临沂市伤寒监测及流行病学研究

Surveillance and epidemiological study on typhoid in Liyi city

目的 探讨临沂市伤寒爆发的流行规律和影响因素 ,提出有效的防治对策和措施。方法 采用点、面结合 ,病例对照等方法进行流行病学调查 ,实验室检测及数据统计分析。结果 195 6～ 2 0 0 1年共报告伤寒病人 944 4例 ,年均发病率为2 2 7/ 10万 ,发病以青壮年农民和小学生为主 ,年龄主要集中在 5～ 10岁和 2 0～ 3 5岁。传播途径仍以水型传播为主 ,对 10 2例伤寒病人作流行因素调查 ,病例组喝生水及不洁食物史的比例均高于对照组 ( χ21=49.63 ,P <0 0 0 5 ,OR =13 .2 2 ;χ22 =2 3 .40 ,P <0 0 0 5 ,OR =4.2 3 )。 1997年调查该市的伤寒慢性带菌率为 1 0 6% ,其中有病史者的慢性带菌率为 2 81%。结论 临沂市慢性伤寒带菌者是重要传染源 ;伤寒以水型传播为主 ;伤寒菌型主要为D2、E1和M1型 ,菌株对氟哌酸 (Nor floxacin)、吡哌酸 (Pipemidicacid)等 8种抗生素高度敏感。

ObjectiveTo investigate the epidemic law and affecting factors of typhoid prevalence in Linyi city and to provide effective preventive countermeasures.[Methods]Epidemiological investigation was made with the method of case contrast; laboratory testing and statistical analysis were also made.[Results]During the period of 1956～2001, the total reported typhoid were 9 444 cases with the annual morbidity of 2.27/100,000. The patients were mainly young peasants and primary school students aged 5～10 and 20～35. The main route of transmission was unclean water. The proportion of unclean water and food intake in the case group was higher than that in the control group (χ1 2=49.63,P<0.005,OR=13.22; χ2 2=23.40,P<0.05, OR=4.23). According to the survey in 1997, the rate of carrying chronic typhoid bacteria was 1.06%, the rate of carrying chronic typhoid bacteria among those with case history was 2.81%.[Conclusion]Chronic typhoid bacteria barriers are a primary source of infection. Unclean water is the main route of transmission. The types of typhoid bacteria are mainly D2, E1 and M1. The strains are highly sensitive to the antibiotics like Norfloxacin and Pipemidic acid, etc.