安康市3所学校细菌性痢疾暴发疫情特征

原凌云; 陈果; 张义; 宁少奇; 张展魁; 杨敏; 陈元慧; 焦欢; 杜冬冬; 刘万静; 姜伟

doi:10.16835/j.cnki.1000-9817.2021.06.029

安康市3所学校细菌性痢疾暴发疫情特征

doi: 10.16835/j.cnki.1000-9817.2021.06.029

1.
陕西省安康市疾病预防控制中心传染病控制科，725000
2.
陕西省疾病预防控制中心传染病防治所
3.
安康市汉滨区疾病预防控制中心传染病控制科

详细信息

作者简介:
原凌云(1982-)，女，陕西渭南人，硕士，副主任医师，主要研究方向为疾病预防与控制

通讯作者:
陈果，E-mail: chenguo87@126.com

中图分类号: R183 R181.3 R516.4
计量
- 文章访问数: 661
- HTML全文浏览量: 405
- PDF下载量: 40
- 被引次数: 0
出版历程
- 收稿日期: 2020-10-07
- 修回日期: 2021-02-13
- 网络出版日期: 2021-06-22
- 刊出日期: 2021-06-25

An investigation of bacillary dysentery outbreaks in three schools in Ankang

1.
Infectious Disease Control Division, Ankang Center for Disease Control and Prevention, Ankang(725000), Shaanxi Province, China

摘要

摘要: 目的了解安康市某3所学校细菌性痢疾暴发原因，分析疫情发生特点，积累疫情处置经验，为以后疫情防控提供科学依据。方法建立病例定义，选取3所学校(A、B、C)全部学生和教职员工中所有疑似病例、可能病例、确诊病例开展流行病学调查，选择对照组进行病例对照分析，采集相关样品进行实验室检测。结果 3所学校共发病132例，均为学生，罹患率为17.74%；A幼儿园罹患率为20.00%、B中心小学罹患率为21.74%、C初级中学罹患率为11.61%。队列和病例对照研究提示学校为暴露场所，学校内生水洗手为危险因素。实验室检测9份粪便样品，8份为志贺菌阳性，阳性率为88.99%，学校管网末梢、食堂水桶水样、下水管道地漏检出志贺菌。结论该疫情是一起由志贺菌引起3所学校细菌性痢疾暴发疫情，可能由于3所学校生活用水开学前被粪便污染导致。建议加强农村集中供水和施工管理，各级监督部门加大监管力度，各级学校开学前做好卫生清洁和消毒工作。
- 志贺菌, 痢疾 /
- 疾病暴发流行 /
- 发病率 /
- 学生 /
- 流行病学研究
Abstract: Objective To investigate risk factors and epidemiological characteristics of bacillary dysentery outbreaks in three schools, and to provide scientific basis for the prevention and control of the epidemic in the future. Methods Case definition was established. All suspected, possible and confirmed cases of all students and faculty members from 3 schools (A, B, C) were selected for epidemiological investigation. Control group was used for case-control analysis, and relevant samples were collected for laboratory testing. Results A total of 132 cases were found in 3 schools, all of which were from students, with the incidence rate of 17.74%. The morbidity in kindergarten A was 20.00%, in center primary school B it was 21.74%, and in junior middle school C it was 11.61%. Cohort studies and case-control studies suggested that schools are exposed places and that washing hands with raw water in schools was possible risk factor. Nine stool samples were tested in laboratory, among which 8 were positive for Shigella(88.99%), and Shigella was detected in the end nodes of school's pipeline network, the water samples from canteen bucket, and the floor drains of sewer pipe. Conclusion The bacillary dysentery outbreaks in 3 schools was caused by Shigella, which may be due to fecal contamination of domestic water in 3 schools before the start of the school year. It is suggested to strengthen the management of centralized water supply and construction in rural areas, intensify the supervision at all levels, and sanitation and disinfection before school opens at all levels.
- Shigella, dysentery /
- Disease outbreaks /
- Incidence /
- Students /
- Epidemiologic studies

HTML全文

图 1 3所学校细菌性痢疾暴发疫情时间分布

Figure 1. The time distribution of bacillary dysentery outbreaks in three schools

下载: 全尺寸图片幻灯片

表 1 B校细菌性痢疾暴发患者病例对照研究结果

Table 1. Case-control study results of patients with bacillary dysentery outbreaks in B school

组别	例数	生水洗手	生水洗脸	饮食
组别	例数	生水洗手	生水洗脸	3日晚餐	4日早餐	4日午餐	4日晚餐	5日早餐
病例组	21	18(85.71)	18(85.71)	18(85.71)	20(95.24)	10(47.62)	7(33.33)	5(23.81)
对照组	21	12(57.14)	17(80.95)	15(71.43)	19(90.48)	12(57.14)	5(23.81)	6(28.57)
χ²值		4.20	10.17	1.27	0.36	0.38	0.48	0.12
P值		0.04	0.68	0.26	0.55	0.54	0.50	0.73
注：()内数字为报告率/%。

