2008—2011年我国细菌性痢疾暴发疫情分析

Analysis on bacillary dysentery outbreaks in China,2008—2011

目的了解我国2008—2011年菌痢暴发疫情的流行特征,进一步寻找危险因素和可控环节,为细菌性痢疾的防控提供依据。方法根据《突发公共卫生事件报告管理信息系统》中2008—2011年报告的细菌性痢疾突发公共卫生事件疫情信息和结案报告,按暴发疫情病例定义进行筛选后,用描述性流行病学方法对数据进行分析。结果 2008—2011年我国共报告细菌性痢疾暴发疫情82起,发病人数3 805例,罹患率为4.05%。疫情分布在湖南、贵州、四川、浙江、重庆等西南及沿海省市,宋内氏(占57.14%)和福氏(占38.78%)志贺菌为引起疫情发生的主要病原,学校(占68.29%)和农村(占25.61%)是疫情发生的高发场所。引起暴发疫情发生的主要原因有:①学校食堂从业人员带菌(占36.84%)和食品加工过程中被污染(占31.58%)是学校食源性暴发疫情发生的主要原因;②学校饮用水污染、食堂储备水和储水容器污染是学校发生水源性暴发疫情的主要原因;③聚餐和使用未经消毒的水是农村村庄发生食源性和水源性暴发疫情的原因。结论针对引起菌痢暴发疫情发生的原因,为预防和控制学校和农村菌痢暴发疫情的发生,需采取以下防控措施:加强对学校食堂从业人员的健康管理和食品加工卫生知识的宣教,加强水源消毒和监测,加强对学生和村民饮水卫生知识的宣教,对设置不合理的取水口进行改制。

Objective To understand the epidemic characteristics of bacillary dysentery outbreaks in China from 2008 to 2011,explore the risk factors and potential intervention measures,and to provide refference for the prevention and control of bacillary dysentery.Methods The epidemic reports of bacillary dysentery outbreaks in China from 2008 to 2011 were collected from national public health emergency reporting information system and screened according to the outbreak criteria to conduct descriptive epidemiological analysis.Results From 2008 to 2011,a total of 82 bacillary dysentery outbreaks were reported in China with 3805 cases and the attack rate was 4.05%.The geographic distribution of the outbreaks concentrated in the southwest and coastal provinces,i.e.Hunan,Guizhou,Sichuan,Chongqing and Zhejiang.The main pathogens were Shigella sonnei（D group） and Shigella flexneri（B group）,accounting for 57.14% and 38.78% respectively.The most occurrence settings were school and rural area,accounting for 68.29% and 25.61% respectively.The main risk factors associated with foodborne outbreaks in school were infected food handlers and improper food processing.The main risk factors associated with school waterborne outbreaks were contaminated drinking water,reserved water and water containers in canteen.Dinning together and using unsterilized water were the risk factors for foodborne and waterborne outbreak in countryside.Conclusion In order to prevent and control bacillary dysentery outbreak in school and rural area,it is necessary to strengthen the health management and education of food handlers in school canteens,enhance water disinfection and surveillance,promote health education on drinking water hygiene among students and villagers,and improve the settings of water intake.