2017年浙江省杭州市拱墅区登革热暴发疫情调查分析
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摘要
目的调查2017年浙江省杭州市拱墅区登革热暴发疫情情况及原因,为今后开展登革热防控工作提供参考和依据。方法通过对社区、医院进行主动搜索,对2017年杭州市拱墅区登革热病例进行流行病学个案调查,掌握病例的临床表现、流行病学资料,并对疫情暴发原因进行分析。结果本次疫情共报告登革热病例327例,发病高峰为8月21日至9月15日,病例主要集中分布在运河沿线的4个街道,以>50岁人员为主,占全部病例的61.16%,职业以离退人员(123例,占37.61%)及家务及待业(76例,占23.24%)为主。病例发病到诊断时间间隔平均为5.20 d,其中住院病例为3 d(2～5 d),非住院病例为5 d(3～7 d),两者差异有统计学意义(Ζ=6.383,P<0.001)。结论本次暴发疫情可能是由登革热输入病例或隐性感染者引起的本地传播,建议加强医疗机构登革热诊断水平,提高登革热监测敏感性,长效运行登革热"网格区域责任制",确保及早发现和控制疫情。
Objective To understand the cause of an outbreak of dengue fever occurred in Gongshu district of Hangzhu,Zhejiang province, in 2017, and provide evidence for the prevention and control of dengue fever in the future. Methods Epidemiological survey was conducted through active search of dengue fever cases in hospitals and communities to describe the epidemiological characteristics of the cases and analyze the cause of the outbreak. Results A total of 327 cases were reported in this outbreak, most cases occurred from 21 August to 15 September and distributed in 4 communities along with the Beijing-Hangzhou Grand Canal. The cases were mainly the retired(123, 37.61%) and the jobless(76, 23.24%) and aged >50 years(61.16%). The average interval between onset and diagnosis was 5.20 days, and the interval was 3 days(2–5 d) in inpatient group and 5 days(3–7 d) in outpatient group, the difference was significant(Ζ=6.383, P<0.001). Conclusion This outbreak, a local transmission of dengue fever, might be caused by imported or latent infection cases. It is suggested to improve the diagnosis and surveillance of dengue fever in hospitals at all levels and implement community responsibility protocol regularly for the timely detection and control of dengue fever epidemic in the future.
Objective To understand the cause of an outbreak of dengue fever occurred in Gongshu district of Hangzhu,Zhejiang province, in 2017, and provide evidence for the prevention and control of dengue fever in the future. Methods Epidemiological survey was conducted through active search of dengue fever cases in hospitals and communities to describe the epidemiological characteristics of the cases and analyze the cause of the outbreak. Results A total of 327 cases were reported in this outbreak, most cases occurred from 21 August to 15 September and distributed in 4 communities along with the Beijing-Hangzhou Grand Canal. The cases were mainly the retired(123, 37.61%) and the jobless(76, 23.24%) and aged >50 years(61.16%). The average interval between onset and diagnosis was 5.20 days, and the interval was 3 days(2–5 d) in inpatient group and 5 days(3–7 d) in outpatient group, the difference was significant(Ζ=6.383, P<0.001). Conclusion This outbreak, a local transmission of dengue fever, might be caused by imported or latent infection cases. It is suggested to improve the diagnosis and surveillance of dengue fever in hospitals at all levels and implement community responsibility protocol regularly for the timely detection and control of dengue fever epidemic in the future.
引文
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[11]王慧敏,詹伟祥,陈培松,等.广州市区疑似登革热643例临床特征分析[J].热带医学杂志,2015,15(10):1396-1398,1445.Wang HM,Zhan WX,Chen PS,et al.Retrospective study on clinical characteristics of 643 patients with suspected dengue in Guangzhou[J].J Trop Med,2015,15(10):1396-1398,1445.
[12]叶子,黄应雄,蒋鹏,等.2014年广州地区158例登革热住院患者临床特征分析[J].中华危重病急救医学,2015,27(4):300-304,305.DOI:10.3760/cma.j.issn.2095-4352.2015.04.015.Ye Z,Huang YX,Jiang P,et al.Analysis of clinical characteristic of 158 inpatients with dengue fever in Guangzhou area during the2014 epidemic[J].Chin Crit Care Med,2015,27(4):300-304,305.DOI:10.3760/cma.j.issn.2095-4352.2015.04.015.
[13]谭晓君,何瑞华,王建华,等.2014年秋季佛山地区登革热临床特点及误漏诊原因分析[J].临床误诊漏诊,2015,28(4):51-53.DOI:10.3969/j.issn.1002-3429.2015.04.014.Tan XJ,He RH,Wang JH,et al.Analysis of clinical characteristics and causes of diagnostic errors of dengue fever in Foshan district in the autumn of 2014[J].Clin Misdiagn Misther,2015,28(4):51-53.DOI:10.3969/j.issn.1002-3429.2015.04.014.
[14]王成岗,刘起勇,姜宝法.中国登革热患者发病至确诊间隔时间及其影响因素分析[J].中华流行病学杂志,2012,33(10):1064-1066.DOI:10.3760/cma.j.issn.0254-6450.2012.10.016.Wang CG,Liu QY,Jiang BF.Time between the onset and diagnosis of dengue fever and related influencing factors in China[J].Chin J Epidemiol,2012,33(10):1064-1066.DOI:10.3760/cma.j.issn.0254-6450.2012.10.016.
[2]Brady OJ,Gething PW,Bhatt S,et al.Refining the global spatial limits of dengue virus transmission by evidence-based consensus[J].PLoS Negl Trop Dis,2012,6(8):e1760.DOI:10.1371/journal.pntd.0001760.
