上海甲型肝炎流行因素分析  

Epidemiological Study on Epidemic of Hepatitis A in Shanghai

作　　者：肖再平[1] 徐志一[2] 李永良 苏竹君 谈楚仪 钱婉华 

机构地区：[1]上海生物制品研究所,200052 [2]上海医科大学 [3]上海市徐汇区卫生防疫站 [4]上海市闵行区卫生防疫站 [5]上海市长宁区卫生防疫站

出　　处：《中国公共卫生学报》1991年第3期149-152,共4页

摘　　要：1988年,上海市区甲型肝炎流行。流行期间随机抽取1830份居民血清,用Abbott酶标试剂检测抗-HAV与抗-HAV IgM,并询问食毛蚶、发病情况。易感人群食毛蚶率达41.46％,食毛蚶者罹患率为32.35％,隐性感染率为5.51％。未食毛蚶人群依次为1.82％、3.13％。显性感染与隐性感染相对危险度分别为17.75和1.76。87.43％的病例与食蚶有关。食蚶量越大,发病率越高,呈剂量效应关系,20～49岁年龄组,食蚶率最高(46％～58％),罹患率亦最高(21％～29％),流行前、后人群易感率分别为35.85％和29.18％,1988年1～2月份出现的3次发病高峰,同3次毛蚶大量供应的日期分别相距30天左右。相当于一个平均潜伏期。1月4日禁止毛蚶出售,40天后发病高峰下降。本次血清流行病学研究表明,该次流行由生食毛蚶所致。An apidemic of hepatitis A occurred in Shai- ghai in 1988. During the epidemic period, 1830 serum specimens were randomly collected from Local residents and tested for anti--HAV and anti- HAV IgM. These residents were also inquired of whether they had eaten raw clam. The rate of eating raw clam in susceptibles reached 41. 46%. In clam-eating group, the attack rate was 32. 35% and the subclinical infection rate was 5. 51%. The rates in the individuals who hadn't eaten raw clam were 1. 82% and 3. 31% respectively. 87. 43% cases were associated with eating clam. The dose-effect rela- tionship between clam consumption and the attack rate was demonstrated. Before and after the outb- reak the percentages of susceptibles to hepatitis A virus were 35. 85% and 29. 18% respectively. The sale of clam was forbidden by the Shanghai muni- cipal goverment on Jan. 4 because of the diarrhea caused by contaminated clam. Forty days later, the attack rate drastically declined. This sero-epidemio- logical study showed that the clam was the vehicle of the epidemic of the hepatitis A in Shanghai in 1988.

关 键 词：甲型肝炎 毛蚶 流行病学 

分 类 号：R512.610.1[医药卫生—内科学]