发热症状监测在前瞻性登革热早期暴发中的应用
|
摘要
目的探索发热症状监测在基层早发现和控制重要传染病中的应用。方法收集某市18个乡镇(A至T)B镇以外的17个乡镇卫生院2014年1月至9月及2013年同期门诊日志发热人数或退热用药数据,对异常事件进行现场流行病学调查和实验室检测。结果 17个乡镇中只有A镇卫生院发热人数异常增加(1 671人),比2013年同期(604人)上升1.8倍。现场采集5例新发发热患者的血清标本,3份登革热病毒核酸Ⅱ型阳性。分离到的2株病毒与DENV2/CN/GZ05/2014分离株的同源性达99%,与来自广东的毒株处于同一进化树分支,均为基因Ⅳ型。通过前瞻性症状监测发现A镇疫情仅持续了1星期,共报告8例患者,而未采取症状监测的该市B镇疫情持续了1个多月,共报告110例患者。结论症状监测在基层实际工作中是可行的,能够及早发现异常疫情,为公共卫生反应赢得时间。
Objective To explore the application of fever syndromic surveillance in early detection and control of important infectious diseases outbreak in towns.Methods The data of fever outpatient or fever medication in 18 township hospitals(A-T)except B of the hospitals electronic information system from January to September,2014 and the same period in 2013 were collected.The abnormal data were investigated by field epidemiological methods and laboratory detection.Results Totally 1 671 fever cases were abnormally reported in Town A only and the case were increased by 1.8 times by comparing with the same period in 2013(604 cases).Serum samples were collected from five new fever patients,and three samples were positive for serotype DNA Ⅱ dengue.The homology of two DENV-2 isolated strains was 99% with the strains of DENV2/CN/GZ05/2014,and they were in the same branch of the phylogenetic tree from Guangdong and both were gene of type IV.The epidemic situation in Town A lasted for 1 weeks only and eight cases were reported by prospective syndromic surveillance.However,the epidemic situation of Town B lasted for more than one month and 110 patients were reported without syndromic surveillance.ConclusionThe syndromic surveillance was feasible in practical work at township level.The syndromic surveillance can find abnormal events early and win time for public health reactions.
Objective To explore the application of fever syndromic surveillance in early detection and control of important infectious diseases outbreak in towns.Methods The data of fever outpatient or fever medication in 18 township hospitals(A-T)except B of the hospitals electronic information system from January to September,2014 and the same period in 2013 were collected.The abnormal data were investigated by field epidemiological methods and laboratory detection.Results Totally 1 671 fever cases were abnormally reported in Town A only and the case were increased by 1.8 times by comparing with the same period in 2013(604 cases).Serum samples were collected from five new fever patients,and three samples were positive for serotype DNA Ⅱ dengue.The homology of two DENV-2 isolated strains was 99% with the strains of DENV2/CN/GZ05/2014,and they were in the same branch of the phylogenetic tree from Guangdong and both were gene of type IV.The epidemic situation in Town A lasted for 1 weeks only and eight cases were reported by prospective syndromic surveillance.However,the epidemic situation of Town B lasted for more than one month and 110 patients were reported without syndromic surveillance.ConclusionThe syndromic surveillance was feasible in practical work at township level.The syndromic surveillance can find abnormal events early and win time for public health reactions.
引文
[1]欧剑鸣,吴生根,陈武,等.福建省2014年登革热流行病学特征分析[J].疾病监测,2016,31(1):14-17.
[2]吴生根,翁育伟,叶雯婧,等.探讨症状监测在疾病暴发早期发现中的作用[J].中华流行病学杂志,2016,37(4):531-534.
[3]王金章,陈宏彬,张拥军,等.2014年福建省南平市登革病毒E基因序列分析[J].中国人兽共患病学报,2016,32(3):281-285.
[4]HENNING KJ.Overview of syndromic surveillance.What is syndromic surveillance[J].USCDC MMWR,2003,53(Suppl.):5-11.
[5]陈超,田鑫,周剑惠,等.流行性腮腺炎疫情时间序列模型建立与应用[J].中国公共卫生,2012,28(2):252-253.
