一起由O1群小川型霍乱弧菌引起的局部流行调查

Investigation of a local cholera outbreak caused by Vibrio cholerae O1 strain

目的通过对2008年儋州市沿海一带发生的一起霍乱局部流行的调查分析,探讨霍乱防治的对策和措施。方法对2008年儋州市发生的霍乱局部流行所有霍乱病例的个案调查表、密切接触者流行病学调查表和相关的检测信息,以及外环境的气象资料、人口学资料和流行区当地居民卫生条件等信息进行收集和整理,并结合现场调查,对当时疫情发生的成因及采取的对策和防治效果进行综合分析。实验室检测方法采用碱性蛋白胨霍乱弧菌增菌液进行增菌,然后做细菌分离,对分离出来的霍乱弧菌进行毒素鉴定,以判别是否是流行毒株。结果儋州市累计发生34例霍乱病例,其中实验室确诊的29例,临床诊断(疑似病例)5例,无死亡病例。首例病人于9月30日发生,最后1例病例于10月31日发生,11月1日以后不再出现新的病例,本次霍乱流行是在强台风后发生,灾区有90%的水井因海水倒灌而被淹没,外环境调查检测的结果证明,灾后外环境水体检测到霍乱弧菌。结论对流行原因分析结果表明,本次流行的原因主要是强台风引起北部湾海水倒灌,污染了沿海一带岸边居民的生活环境和水源,导致的一起霍乱局部流行。

Objective To discuss the measures for prevention of cholera outbreak through investigating the epidemic features of a local cholera outbreak caused by Vibrio cholerae O1 strain. Methods Data of individual cholera cases, infection records and laboratory test results closely contacted with the cholera patients, meteorological data, local hygienic conditions in Danzhou city in 2008 were collected and analyzed. Results There were 34 cholera eases all together, of which 29 cases were confirmed by laboratory test, and 5 were probable cases. No death occurred. The first case was found on 30 September, 2008, and the last one was on 31 October 2008. And the outbreak started not long after the occurrence of super typhoon ＂ Sinlaku ＂ caused huge damage and loss to 53 793 families, and 90% water wells were submerged then. Vibrio cholerae strain was detected from environmental water samples. Conclusion Contamination of well water with Vibrio cholerae and poor hygienic conditions following the disaster of typhoon were the main cause of the local cholera outbreak in Danzhou city.