一起水源水污染引起甲型副伤寒暴发的流行病学调查分析  

Epidemiological Survey and Analysis on A Contaminated Water Source Caused Outbreak of Paratyphoid A

作　　者：满勐 Man Meng(Shizong Center for Disease Control and Prevention,Qujing 655700,Yunnan Province,China)

机构地区：[1]师宗县疾病预防控制中心,云南曲靖655700

出　　处：《中国社区医师》2023年第14期148-150,共3页Chinese Community Doctors

摘　　要：目的:分析一起水源水污染引起甲型副伤寒暴发的流行病学调查情况,为伤寒疫情的防控提供依据。方法:选取2017年5月31日—7月9日在县级以上人民医院确诊为伤寒、副伤寒且居住在葵山镇的患者作为研究对象。疫情资料、实验室资料来源于师宗县疾病预防控制中心,气象资料来源于师宗县气象局,其他现场材料经现场调查获得。分析疫情暴发的危险因素和传播途径,采集相关标本送上级实验室检测,并应用流行病学方法进行分析。结果:饮用水源排污渠道不畅,污水四溢,高处有渗涌的厕所、粪堆、小型养牛场,经过大雨冲刷渗漏而污染水源。不久后病例集中暴发,水质检测菌落总数、大肠菌群严重超标,病例分布与水源地供水范围基本一致。经对照分析发现,饮生水OR(95%CI)为11.5(1.4~92.8),认为饮用生水是本次伤寒、甲型副伤寒暴发流行的危险因素。结论:此次疫情由水源水污染引起,居民常引用生水是疫情暴发的危险因素,相关部门应制定针对性防控措施,加强水污染管理,避免疫情再次暴发。Objective:To analyze the epidemiological survey on an outbreak of paratyphoid A caused by the contaminated water source,and provide basis for the prevention and control of typhoid epidemic.Methods:Patients diagnosed with typhoid fever and paratyphoid fever in people's hospitals at or above the county level from May 31,2017 to July 9,2017 and living in Kuishan Town were selected as the study subjects.The epidemic data and laboratory data were provided by Shizong Center for Disease Control and Prevention,the meteorological data were provided by Shizong County Meteorological Bureau,and other on-site materials were obtained through on-site survey.The risk factors and transmission route of epidemic outbreak were analyzed.The relevant samples were collected and sent to higher level laboratories for testing.The epidemiology method was used for analysis.Results:Drinking water sources were poorly drained,the sewage overflew,and there were seeping toilets,manure piles,and small cattle farms in high places,which had been washed by heavy rains and leaked to pollute water sources.Shortly,the affected cases appeared in a concentrated manner,the total number of colonies and coliform bacteria by water quality testing seriously exceeded the standard,and the distribution of cases was basically consistent with the water supply range of water sources.The contrast analysis showed that,drinking raw water OR(95%CI)was 11.5(1.4-92.8).Therefore,drinking raw water was considered to be a risk factor for this outbreak of typhoid fever and paratyphoid fever.Conclusion:This epidemic is caused by contaminated water sources.Residents often drinking raw water is a risk factor for epidemic outbreak,and relevant departments should formulate targeted prevention and control measures to strengthen water pollution management and avoid secondary outbreak.

关 键 词：水源水污染 甲型副伤寒 流行病学调查 防控 

分 类 号：R516.3[医药卫生—内科学] R181.3[医药卫生—临床医学]