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目的探讨2013年夏季蒲县儿童病毒性脑炎的流行病学特征、临床表现和病原学因素,为今后地区性病毒性脑炎的预防控制提供科学依据。方法通过96例病毒性脑炎个案调查资料,描述性分析病例的流行病学及临床特征。结果96例病例分布于蒲县5个乡镇,罹患率为123.91/10万,发病时间为5~7月,首发病例是5月19日,发病高峰期为6月,占总病例的72.92%,7月19日疫情平息。发病人群以小学及托幼儿童为主,占总病例的95.84%,男女发病比为1.53∶1,发病年龄为2~13岁,以4~10岁为主,占总病例的83.33%,城区及近郊为主要发病区域,占总病例的94.79%,具有明显的聚集性,家庭、学校聚集率分别为12.5%、33.3%。病例的主要临床症状为发热、头痛、呕吐等,血常规白细胞计数大多正常(73.68%),脑脊液细胞计数轻度增高,病情普遍较轻,预后良好。10份患者咽拭子、粪便标本,检出肠道病毒(EV)8份阳性,EV71、CoxA16均为阴性,经北京市朝阳区疾控中心实验室证实为埃可病毒30型(ECHO30)。结论 2013年夏季蒲县病毒性脑炎流行是由埃可病毒30型引起。
Objective To explore the epidemiological characteristics, clinical manifestations and etiological factors of viral encephalitis in Puxian County in summer of 2013, and to provide a scientific basis for the prevention and control of regional viral encephalitis in the future. Methods A total of 96 cases of viral encephalitis were selected to describe the epidemiological and clinical features of the cases. Results 96 cases were found in 5 villages and towns in Pu County, the attack rate was 123.91 / 100000, the onset time was from May to July, the first case was May 19, the peak incidence was June, accounting for 72.92% of the total cases, July 19 epidemic subsided. The incidence of the disease mainly in primary and child care children, accounting for 95.84% of the total cases, the incidence of male-female ratio was 1.53: 1, the age of onset was 2 to 13 years old, 4-10 years old, accounting for 83.33% of the total cases, And the outskirts as the main disease area, accounting for 94.79% of the total cases, with significant aggregation, family, school concentration was 12.5%, 33.3%. The main clinical symptoms of the cases were fever, headache, vomiting, blood routine white blood cell count was mostly normal (73.68%), cerebrospinal fluid cell count was slightly elevated, the disease is generally mild, the prognosis is good. Throat swabs and stool samples from 10 patients were positive for Enterovirus (EV). EV71 and CoxA16 were negative in all 10 patients. ECHO30 was confirmed by the laboratory of Chaoyang CDC in Beijing. Conclusions The prevalence of viral encephalitis in Pu County in the summer of 2013 was caused by echovirus type -30.