下载: 导出CSV

参考文献(9)

[1]	李红军, 杨艳娜, 杜娟, 等. 某大学一起细菌性痢疾暴发疫情流行病学调查[J]. 首都公共卫生, 2019, 13(4): 199-201, 208. https://www.cnki.com.cn/Article/CJFDTOTAL-SDGW201904011.htm LI H J, YANG Y N, DU J, et al. Epidemiological investigation of an outbreak of bacterial dysentery in a university[J]. Capital J Public Health, 2019, 13(4): 199-201, 208. https://www.cnki.com.cn/Article/CJFDTOTAL-SDGW201904011.htm
[2]	潘欢弘, 刘晓青, 杨富强, 等. 某中学一起细菌性痢疾暴发疫情流行病学调查[J]. 应用预防医学, 2015, 21(6): 413-414, 417. doi: 10.3969/j.issn.1673-758X.2015.06.015 PAN H H, LIU X Q, YANG F Q, et al. Epidemiological investigation of an outbreak of bacterial dysentery in a middle school[J]. Appl Prev Med, 2015, 21(6): 413-414, 417. doi: 10.3969/j.issn.1673-758X.2015.06.015
[3]	经正敏, 马涛, 冯智, 等. 南京市两所高校细菌性痢疾暴发调查[J]. 中华卫生应急电子杂志, 2016, 2(6): 358-364. https://www.cnki.com.cn/Article/CJFDTOTAL-YJWS201606006.htm JING Z M, MA T, FENG Z, et al. Outbreak investigation of bacterial dysentery in two colleges in NanJing[J]. Chin J Hyg Res(Elet Edit), 2016, 2(6): 358-364. https://www.cnki.com.cn/Article/CJFDTOTAL-YJWS201606006.htm
[4]	国家卫生健康委员会. 全国细菌性痢疾监测方案(试行)[A]. [2015-08-22]. http://www.nhc.gov.cn/wjw/zcjd/201304/ac06031652644d308429d8a5a36ff443.shtml. National Health Commission of the People's Republic of China. National Bacillary Dysentery Program[A]. [2015-08-22]. http://www.nhc.gov.cn/wjw/zcjd/201304/ac06031652644d308429d8a5a36ff443.shtml.
[5]	李兰娟, 任红, 高志良, 等. 传染病学[M]. 9版. 北京: 人民卫生出版社, 2018: 182-187. LI L J, REN H, GAO Z L, et al. Infectious Diseases[M]. 9nd Edition BeiJing: People's Medical Publishing House, 2018: 182-187.
[6]	龙术国, 熊新平, 杨健, 等. 醴陵市某学校一起菌痢暴发调查[J]. 实用预防医学, 2016, 23(8): 975-977. doi: 10.3969/j.issn.1006-3110.2016.08.024 LONG S G, XIONG X P, YANG J, et al. Outbreak investigation of bacterial dysentery in school in Li Ling[J]. Pract Prevent Med, 2016, 23(8): 975-977. doi: 10.3969/j.issn.1006-3110.2016.08.024
[7]	常昭瑞, 张静, 张伟东, 等. 2008-2011年我国细菌性痢疾暴发疫情分析[J]. 中国食品卫生杂志, 2012, 24(6): 554-558. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSPZ201206013.htm CHANG Z R, ZHANG J, ZHANG W D, et al. Analysis on bacillary dysentery outbreaks in China, 2008-2011[J]. Chin J Food Hyg, 2012, 24(6): 554-558. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSPZ201206013.htm
[8]	黄兆勇. 食源性疾病的流行和监测现状[J]. 应用预防医学, 2012, 18(2): 125-128. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX201202024.htm HUANG Z Y. Foodborne diseases of epidemic and monitoring situation[J]. J Appl Prevent Med, 2012, 18(2): 125-128. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYX201202024.htm
[9]	孟昭伟, 雷佩玉, 郑晶利, 等. 2015年陕西省农村饮水工程水质监测结果分析[J]. 实用预防医学, 2018, 25(11): 1321-1324. doi: 10.3969/j.issn.1006-3110.2018.11.010 MENG Z W, LEI P Y, ZHENG J L, et al. Monitoring results of water quality in rural drinking water safety projects in Shaanxi Province, 2015[J]. Pract Prev Med, 2018, 25(11): 1321-1324. doi: 10.3969/j.issn.1006-3110.2018.11.010