2009年通海县一起食源性O139霍乱暴发疫情的调查与应急处置

Emergency Response and Investigation on an Outbreak of Food-borne Cholera Epidemic Caused by Vibrio Cholerae O139,Tonhai County,2009

[目的]总结O139霍乱疫情应对经验,为今后的霍乱防治和处置提供借鉴。[方法]对2009年1月在玉溪市所属通海县四街镇四寨村发生一起霍乱暴发疫情,从病例的发现、确诊、报告、现场调查与处理、技术应对与行政应对等方面进行分析。[结果]在所有参宴的639人中,通过粪便或肛拭子检验,结合临床症状,确诊O139型霍乱病例20例(其中实验室确诊17例,临床诊断3例),罹患率为3.13%;检出O139型霍乱弧菌健康带菌者27人,带菌率为4.23%。未发生二代病例、无死亡病例,疫情在1周内完全控制。检测霍乱病例和带菌者的密切接触者228人,检测当地未参加丧宴的67例腹泻病例标本,检测暴发点外环境标本432份,均未检出霍乱弧菌。条件Logistics回归分析结果,丧宴提供的煮萝卜是发病/带菌的危险因素,OR值为3.71。[结论]这是一起由O139霍乱弧菌引起的输入性食源性霍乱暴发疫情,由于发现、诊断、报告及时,应急处置措施得当,疫情得到快速彻底控制。

[Objective] To sum up experience in response of O139 cholera epidemic,in order to provide experience for prevention and treatment of cholera.[Methods]Analysis was made on the discovery,diagnosis,report,field investigation and treatment,technical and administrative responses during the response period of the cholera epidemic that broke out in Sizhai village,Sijie township,Tonghai county,Yuxi city,in January 2009.[Results]In the total of 639 people attending the funeral banquet,test their feces or rectal swab,with clinical symptoms,20 O139 cholera epidemic patients were diagnosed（17 confirmed patients,3 probable patients）,the incidence was 3.13%.27 carriers were reported,the carrying rate was 4.23%.No one death,no secondary case,the cholera epidemic was completely controlled in one week.No Vibrio cholerae strain was detected from 228 samples from the individuals getting in touch with patients and carriers,as well as 67 samples from diarrhea patients who did not attend the funeral banquet,and 432 environment samples.Logistics regression analysis results showed that the cooked turnips offered by the funeral feast were the risk factors of morbidity/carrier,OR value of 3.71.[Conclusion]This is an outbreak of food-borne cholera caused by Vibrio cholerae O139.The successful response to an outbreak of cholera can be attributed to the discovery,diagnosis,report of cases,and an organized and rapid response.