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目的调查分析2015年云南省中缅边境的镇康县一起甲型病毒性肝炎(甲肝)暴发疫情流行特征和原因,提出针对性预防控制措施。方法采用现场流行病调查、病例对照设计等方法收集甲肝发病和相关影响因素数据,进行流行病学分析。结果 2015年4月4日至9月15日镇康县报告本地和缅甸籍甲肝病例75例,发病率为83.65/10万。2个自然村寨和1所村小学发病呈聚集性。入境缅甸边民较多的南伞镇本地感染病例的发病率显著高于其他乡镇(x~2=36.65,P=0.000)。本地感染病例中0-9岁儿童发病构成(13.16%)显著低于缅甸感染病例中同年龄儿童的发病构成(45.16%)(x~2=8.76,P=0.003)。本地感染病例以学生为主(50.00%),缅甸感染病例以散居儿童为主(45.16%)。本次暴发可能与食物污染有关,并存在人-人传播模式。结论中缅边境县甲肝发病从缅甸传入传播的风险较大,加强甲肝疫苗接种、及时发现和处置聚集性疫情是控制甲肝暴发的有效手段。
Objective To investigate and analyze the epidemiological characteristics and causes of hepatitis A (A) outbreak in Zhenkang County along the Sino-Myanmar border in Yunnan Province in 2015, and to put forward targeted prevention and control measures. Methods The prevalence of hepatitis A and case-control design were used to collect the data of incidence and related factors of hepatitis A, and the epidemiological analysis was conducted. Results From April 4 to September 15, 2015, 75 cases of hepatitis A in local and Burmese were reported in Zhenkang County, with an incidence rate of 83.65 / 100 000. 2 villages and 1 village primary school was clustered incidence. The incidence of local infections in Nam Umbrella Township with more Myanmar residents was significantly higher than that in other towns (x ~ 2 = 36.65, P = 0.000). The incidence of locally-infected children aged 0-9 years (13.16%) was significantly lower than that of children of the same age in Myanmar (45.16%) (x 2 = 8.76, P = 0.003). The number of local cases of infection was mainly of students (50.00%). The majority of cases of infectious diseases in Myanmar were scattered children (45.16%). The outbreak may be related to food contamination, and there is a human-human transmission mode. Conclusion The incidence of hepatitis A in border areas of China and Myanmar is at a higher risk of transmission from Myanmar. Strengthening the vaccination against hepatitis A and timely detection and handling of aggregated epidemic is an effective means to control the outbreak of hepatitis A.