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目的查明2010年云南省元江县发生的伤寒、副伤寒疫情的危险因素,为有效控制疫情提供依据。方法对2010-10/12月份云南省元江县发生的伤寒、副伤寒疫情的实验室确诊病例进行流行病学个案调查,并采用1∶1配对的病例对照研究分析可能的危险因素,对出院病例、健康人群和外环境采集标本进行实验室检测。结果该起疫情共发生伤寒、副伤寒593例,发病率为288.49/10万,实验室确诊病例509例,其中甲型副伤寒病例497例,占实验室确诊病例的97.67%;发病曲线呈单峰状,病例分布以县城所在地为中心波及到周边乡镇,发病以25~49岁的青壮年为主;病例对照研究显示:食用生冷食品的危险为对照组的3.644倍(OR=3.644,CI95%:1.507~8.815,P<0.05));病后带菌率为8.06%,健康带菌率为8.0%;同时从用于浇灌菜地的主要污水源头检出1株甲型副伤寒沙门菌。结论此次疫情可能是由食用受甲型副伤寒沙门菌污染的生、冷食品所引起。
Objective To identify the risk factors of typhoid and paratyphoid outbreaks in Yuanjiang County in Yunnan Province in 2010 and provide evidence for effective control of the outbreak. Methods The epidemiological investigation of laboratory confirmed cases of typhoid and paratyphoid outbreaks in Yuanjiang County of Yunnan Province from January to December in December 2010 was conducted. The case-control study of 1: 1 matched cases was used to analyze the possible risk factors and the discharge cases , Healthy people and external environment collected specimens for laboratory testing. Results A total of 593 cases of typhoid fever and paratyphoid fever were found. The incidence rate was 288.49 / 100 000. There were 509 laboratory confirmed cases, of which 497 cases were Paratyphoid A, accounting for 97.67% of the confirmed cases in the laboratory. The incidence curve was single The distribution of the peak shape and the distribution of the cases took the location of the county seat as the center to the surrounding towns and villages. The incidence was mainly in young adults aged 25 to 49 years. Case-control study showed that the risk of eating cold food was 3.644 times of the control group (OR = 3.644, CI95% : 1.507 ~ 8.815, P <0.05). After the disease, the rate of infection was 8.06% and the rate of healthy infection was 8.0%. At the same time, one strain of Salmonella paratyphi A was detected from the main wastewater source used for watering vegetables. Conclusion The outbreak may be caused by the consumption of raw and cold foods contaminated with Salmonella typhi.