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目的分析职业暴露人群高危行为和感染高危环节,为制定科学的防控措施提供参考依据。方法采用流行病调查和标本检测,对苍南县职业暴露人群开展抽样调查和养殖场及市场的外环境标本检测并分析。结果暴露种类散养户最多253人(65.89%),职业暴露人群中一人有多种暴露方式,其中含喂养方式最多暴露有329人;禽流感疫苗防护率17.45%,其中灵溪最高71.43%,各乡镇差异有统计学意义(χ~2=154.20,P=0.000),按职业分析,规模养殖的禽流感疫苗防护率最高,达到46.77%,各职业之间差异有统计学意义(χ~2=67.43,P=0.000);流感疫苗接种率方面为3.91%,其中灵溪接种率最高达42.86%,各乡镇差异有统计学意义(χ~2=155.65,P=0.000),各职业人群的流感疫苗接种率差异无统计学意义(χ~2=8.68,P=0.034);甲型流感阳性率25.36%,各乡镇(χ~2=44.79,P=0.000)、各标本类型(χ~2=33.06,P=0.000)、各环境场所(χ~2=13.40,P=0.000)和各季度(χ~2=39.38,P=0.000)的甲型流感阳性率总体差异均有统计学意义;H7N9阳性率11.79%,各乡镇(χ~2=26.24,P=0.006)、各环境场所(χ~2=11.61,P=0.001)和各季度(χ~2=23.86,P=0.000)的H7N9阳性率总体差异均有统计学意义,各标本类型的H7N9阳性率总体差异无统计学意义(χ~2=9.45,P=0.092)。结论苍南县各乡镇和各职业的禽流感防护不均衡,市场的甲型流感和H7N9病毒污染多见,应加强职业防护和市场管理。
Objective To analyze the high-risk behavior of occupationally exposed people and the links of high-risk infection in order to provide a reference for the formulation of scientific prevention and control measures. Methods Epidemiological survey and specimen testing were conducted to investigate occupational exposure in Cangnan County and to investigate and analyze the environmental samples from farms and markets. Results The number of exposed households was 253 (65.89%). There was a variety of exposures among occupationally exposed groups, of which 329 were exposed with feeding mode. The bird flu vaccination rate was 17.45%, of which, Lingxi was the highest with 71.43% The differences among towns were statistically significant (χ ~ 2 = 154.20, P = 0.000). According to occupational analysis, the vaccinated rate of bird flu was the highest (46.77%), with significant difference among occupations (χ ~ 2 = 67.43, P = 0.000). The flu vaccination rate was 3.91%, in which the highest Lingchong vaccination rate was 42.86%, and the differences among towns were statistically significant (χ ~ 2 = 155.65, P = 0.000) The positive rate of influenza A was 25.36% in each township (χ ~ 2 = 44.79, P = 0.000), and the type of influenza virus (χ ~ 2 = 33.06, P = 0.000). There was a significant difference in the positive rate of influenza A in all environmental sites (χ ~ 2 = 13.40, P = 0.000) The positive rate of H7N9 was 11.79% in each township (χ ~ 2 = 26.24, P = 0.006), H7N9 in each environment (χ ~ 2 = 11.61, P = 0.001) The positive rate of the overall differences were statistically significant, the specimens H7N9 type overall positive rate was no significant difference (χ ~ 2 = 9.45, P = 0.092). Conclusion There is an unbalanced protection against bird flu in all towns and cities in Cangnan. Influenza A and H7N9 viruses in the market are more common. Occupational protection and market management should be strengthened.