广州市某建筑工地一起登革热暴发的流行病学调查

The epidemiological investigation and analysis of dengue fever outbreak in a construction site in Guangzhou

目的调查广州市某工地一起登革热暴发疫情,探讨登革热暴发的流行病学特征及原因,为登革热疫情的科学防控提供参考。方法采用描述性流行病学队列研究方法对疫情暴发的危险因素进行分析;采用ELISA、RT-PCR和病毒分离的方法对标本病原学进行检测。结果工地工人登革热罹患率为16.96%;全部病例均在同一潜伏期内发病;未使用防蚊措施(RR=2.9,95%CI=1.6~5.0)、地下室工作(RR=2.6,95%CI=1.5~4.6)、工地板房住宿(RR=5.2,95%CI=1.7~16.3)工人罹患登革热风险更高;叉生分析结果显示工地住宿暴露与地下室工作暴露存在交互作用,工地住宿是主要患病风险,地下室工作增加患病风险。结论工地蚊媒密度高是引起本次疫情的主要原因,工人在工地住宿、地下室工作为共同危险因素,未采取防蚊措施增加了患病风险。尽早隔离病人、杀灭成蚊、清理孳生地是登革热防控的有效措施。

Objective To investigate and analyze a dengue fever outbreak in a construction site in Guangzhou, we studythe epidemiological features and causes of the outbreak of dengue fever, to provide a scientific reference for prevention andcontrol of dengue fever. Methods Descriptive epidemiological analysis was carried out on the cases, a cohort study was usedto explore risk factors of outbreaks. Serum samples were analyzed by ELISA, RT-PCR, and virus isolation. Results Workersat the construction site with dengue fever was at a rate of 16.96%; All cases were occurring in the same incubation period;Itwas higher risk for workers in suffering dengue fever that failing to use anti mosquito measures（RR=2.9, 95%CI=1.6-5.0）,working（RR=2.6,95%CI=1.5-4.6）and sleeping（RR=5.2,95%CI=1.7-16.3）at the construction site. The results of crossoveranalysis showed that there were interactions effect between living in and working at the construction site. Living in the site wasthe main risk, and working in the site increased the risk of suffering dengue fever. Conclusion It＇s the main reason that thehigh mosquito density of construction site causes the outbreak. Workers sleeping and working at the site was the common riskfactors. Failing to take anti-mosquito measures increased the risk of suffering from dengue. It＇s the effective measures to preventand control dengue fever that isolation of patients at early stage, killing adult mosquitoes and cleaning up the breeding grounds.