台州地区伤寒副伤寒的流行状况及防控对策

Epidemic status of typhoid fever and paratyphoid fever and its counter measures in Taizhou

目的了解和掌握台州地区伤寒副伤寒流行病学和病原分子生物学特征，分析其流行因素，探讨防控对策。方法对全市伤寒副伤寒疫情资料进行描述流行病学分析，结合实验研究对采取的防控措施进行科学评价。结果台州市伤寒副伤寒疫情从2001年开始逐年抬升，发病率从2001年的22．83／10万上升到2004年的61．55／10万，2007年降到9．02／10万；优势病原菌由伤寒杆菌转变为甲型副伤寒杆菌，后者又以X2基因为主。发病季节提前，发病点多面广相对集中，临床表现极不典型，各年龄组均有发病，10～59岁之间的占报告病例总数的90．3_4％，男女发病之比为1．31：1，以民工、农民、学生为主；饮用水污染和生食或半生食贝类食品为发病的主要危险因素。结论针对流行病学和病原学病因采取综合性防控措施，推进饮用水安全卫生与改厕无害化建设、落实健康教育与健康促进等是控制伤寒副伤寒流行的根本性措施。

Objective To learn and analyse the epidemiologic and pathogenfic characteristics of typhoid fever and paratyphoid fever, and explore counter measures for diseases prevention and control. Method A descriptive epidemiological and experimental analysis was made on the data of epidemic situation monitoring for typhoid fever and paratyphoid fever in the whole districts of Taizhou. Results The incidence of typhoid fever and paratyphoid fever increased from 22.83/100 000 in 2001 to 61.55/100 000 in 2004, but decreased to 9.02/100 000 from 2005 to 2007. Salmonella paratyphi A become dominant strains prevailed over Salmonella typhi from 2001, and dominated by X2 genotype in later years. The season of disease onset was in advance and its regional distribution of diseases was still shown to be wide, but relatively localized. The clinical features were not typical. The age distribution was also shown wide, however, 90.34% of the disease was in the age from 10 to 49 years old. The incidence ratio of the male and female was 1.31 ： 1. The occupational distribution was mainly in the group of peasants, migrant workers and students. The main causation＇was the unsanitary drinking water and shellfish taking. Conclusions Comprehensive measures for the epidemic situation and etiology are urgently needed, such as improvement management and disinfections of drinking water, health education and promotion, and eonstruction of domestic flushing toilet system.