重庆市开县流行性乙型脑炎疫情流行病学分析

Epidemiological analysis of Japanese encephalitis in Kai County of Chongqing Municipality

目的分析开县流行性乙型脑炎的流行病学、临床表现、实验室检查等特点。方法对开县2006年6～8月份出现的流行性乙型脑炎66例病例的流行病学资料及临床资料进行分析。结果患者年龄从6月龄至18岁,流行从6月17日至8月30日,乙脑病例分布于30个乡镇,没有家庭聚集现象。患者62.12%无疫苗接种史。症状均有发热,抽搐、昏迷。体征颈强直占84.85%,克氏征阳性62.12%、布氏征阳性69.70%。血象白细胞总数平均17.0×10^9/L,中性粒细胞平均8.4×10^9/L。患者早期血清检测乙脑IgM抗体阳性率75%。经综合治疗后死亡5例,病死率7.58%。结论此次乙型脑炎流行具严格的季节性和年龄特征,呈高度散发。患者居住卫生条件差、传媒蚊子多、山区防疫工作有漏洞、免疫接种率低,是引起流行的主要因素。

Objective The study was conducted to analyze the epidemiological characteristics, clinical manifestations,laboratory findings of Japanese Encephalitis in Kai County.Methods The epidemiological and clinical data of Japanese encephalitis in Kai County from June to August 2006 were collected lot analysis.Results The patients＇ age ranged from six months to 18 years.The epidemic lasted from June 17 until August 30,and the cases distributed among 30 towns without family cluster.62.12% of the patients had no vaccination history.Their symptoms included fever, convulsions,and coma.As to the signs,neck stiffness accounted for 84.85%,positive Kernig sign 62.12%,and positive Brudzinski＇s sign 69.70%.The average total white cell count was 17.0×10^9/L,and neutrophil count 8.4×10^9/L.In early detection of serum,the positive rate of Japanese encephalitis IgM antibody was 75%.Five patients died after combined therapy,the fatality rate being 7.58%.Conclusion Strict seasonal and age characteristics were found in the highly sporadic Japanese Encephalitis epidemic.Affected cases lived with poor sanitation,where also lived the media,mosquitoes. Insufficient epidemic prevention in mountain areas and low immunization rate were the main factor causing the epidemic.