北京市海淀区2007年细菌性痢疾流行病学调查

Epidemiological Investigation and Analysis of Bacillary Dysentery in Haidian District in 2007

目的了解2007年北京市海淀区细菌性痢疾发病率水平、流行特征及菌谱分布和耐药情况,为2008年奥运会菌痢科学防控提供基础数据。方法根据海淀区的直报疫情网资料,对2007年菌痢发病现状进行描述性分析,对肠道门诊送检的志贺菌进行菌型和耐药试验。结果2007年海淀区报告菌痢5286例,发病率为213.98/10万,发病居38种法定传染病的第2位;全年6—9月为发病高峰期,峰顶为8月份,发病1288例,占全年发病例数的24.37%;重点发病年龄组为0～4岁组,20岁组,5岁组和70岁以上组;发病人群以学生、散居儿童、公务人员及职员、离退休人员为主,构成比达70.17%;引发菌痢以食源性因素为主;菌型以宋内志贺菌占80.00%,福氏志贺菌占20.00%;志贺菌对各种抗生素耐药有一定差异。结论菌痢仍是危害海淀区人群健康的重要的公共卫生问题之一,发病率远远高于全国平均水平;发病有明显的季节高峰;0～4岁组、学生、公务人员职员为重点防控对象;宋内志贺菌已成为海淀区优势流行株,应加强各部门菌痢预防控制工作,特别是食品卫生的管理督察。

[Objective] To understand the morbidity, epidemic character, bacterial spectrum and drug resistance of bacillary dysentery in Haidian district in 2007, provide the basic data for scientific control and prevention of bacillary dysentery in the Beijing 2008 Olympic Games. [ Methods ]According to the information from Disease Directly Reporting Network in Haidian District in 2007, the current incidence of bacillary dysentery was analyzed descriptively. The Shigella samples in enteric clinics were tested in subtypes and drug resistance. [ Results ] In 2007, there are 5286 cases of bacillary dysentery reported in Haidian District, and the incidence rate was 213.98/lakh with the second place among 38 kinds of legal notifiable infectious disease. The epidemic peak occured through June to September, and the August had the highest incidence rate of bacillary dysentery with 1288 cases reported, which accounted for 24.37% of the cases during the year. The cases focused on 0 -4 years old group, 20 years old group, 5 years old group and 70 ＋ years old group. The majority of patients were students, scattered children, government functionaries and retirees, with the constituent ratio at 70. 17%. The food was the main inducing factor of bacillary dysentery. The distribu- tion of subtypes showed that Shigella Sonnei and Shigella Flexneri accounted for 80.00% and 20. 00% respectively. The drug resistances of Shigella for various antibiotics were different. [Conclusion] Bacillary dysentery still was one of the important public health problems which harm to the health of Haidian people, and the incidence rate was higher than the national average level. The prevalence showed significant season peak. The society should pay more attention to prevention and control among the key populations, including 0 -4 years old group, school students, government functionaries and clerks. Shigella Sonnei was the dominant subtype in Haidian District. Therefore, the prevention and control of Bacillary dysentery in all departments should be strengthened, especially in the administration of food health.