新疆南部戊肝疫区间隔20年后局部再爆发的调查

Investigation of an reccurrence of Hepatitis E outbreak in a 20 years interval after a widespread epidemic in a limited area of southern XingJiang

为了探讨戊肝流行 2 0年后再爆发的特点 ,对 2 0 0 1年喀什地区莎车县某乡戊型肝炎的流行和临床特点进行了调查 ,并对病后半年的部分病例用ELISA方法检测戊肝抗体水平。结果发生在 1981～ 1983年大流行时散发病的疫区 ,间隔 2 0年后再次局部爆发戊肝 ,乡总患病率 0 .6 4 % (16 7/ 2 5 979) ,分布在相邻六个自然村 ,每村平均患病人数为 2 8人。饮用水为手压井 (地下水 ) ,全年以 8～ 12月为一高峰 ,均为维族农民 ,男 98人 ,女 6 9人 ,最大年龄 5 4岁 ,最小年龄 12岁 ,中位年龄 2 8.9岁。临床表现符合急性黄疸型肝炎 ,病情轻 ,无重症和死亡病例。抽查病例中病后半年抗 HEVIgG阳性率 6 8% ,IgM阳性率 16 % ,双阳性 12 %。首发病例传染源尚不清楚 ,可排除水源和食物污染 ,流行和临床特征符合戊肝 。

To investigate the characteristics of Hepatitis E reccurrence in 20 years interval after a widespread epidemic. clinical features and epidemiology were investigated in several villages of shache,Kashi county.The hepatitis E antibody were detected in some cases 6 months after onset of hepatits on reccurrence of outbreak happened 20 years later in the area where had had only sporadic cases during the period of widespread epidemic from 1981 to 1983.The prevalence was 0.64%(167/25979)and the patients distributed among six nearby natural villages ,average number of the patients were 28 per village with a little preponderance and median age was 28.9,all patients were Uigur farmers and their drinking water was from undergrownd well.The epidemic peak lasted from August to December. Clinical manifestation was mild acute jaundiced hepatitis without serious cases and death.some of the investigated cases were selected for detection of anti-HEV antibody 6 months after the reccurrence. Of these,positive rate of anti-HEV IgG and IgM were 68% and 16% respectively, both positive 12%.The first case could not be identified.The contamination of water and food could be excluded. Epidemiology and clinical features were in agreement with those of hepatitis E.The variation of HEV and lasting time of protectine antibody occurence need to be studied.