海南省一起流行性乙型脑炎暴发的调查分析

Investigation of an outbreak of Japanese B encephalitis in Hainan Provicne

目的 为了寻找导致本次流行性乙型脑炎（乙脑）暴发的因素,以防止类似暴发疫情提供科学依据。方法按疫情暴发调查方法,对病例进行个案调查和疫区处理,并采用ELISA和间接免疫荧光血清学方法检测所采集的患者、疫区生猪静脉血以及对患者粪便标本进行肠道病毒分离。结果 本次暴发疫情呈高度散发,年龄集中在10岁以下儿童,共有19例病例,2例死亡,病死率为10.53％。临床以轻型与普通型为主,表现为发热、头痛、呕吐等主要症状。实验室检测9份病例血清标本,间接免疫荧光法乙脑IgG抗体均阴性,IgM8例阳性,其中有6例用ELISA法检测乙脑IgM抗体阳性,双阳性符合率达到75％。2例生猪血标本未检出乙脑抗体,粪便培养不出肠道病毒。结论 儿童乙脑疫苗基础免疫空白是导致本次乙脑疫情暴发的主要原因。

ve To investigate the factors leading to the outbreak of Japanese B encephalitis(JE) an provide scientific basis for prevention and control of similar outbreaks. Methods The infectious focus was dealt with and all the cases were investigated. ELISA and IFAT were employed for testing the sera samples from the patients and pigs in the infectious focus and the stool sample from the patients was also examined for en-terovirus. Results Totally 19 cases, sporadically distributed in the outbreak area and most of them under the age of 10 years, were detected and 2 case died with a fatality rate of 10.53 % . The clinical signs observed in the patients were light and moderate and the main manifestations were fever, headache, vomitting. Of 9 samples tested with IFAT all were negative for JE IgG antibody and 8 positive for JE IgM antibody and 6 of them tested with ELISA were also positive for JE IgM with a coincidence rate of 75% . The 2 pig samples were negative for JE antibody and no enterovirus was deected. Conclusion The blank of basic vaccination of JE vaccine is the major cause resulting in the outbreak in this area.