佛山市禅城区石湾镇登革热疫情爆发流行病学调查

Investigation on Dengue fever outbreaks in Shiwan town of Chancheng district of Foshan city

目的对佛山市禅城区石湾镇登革热社区爆发疫情进行调查分析,为登革热的防控积累经验。方法采用现场流行病学调查方法了解疫情分布情况,即爆发时长、波及范围、人群分布以及蚊媒密度;采用ELISA法进行登革热IgM抗体检测;率的比较采用χ2检验,计量资料采用t检验,P<0.05为差异有统计学意义。.结果 2012年9—11月,佛山市禅城区石湾发生了一起登革热爆发疫情,共报告确诊病例117例,发病率为49.4/10万,无死亡病例。男性发病率为46.3/10万,女性发病率为52.6/10万,男女发病差异无统计学意义(χ2=0.4787,P>0.05)。主要发病人群以青壮年为主。患者平均年龄为(39.96±1.49)岁,其中男性平均年龄为(36.40±1.98)岁,女性患者的平均年龄为(43.10±2.28)岁,女性患者的年龄比男性大6.70岁(t=2.876,P<0.05)。职业分布以商业服务、工人和离退老人为主。病例有聚集性:以疫点200 m范围聚集的病例占91.5%。发病曲线呈多峰形,说明本次疫情属多次暴露。有家庭续发,续发率为4.85%。主要发病区为石湾镇街道的传统制陶区以及陶制品销售区。扩散范围较大,有65.7%(23/35)的村居委受波及。结论本次疫情爆发属本地感染的登革热,是一次疫情控制不佳的案例。主要原因是疫情监测不灵敏,传染源发现和控制不及时;早期重视程度不足,切断传播途径的综合措施不力,蚊密度高,造成疫情不断扩大和绵延,应汲取教训。

Objective To investigate dengue fever outbreaks in communities of Shiwan town of Chancheng district of Foshan city and to accumulate experience on the prevention and control of dengue fever.Methods On-the-spot epidemiological investigation was conducted for the three distribution of the epidemic,i.e.the duration,range of spread,population distribution and density of mosquito.Elisa was used to determine dengue fever IgM.χ2 test was used for comparison of rates,t-test for measurement data,the result of P〈0.05 was considered statistically different.Results There were 117 dengue fever cases reported in this epidenmic outbreak from September to November in 2012.The incidence was 49.4/105,no death cases occurred.The incidence was 46.3/105 in males and 52.6 /105 in females,which showed no significant difference（χ2=0.4787,P〉0.05）.Young adults were the typical sufferers with an average age of（39.96±1.49） y [（36.40±1.98） y for men and（43.10±2.28） y for women].Female sufferers were 6.70 years older than males（t=2.876,P〈0.05）.Most of the sufferers engaged in business service,served as workers or were the retired elderly.Cases had the characteristics of aggregation,91.5% of the cases concentrated in the place that was 200 m away from the epidemic area.The incidence curve was of multimodality,showing that this was a multiple exposure epidemic and had secondary attack in family,the secondary attack rate was 4.85%.The epidemic area covered traditional ceramics pottery and ceramics sales region.This epidemic spread widely and 65.7% of the villages were involved.Conclusions This epidemic of dengue fever is a local infection,which is badly controlled.The main reasons are that epidemic monitoring is insensitive,detection and control of the source of infection are not timely,early attention and measures to cut off the transmission are inadequate,mosquito density is high,causing the progress of this epidemic.