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目的 查明 2 0 0 3年接连发生的 9起O13 9霍乱疫情的传染来源、传播途径及各起疫情间的内在联系 ,为指导今后的霍乱防治工作提供依据。 方法 以现场流行病学调查并采用PFGE对分离的O13 9菌株进行分子生物学检测。 结果 各起疫情间的人群之间无生活往来和接触 ,无家庭聚集性 ,疫区在地理方面无联系 ,以前均未发生过霍乱疫情 ,当地人群无腹泻病大面积流行 ,外环境污染率低 ,参与聚餐和食用剩菜人员培养阳性率高 ,厨师带菌污染食物的可能性很小。聚餐的共同食物———甲鱼主要来源于同一市场 ,疫情间菌株PFGE图谱基本一致。 结论 这几起疫情之间不存在人与人之间的连续传播 ,为通过食物传播引起 ,最可疑的食物是甲鱼。食品制作时生熟未彻底分开是造成食物污染的原因。提示在今后的O13 9群霍乱防制工作中要重点加强对甲鱼等海水产品的监测 ,加强农村集体聚餐的卫生指导管理。
Objective To identify the source, transmission and epidemic of 9 O13 9 cholera epidemics in succession in 2003 and provide the basis for future cholera prevention and control work. Methods An epidemiological investigation was conducted in the field and the molecular biology of O13 9 isolates was detected by PFGE. Results There was no life contact and no family aggregation among all the outbreaks of the epidemic. There was no geographical connection between the epidemic areas. None of the cholera epidemics had occurred before. There was no epidemic of diarrheal disease in the local population and the rate of external environmental pollution was low , Participation in meals and consumption of leftovers staff positive rate of cultivation, the possibility of contaminated food contaminated by chefs is very small. The common meal of the meal --- the turtle mainly came from the same market, and the PFGE patterns of the isolates were basically the same. Conclusion There is no continuous transmission between people in these few outbreaks. The most suspicious food caused by food is turtle. Food production is not completely separate from raw and cooked food caused by pollution reasons. It is suggested that in the future O139 cholera prevention and control work, the monitoring of turtles and other marine products should be strengthened and the hygiene guidance and management of rural collective meals should be strengthened.