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目的分析该起戊肝暴发疫情的流行特征,明确感染来源,为制定预防控制措施提供依据。方法对病例及其密切接触者和部分其他服刑人员进行访谈和个案调查,并采集血清标本检测抗-HEV IgM和抗-HEV IgG;开展现场卫生学调查;运用描述流行病学方法分析疫情流行特征,提出可能暴露因素;应用病例对照研究方法验证可能暴露因素。结果此次疫情共发现4例确诊病例,发病时间范围为5月1~13日;调查对象HEV感染率为11.80%(21/178);抗-HEV IgM阳性组食用小食堂炒菜的比例明显高于对照组,差异有统计学意义(χ~2=4.792,P=0.029);食用炒猪肝频次越高者血清抗-HEV IgM阳性率越高(χ~2=4.822,P=0.028),越喜欢吃炒猪肝者血清抗-HEV IgM阳性率越高(χ~2=6.327,P=0.012)。结论此次戊肝暴发疫情最可能的暴露因素是食用未熟透的猪肝。
Objective To analyze the epidemiological characteristics of hepatitis E outbreak, clarify the source of infection, and provide the basis for the development of prevention and control measures. Methods Interviews and case studies were conducted among the cases, their close contacts and some other prisoners. Serological samples were collected for detection of anti-HEV IgM and anti-HEV IgG. An on-site hygiene survey was conducted. Epidemiological characteristics were analyzed using epidemiological methods , Proposed possible exposure factors; application of case-control study to verify the possible exposure factors. Results A total of 4 confirmed cases were found in this outbreak. The onset time range was from May 1 to May 13, and the infection rate of HEV in the surveyed subjects was 11.80% (21/178). The proportion of edible canteen cooking in anti-HEV IgM positive group was significantly higher In the control group, the difference was statistically significant (χ ~ 2 = 4.792, P = 0.029); the positive rate of serum anti-HEV IgM was higher in the fried liver (χ ~ 2 = 4.822, P = 0.028) The more the positive rate of serum anti-HEV IgM in fried pig liver (χ ~ 2 = 6.327, P = 0.012). Conclusion The most likely exposure factor for the outbreak of hepatitis E is the consumption of immature pig liver.