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目的 :查明人 -猪链球菌感染性综合征的流行范围 ,感染来源及途径 ,流行特征以及控制效果评价。方法 :制订统一诊断标准对所有病例进行诊断 ,制订个案表进行流行病学调查并进行分析 ,采集病人的早期血液及脑脊液进行病原分离 ,对所有病例均进行系统地临床体检与观察 ,对死亡病例进行尸解。结果 :在 1998年 7月 2 0日至 8月 8日 ,在苏中部份地区共发生 16例链球菌中毒性休克综合征和 9例链球菌脑膜炎综合征 ,死亡人数分别为 13例和 1例。病例分布特点为相对局限 ,高度散发 ,主要感染有屠宰或直接接触病、死猪的男性人群 ,病例之间没有明显的接触史 ,没有二代病例发生。病例临床表现复杂 ,病情凶险 ,潜伏期短 ,只有 1～ 2天 ,病理改变为多器官、多脏器损伤、出血、DIC和全身血液不凝固等。经采取禁宰病、死猪等综合性措施 ,疫情得到控制。结论 :本起疫情为人 -猪链球菌感染性综合征 ,临床表现有两种类型 ,即中毒性休克型和脑膜炎型 ,感染来源为直接接触病、死猪 ,在人间没有传染性 ,禁宰病、死猪为有效控制措施
OBJECTIVE: To identify the prevalence of human-Streptococcus suis infectious syndrome, the sources and routes of infection, epidemiological characteristics and evaluation of control effects. Methods: To develop a unified diagnostic criteria for diagnosis of all cases, the development of a case table for epidemiological investigation and analysis, the acquisition of patients with early blood and cerebrospinal fluid pathogen isolation, all cases were systematically clinical examination and observation of deaths For autopsy. Results: From July 20, 1998 to August 8, 16 cases of streptococcal toxic shock syndrome and 9 streptococcal meningitis syndromes occurred in some areas of central Jiangsu province. The death toll were 13 and 1 case. The distribution of cases is relatively limited, highly distributed, the main infection slaughtered or direct contact with disease, dead pigs male population, there is no obvious history of contact between cases, there is no second-generation cases. Clinical manifestations of cases complicated, dangerous condition, short incubation period, only 1 to 2 days, pathological changes of multiple organs, multiple organ injury, bleeding, DIC and systemic blood coagulation. The epidemic was under control after adopting comprehensive measures such as ban on zoonosis and dead pigs. Conclusion: This outbreak is human - Streptococcus suis infectious syndrome, clinical manifestations have two types, namely, toxic shock and meningitis type, the source of infection for direct contact with disease, dead pigs, no infectious in the world, ban slaughter Disease, dead pigs as an effective control measures