一起细菌性痢疾水型暴发流行的调查

A water-borne outbreak of bacillary dysentery

目的：掌握细菌性痢疾水型暴发的流行特征和流行因素，为制定防控措施提供依据。方法：调查登记患者的临床表现、流行病学和实验室等资料，对收集的资料进行统计、分析。结果：共发病180人，罹患率48．13‰，男女发病差异无统计学意义，发病最小年龄3个月，最大年龄91岁，罹患率以1～4岁最高，10～14岁最低，年龄组别罹患率不同（X2=99．12，P〈0．01）。饮用污染水源的人群罹患率（91．10‰）高于饮用非污染水源的人群罹患率（21．94‰）。结论：本次疫情为饮用水源连续污染而导致的水传暴发流行，并伴生活接触传播；应加大农村改水改厕力度，加强集中供水设施的管理和维护，保护饮水卫生。强化疫情报告制度，及时发现、报告、并隔离治疗菌痢患者。在对轻型病人不能及时作出准确诊断的地区，为防止误诊而放弃病人管理，应将可疑患者，特别是夏秋季肠炎病人列为隔离管理对象。并加强卫生宣教，把好病从口入关，将1～4岁年龄组和20岁以上成人作为痢疾防治工作的重点人群。

Objective To explore the epidemiological features and causes for a water--borne outbreak of bacillary dysentery, and to provide a scientific evidence for taking measures to prevent the epidemics. Methods We conducted sta- tistical analysis of the data including patients＇ clinical features, epidemiological and laboratory data. Results A total of 180 patients developed the diseases, with a morbidity rate of 48. 13‰, There was no significant difference between males and females. The patients ranged from three--month--old baby to 91--year--old old man. The age group of 1 to 4 years old had the highest morbidity rate while the age group between 10 and 14 years old had the lowest. The morbid- ity rates changed among age groups（x2 =99.12 ,P〈0.01）. The outcome showed that age and polluted drinking water affected people＇s health seriously,The morbidity rate of the population who drank polluted water （91.10‰） was higher than that of the population who drank non--polluted water（21.94‰）. Conclusions The cause of the outbreak is continuous pollution of the drinking water and contact infection in daily life. Water hygiene should be enhanced by promoting rural healthy infrastructure construction and management as well as maintenance of centralized water supply. Besides, epidemic report system should be strengthened for solving problems timely. In the areas where mild patients can＇t be diagnosed and confirmed, the suspected patients, especially those who had enteritis in summer or autumn, should be isolated. Meanwhile,it＇s necessary to strengthen health publicity and children in the age group of 1--4 years and adults ahove 20 years old are target population.