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一起不明原因脑炎爆发疫情的调查

Investigation on an Outbreak of Encephalitis of Unknown Reason
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摘要 目的通过对不明原因脑炎病例的现场调查,分析确认疫情的性质和原因。方法通过规范的现场流行病学调查,对收集到的实验室检测、临床表现和流行病学资料进行综合分析。结果2003年5月8日~6月2日,某市“不明原因脑炎”发病34例,罹患率2.03/10万;死亡4例,病死率11.76%。发生不明原因脑炎病例疫情的乡(镇),1~4月应种儿童(1~15岁)流行性乙型脑炎(乙脑)疫苗的接种率仅为21.82%。当地卫生环境较差,蚊虫孳生严重,未开展有效的预防,三带喙库蚊是当地优势蚊种。病例皆急起发热,体温≥38.5℃,伴嗜睡、抽搐、喷射状呕吐等症状。实验室检测患者的脑脊液压力增高,检测的标本数占病例数的67.65%(23/34),标本中乙脑IgM阳性率82%(19/23)。结论这次“不明原因脑炎”疫情最终确认为一起乙脑疫情。疫情发生的主要原因是2003年5月以前乙脑疫苗接种率低。敏感和质量可靠的诊断试剂.对于这次疫情的判定起了重要作用。 Objective According to field investigation about Encephalitis cases of unknown reason, the character and reason were confirmed. Method Through particular and standard field epidemiological investigation, laboratory test data, epidemological and clinical symptom information of the cases were analyzed. Results There' re 34 Encephalitis cases of unknown reasons from Mar. 8, 2003 to Jun. 9, 2003. The attack rate is 20.3/million, death case is 4, fatality rate is 11.76%. In the areas which have cases, inoculation rate of Japanese Encephalitis (JE)vaccine among 1 - 15 years old children that should be immuned from Jan. to Apr. covered 21.82%. The health status was poor, mosquito could be seen everywhere. No effective measures were done for prevention from mosquito. Culex tritaeniorhynchus was the most popular kind of mosquito in these areas. All cases were acute, with fever (the tempreture was up 38.5℃ ), snooze, twitch, spraying vomit. JE IgM antibody positive rate was 82 % and labortary diagnosis cases were 67.65 % of total cases. Conclusion We confirmed that it was an outbreak of JE. The reason was low immunization rate of JE vaccine before Mar. 2003. Sensitivity and credible diagnose reagent is an important role in this confirming progress.
作者 杨慧军 黎学铭 杨进业 陈杰 耿文奎 龚健 刘伟 李荣成 莫建军 莫兆军 YANG Hui-jun, LI Xue-ming,YANG jin-ye, et al. ( Shanxi Provincial Center for Disease Control and Prevention, Taiyuan 030012, Shanxi , China )
出处 《中国计划免疫》 2006年第3期203-205,共3页 Chinese Journal of Vaccines and Immunization
关键词 不明原因 脑炎 爆发 调查 Unknown reason Encephalitis Outbreak Investigation
作者简介 杨慧军(1970-),男,山西省太原市人,山西省疾病预防控制中心主管医师,中国疾病预防控制中心在读硕士研究生,主要从事卫生应急工作。
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