1994～2002年广西甲型副伤寒和伤寒流行情况分析

Analysis of prevalent status of paratyphus A and typhus in Guangxi Autonomous Region in 1994～2002

目的 了解 1994～ 2 0 0 2年接种伤寒Vi疫苗后的 7年间伤寒和副伤寒流行变化 ,评价Vi疫苗对控制伤寒流行的效果并分析甲型副伤寒的特征及影响其爆发流行的因素。 方法 对自治区疾病控制中心实验室记录、伤寒副伤寒爆发调查报告、监测系统资料、全区伤寒流行地区伤寒Vi疫苗供应情况进行统计分析。 结果 经过血培养证实甲型副伤寒病例为 12 0 0例、伤寒为 2 85例 ;甲型副伤寒与伤寒的流行病学、临床特征十分相似 ;饮用污染水是引起甲型副伤寒爆发的主要原因 ;从 1999年起 ,甲型副伤寒杆菌开始超过伤寒菌为优势流行菌株。 结论 在广泛使用伤寒Vi疫苗后 ,伤寒基本得到控制 ,但因为引起副伤寒发病的危险因素依然存在 ,甲型副伤寒已取代寒 ,成为广西农村地区的最重要的传染病之一。为控制甲型副伤寒的流行 ,在安全饮用水供应状况得到全面改善之前 ,应尽快研制出副伤寒疫苗。

Objective To describe the characteristics of paratyphoid A,comparing with typhoid,and to investigate the impact factors of outbreaks in Guangxi,China Methods Data collected from laboratory records,investigation reports of outbreaks,surveillance and vaccine distribution lists of the typhoid endemic area were analyzed Results 1200 paratyphold A cases and 285 typhoid cases were confirmed by bacterial culture The epidemiological and clinical characteristics of the two diseases were very similar Pollution of drinking water was the main cause for paratyphoid A outbreaks Since 1999,S paratyphi A became dominant strains prevailed over S typhi Conclusion After wide use of Vi vaccine,typhoid was considerably controlled Paratyphoid A became more prevalent because the risk factors associated still remained as typhoid Paratyphoid A becomes and important infectious disease affecting the people in some rural area in Guangxi An effective paratyphoid A vaccine is necessary for controling this disease before save water supply system can be provided completely