一起乡镇中学甲型病毒性肝炎暴发疫情的流行病学调查和控制措施  

Epidemiological investigation and control measures of a hepatitis A outbreak in a township middle school

作　　者：刘义威[1] 梁炯明[1] 卢耀娟[1] 胡昱[1] 陈锦秀[2] 郑志刚[2] 

机构地区：[1]广西玉林市疾病预防控制中心,广西玉林537000 [2]广西博白县疾病预防控制中心

出　　处：《疾病监测》2008年第9期554-557,共4页Disease Surveillance

摘　　要：目的调查分析一起乡镇中学甲型病毒性肝炎(甲肝)暴发疫情原因和特点,探讨暴发因素和控制措施。方法应用描述性流行病学方法对一起乡镇中学甲肝暴发疫情进行分析。结果广西博白县凤山镇甲肝暴发疫情共报告病例69例,罹患率为3.62%,其中凤山镇二中、凤山小学罹患率分别为4.58%、0.45%,经统计学检验,两者有显著差异;二中寄宿生发病63例,罹患率为6.09%(63/1035),走读生发病3例,罹患率为0.10%(3/301),两者差异有统计学意义(χ2=12.87,P<0.05)。发病时间主要集中在首发病例发病后的11～20d,占发病总数的75.36%。发病年龄主要集中在14～16岁,占发病总数的79.71%。结论学校环境卫生差、水质受污染,人群甲肝疫苗的免疫率低、存在大量的免疫空白,疫情报告不及时、未能及时采取有效控制措施,以及学生未能养成良好的卫生习惯是本次疫情暴发原因。Objective The study was designed to investigate the cause and the epidemiological characteristics of a hepatitis A outbreak in a rural middle school, and discuss the outbreak factors and control measures. Methods Descriptive epidemiological analysis was performed on this outbreak. Results A total of 69 hepatiutis A eases were reported during the outbreak in Fengshan town, Bobai county, Guangxi with an attack rate of 3.62%. The attack rates in Fengshan No.2 middle school and in Fengshan primary school were 4.58% and 0.45% respectively with significant statistical difference between them. In Fenghsan No.2 middle school, 63 eases occurred among the resident students with the attack rate of 6.09% （63/1035）, while 3 cases ocemTed among the nonresident students with the attack rate of 0.10% （3/301）, and the two rates had statistical difference （X^2 = 12.87, P 〈0.05）. Most hepatitis A cases occurred within 11-20 days after the occurrence of the first ease, accounting for 75.36% of total cases, and most eases were at the age of 14-16 years, accounting for 79.71% of total eases. Conclusion Poor sanitation and water pollution in school, low coverage rate of hepatitis A vaccine, immunization gaps, delayed report of the outbreak, failure to take effective control measures and poor hygiene habits among the students were the causes of this outbreak. By comprehensive prevention and control measures such as announcing the infection source, strict management of infection source, disinfection in epidemic area and protecting susceptible population, the outbreak was controlled effectively.

关 键 词：甲型肝炎 暴发疫情 控制 

分 类 号：R512.61[医药卫生—内科学]