2017—2018年庆阳市流行性乙型脑炎暴发流行病学和临床特征

Epidemiological and clinical characteristics of epidemic encephalitis B outbreak in Qingyang county from 2017 to 2018

目的分析2017—2018年甘肃省庆阳市流行性乙型脑炎(乙脑)暴发流行病学和临床特征,为今后乙脑防治工作提供参考和决策依据。方法从中国疾病预防控制信息系统疾病监测信息报告管理系统中获取2017—2018年庆阳市乙脑暴发的确诊病例,住院病历资料来源于庆阳市人民医院病案室,采用流行病学方法进行分析。结果 2年共报告乙脑病例70例,病死率11.25%(8/70);七县一市均有发病,2017年和2018年发病分别占21.43%(15/70)和78.57%(55/70),8月发病占63.64%(35/55)、7月和9月发病分别占14.54%(8/55)和21.82%(12/55),2017年发病均在8月,2018年发病于7,8和9月;男女性别比为0.67∶1,平均年龄(60.84±11.6)岁;以农民为主(91.42%),其次为教师(2.86%)、离退休人员(2.86%)和家务及待业人员(1.43%);发病到确诊时间平均(6.14±1.5)d,其中2017年(5.4±1.7)d与2018年(6.7±1.4)d相比,差异有统计学意义(t=2.708 3,P<0.05);多数病例(65/70)合并多种症状。结论庆阳市乙脑暴发病例以50岁以上农民为主,发病到确诊时间较长,医疗机构应与疾病预防控制部门和农牧部门密切协作、加强信息沟通、有效管理传染源,开展以防蚊灭蚊为主的爱国卫生运动,为易感人群接种乙脑疫苗,进一步提高临床诊疗水平,降低病死率,有效防控乙型脑炎疫情。

Objective To analyze the epidemiological and clinical characteristics of epidemic encephalitis B(encephalitis B) outbreak in Qingyang, Gansu province from 2017 to 2018, and provide reference and evidence for formulating encephalitis B prevention and control strategy. Methods The material of confirmed encephalitis B cases in Qingyang were collected from Chinese Infectious Disease Detection Report Information System during 2017 to 2018. All medical records of inpatient cases were collected from the department of medical records of Qingyang hospital. Epidemiological methods were taken for data analysis. Results Totally 70 cases were reported among these two years, with mortality rate of 11.25%(8/70).The cases with encephalitis B were reported in all 7 counties and 1 city of Qingyang. The proportion of cases was 21.43%(15/70)in 2017 and 78.57%(55/70) in 2018, 63.64%(35/55) in August, 14.54%(8/55) in July and 21.82%(12/55) in September. All cases broke out in August in 2017, and in July, August and September in 2018. The sex ratio of the male cases to the female was 0.67∶1, with average age of(60.84 ± 11.6) years. Farmers were the dominant(91.42%), followed by teachers(2.86%),retirees(2.86%), domestic and unemployed persons(1.43%). The interval time from onset to confirmed diagnosis averaged(6.14±1.5) days, of which(5.4±1.7) days in 2017 and(6.7±1.4) days in 2018, with statistical difference(t=2.708 3,P<0.05). Most cases(65/70) complicated with multiple symptoms. Conclusions Main cases of encephalitis B outbreak are farmers over 50 years old in Qingyang from 2017 to 2018, and the interval time from onset to confirmed diagnosis is long.The close cooperation and information communication should be enhanced among medical institutions, center for disease control and prevention and department of agriculture and animal husbandry. Effective management of infection sources,patriotic health campaign to prevent and eradicate mosquito, vaccination in susceptible population and improvement of diagnosis and treatment could decrease the motality rate and effectively prevent and control the epidemic of encephalitis B.