-type of the current epidemic; most strains showed drug resistance to sulfamethoxypyridazine and tetracycline. According to bacterio-type, D 2 type account for 34 90% while M 1 type seems to arise in recent years. We analysed the main factors which cause the epidemic of the disease, and initially inquire into the prevention strategy of the disease.