2005-2019年浙江省金华市伤寒副伤寒流行特征分析  

Epidemiologic characteristics of typhoid fever and paratyphoid fever in Jinhua, Zhejiang, 2005–2019

作　　者：庞志峰[1] 金学怡 金祝平[1] 吴斌[1] Pang Zhifeng;Jin Xueyi;Jin Zhuping;Wu Bin(Jinhua Prefectural Center for Disease Control and Prevention,Jinhua 321002,Zhejiang China;College of Public Health,Zhejiang Traditional Chinese Medical University,Hangzhou 310053,Zhejiang,China)

机构地区：[1]金华市疾病预防控制中心,浙江金华321002 [2]浙江中医药大学公共卫生学院,浙江杭州310053

出　　处：《疾病监测》2020年第8期757-761,共5页Disease Surveillance

基　　金：浙江省金华市科学技术项目(No.2020–4–082)。

摘　　要：目的分析2005—2019年浙江省金华市伤寒副伤寒流行特征,掌握其流行规律,为制定防控策略提供依据。方法采用描述流行病学方法,对来自中国疾病预防控制信息系统中的伤寒副伤寒疫情资料及有关年度专题调查资料和部分实验室检测结果进行分析。结果 2005—2019年金华市共报告伤寒副伤寒1 356例,其中伤寒595例,副伤寒761例,分别占43.88%和56.12%,无死亡病例。年均发病率为1.71/10万,2007年之后发病率呈现逐年下降趋势(χ2=951.941,Ρ=0.000)。金华市伤寒副伤寒夏秋季高发,地区间发病差异较大,浦江县、义乌市和武义县发病率相对高。病例的乡镇(街道)分布具有高度的聚集性,年均发病数≥1例的乡镇(街道)不到总数的1/5但病例数却占到了2/3,累计病例数≥50例的乡镇(街道)仅7个但病例数却占到了43.44%。病例主要发生在0~4岁儿童和15~39岁青壮年,男性发病高于女性,职业分布以农民、民工和散居儿童为主。对21例伤寒和50例副伤寒的临床检测结果进行回顾性调查,14例伤寒和19例副伤寒有明确的细菌培养及鉴定结果。对2株伤寒沙门菌和20株乙型副伤寒沙门菌进行复核,2株伤寒沙门菌和5株乙型副伤寒沙门菌血清型和医疗机构一致,15株乙型副伤寒沙门菌血清型经鉴定为非伤寒、副伤寒沙门菌。结论 2005年以来金华市伤寒副伤寒发病逐步减少,病例分布有高度的地区聚集性、一定的季节性和人群聚集性。金华市所报告病例中存在一定比例的误报,且该市尚未规范开展伤寒副伤寒病原学监测,无法掌握其菌型变迁、耐药谱变化等情况。今后应进一步加强医疗机构临床医生和实验室检测人员伤寒副伤寒诊断标准、检测技术的培训,并应尽快规范开展流行菌株病原学监测工作。Objective To analyze the epidemiologic characteristics of typhoid fever and paratyphoid fever in Jinhua,Zhejiang province, from 2005 to 2019, and provide basis for the formulation of prevention and control strategies. Methods The method of descriptive epidemiology was used to analyze the incidence data of typhoid fever and paratyphoid fever collected from the disease prevention and control information system in China, the related annual thematic survey data and some laboratory test results. Results A total of 1 356 cases of typhoid fever and paratyphoid fever were reported in Jinhua from2005 to 2019, including 595 typhoid fever cases and 761 paratyphoid fever cases, accounting for 43.88% and 56.12%respectively. No deaths were reported. The average annual incidence rate was 1.71/100 000. After 2007, the incidence showed a downward trend year by year( χ2=951.941, P=0.000). The incidence of typhoid fever and paratyphoid fever was high in summer and autumn, and varied with area, the incidence rates were relatively high in Pujiang, Yiwu and Wuyi of Jinhua. The cases were mainly distributed in <1/5 townships(streets), accounting for 2/3 of the total cases. Only 7 townships(streets) had cumulative case numbers ≥ 50, but their cases accounted for 43.44%. The cases mainly occurred in children aged 0–4 years and young adults aged 15–39 years. The incidence in men was higher than that in women, and most cases were farmers,migrant workers and children outside child care setting. The clinical detection results of 21 cases of typhoid fever and 50 cases of paratyphoid fever were investigated retrospectively, 14 cases of typhoid fever and 19 cases of paratyphoid fever had definite results of bacterial culture and identification. Two strains of Salmonella typhi and 20 strains of Salmonella paratyphi B were reexamined. The detection results of serotypes of 2 strains of S. typhi and 5 strains of S. paratyphi B were consistent with previous detection results. Fifteen strains of S. paratyphi B were identified as non-typhoid Sa

关 键 词：伤寒 副伤寒 沙门菌 流行特征 防制措施 

分 类 号：R211[医药卫生—中医学] R516.3