[3]陈炜,王金章,张拥军,等.福建省2009-2014年登革热流行特征分析[J].中国人兽共患病学报,2015,31(6):589-591.DOI:10.3969/cjz.j.issn.1002-2694.2015.06.020.Chen W,Wang JZ,Zhang YJ,et al.Epidemiological characterization of dengue cases in Fujian province,2009-2014[J].Chin J Zoon,2015,31(6):589-591.DOI:10.3969/cjz.j.issn.1002-2694.2015.06.020.
[4]林钟宇,潘华峰,王正,等.2014年广东登革热流行趋势与防控对策[J].卫生软科学,2015,29(9):590-592.Lin ZY,Pan HF,Wang Z,et al.Study of dengue fever epidemic trend and prevention and control countermeasure in 2014 in Guangdong[J].Soft Sci Health,2015,29(9):590-592.
[5]牟笛,何泱霓,陈秋兰,等.我国2016年登革热输入和本地病例流行病学特征比较[J].疾病监测,2017,32(3):184-189.DOI:10.3784/J.issn.1003-9961.2017.03.004.Mou D,He YN,Chen QL,et al.Comparison of epidemiological features between imported and indigenous dengue fever cases in China[J].Dis Surveill,2017,32(3):184-189.DOI:10.3784/J.issn.1003-9961.2017.03.004.
[6]孙昼,邱晓枫,任晓宾,等.2015年杭州市首例本地感染登革热病例病原溯源调查[J].疾病监测,2017,32(2):132-134.DOI:10.3784/j.issn.1003-9961.2017.02.012.Sun Z,Qiu XF,Ren XB,et al.Molecular tracing of pathogen of the first local dengue fever case in Hangzhou[J].Dis Surveill,2017,32(2):132-134.DOI:10.3784/j.issn.1003-9961.2017.02.012.
[7]吴瑜燕,凌锋,龚震宇,等.浙江省某地登革热聚集性疫情发现延迟原因分析[J].预防医学,2017,29(2):113-116.DOI:10.19485/j.cnki.issn1007-0931.2017.02.002.Wu YY,Ling F,Gong ZY,et al.An analysis on the reasons for the delay in discovering dengue fever outbreak in Zhejiang province[J].Prev Med,2017,29(2):113-116.DOI:10.19485/j.cnki.issn1007-0931.2017.02.002.
[8]曾玉华.2014年深圳市登革热疫情流行病学特点分析[J].传染病信息,2016,29(5):288-290,294.DOI:10.3969/j.issn.1007-8134.2016.05.008.Zeng YH.Epidemiological characteristics of dengue fever in Shenzhen in 2014[J].Infect Dis Inf,2016,29(5):288-290,294.DOI:10.3969/j.issn.1007-8134.2016.05.008.
[9]傅燕艳,戴传文,叶俊,等.深圳市南山区2014年登革热疫情流行病学特征分析[J].南昌大学学报:医学版,2016,56(2):77-79.DOI:10.13764/j.cnki.ncdm.2016.02.021.Fu YY,Dai CW,Ye J,et al.Epidemiological characteristics of dengue fever in Nanshan district of Shenzhen city in 2014[J].JNanchang Univ:Med Sci,2016,56(2):77-79.DOI:10.13764/j.cnki.ncdm.2016.02.021.
[10]吴楠,梅树江,叶俊,等.结合地理信息系统的登革热空间分布研究[J].牡丹江医学院学报,2015,36(3):105-107.DOI:10.13799/j.cnki.mdjyxyxb.2015.03.038.Wu N,Mei SJ,Ye J,et al.Study on space distribution of dengue fever with geographic information system[J].J MuDanJiang Med Univ,2015,36(3):105-107.DOI:10.13799/j.cnki.mdjyxyxb.2015.03.038.
[11]王慧敏,詹伟祥,陈培松,等.广州市区疑似登革热643例临床特征分析[J].热带医学杂志,2015,15(10):1396-1398,1445.Wang HM,Zhan WX,Chen PS,et al.Retrospective study on clinical characteristics of 643 patients with suspected dengue in Guangzhou[J].J Trop Med,2015,15(10):1396-1398,1445.
[12]叶子,黄应雄,蒋鹏,等.2014年广州地区158例登革热住院患者临床特征分析[J].中华危重病急救医学,2015,27(4):300-304,305.DOI:10.3760/cma.j.issn.2095-4352.2015.04.015.Ye Z,Huang YX,Jiang P,et al.Analysis of clinical characteristic of 158 inpatients with dengue fever in Guangzhou area during the2014 epidemic[J].Chin Crit Care Med,2015,27(4):300-304,305.DOI:10.3760/cma.j.issn.2095-4352.2015.04.015.
[13]谭晓君,何瑞华,王建华,等.2014年秋季佛山地区登革热临床特点及误漏诊原因分析[J].临床误诊漏诊,2015,28(4):51-53.DOI:10.3969/j.issn.1002-3429.2015.04.014.Tan XJ,He RH,Wang JH,et al.Analysis of clinical characteristics and causes of diagnostic errors of dengue fever in Foshan district in the autumn of 2014[J].Clin Misdiagn Misther,2015,28(4):51-53.DOI:10.3969/j.issn.1002-3429.2015.04.014.
[14]王成岗,刘起勇,姜宝法.中国登革热患者发病至确诊间隔时间及其影响因素分析[J].中华流行病学杂志,2012,33(10):1064-1066.DOI:10.3760/cma.j.issn.0254-6450.2012.10.016.Wang CG,Liu QY,Jiang BF.Time between the onset and diagnosis of dengue fever and related influencing factors in China[J].Chin J Epidemiol,2012,33(10):1064-1066.DOI:10.3760/cma.j.issn.0254-6450.2012.10.016.