[6]龙璐,严薇荣,许奕华,等.症状监测系统预测预警模型研究进展[J].中国公共卫生,2012,28(5):704-706.
[7]王小皙,杨维中,孙乔,等.上海世界博览会期间浦东新区呼吸道症状监测数据特征与稳定性分析[J].中华流行病学杂志,2012,33(6):562-566.
[8]LAWPOOLSRIS S,KHAMSIRIWATCHARA A,LIULARK W,et al.Real-time monitoring of school absenteeism to enhance disease surveillance:apilot study of a mobile electronic reporting system[J].Jmir Mhealth Uhealth,2014,2(2):e22.
[9]RAZAVI SM,SABOURI-KASHANI A,ZIAEE-ARDKANI H,et al.Trend of diseases among Iranian pilgrims during five consecutive years based on a Syndromic Surveillance System in Hajj[J].Med J Islam Repub Iran,2013,27(4):179-85.
[10]卫生部疾病预防控制局.登革热防治手册[M].2版.北京:人民卫生出版社,2008:81-83.
[11]STANAWAY JD,SHEPARD DS,UNDURRAGA EA,et al.The global burden of dengue:an analysis from the Global Burden of Disease Study 2013[J].Lancet Infect Dis.2016,16(6):712-723.
[12]熊益权,陈清.1978—2014年我国登革热的流行病学分析[J].南方医科大学学报,2014,34(12):1822-1825.
[13]WHO.Dengue:guidelines for diagnosis,treatment,prevention and control[R].WHO/HTM/NTD/DEN/2009.1.Geneva:World Health Organization,2009.
[14]李中杰,张伟东,叶楚楚,等.传染病症状监测系统的设计要点与方法[J].中华流行病学杂志,2010,31(8):942-944.
[2]吴生根,翁育伟,叶雯婧,等.探讨症状监测在疾病暴发早期发现中的作用[J].中华流行病学杂志,2016,37(4):531-534.
[3]王金章,陈宏彬,张拥军,等.2014年福建省南平市登革病毒E基因序列分析[J].中国人兽共患病学报,2016,32(3):281-285.
[4]HENNING KJ.Overview of syndromic surveillance.What is syndromic surveillance[J].USCDC MMWR,2003,53(Suppl.):5-11.
[5]陈超,田鑫,周剑惠,等.流行性腮腺炎疫情时间序列模型建立与应用[J].中国公共卫生,2012,28(2):252-253.
[6]龙璐,严薇荣,许奕华,等.症状监测系统预测预警模型研究进展[J].中国公共卫生,2012,28(5):704-706.
[7]王小皙,杨维中,孙乔,等.上海世界博览会期间浦东新区呼吸道症状监测数据特征与稳定性分析[J].中华流行病学杂志,2012,33(6):562-566.
[8]LAWPOOLSRIS S,KHAMSIRIWATCHARA A,LIULARK W,et al.Real-time monitoring of school absenteeism to enhance disease surveillance:apilot study of a mobile electronic reporting system[J].Jmir Mhealth Uhealth,2014,2(2):e22.
[9]RAZAVI SM,SABOURI-KASHANI A,ZIAEE-ARDKANI H,et al.Trend of diseases among Iranian pilgrims during five consecutive years based on a Syndromic Surveillance System in Hajj[J].Med J Islam Repub Iran,2013,27(4):179-85.
[10]卫生部疾病预防控制局.登革热防治手册[M].2版.北京:人民卫生出版社,2008:81-83.
[11]STANAWAY JD,SHEPARD DS,UNDURRAGA EA,et al.The global burden of dengue:an analysis from the Global Burden of Disease Study 2013[J].Lancet Infect Dis.2016,16(6):712-723.
[12]熊益权,陈清.1978—2014年我国登革热的流行病学分析[J].南方医科大学学报,2014,34(12):1822-1825.
[13]WHO.Dengue:guidelines for diagnosis,treatment,prevention and control[R].WHO/HTM/NTD/DEN/2009.1.Geneva:World Health Organization,2009.
[14]李中杰,张伟东,叶楚楚,等.传染病症状监测系统的设计要点与方法[J].中华流行病学杂志,2010,31(8):942-944.