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目的对广州市发生的一起以发热、皮疹为特点的传染病爆发疫情的特征进行分析,为鉴别诊断和控制疫情提供依据。方法以现场流行病学调查和实验流行病学调查相结合的方法,对爆发点进行流行病学调查、血清学检测和病毒学分离。结果2002年9月,广州市增城石滩镇郭屋社近2个月来出现多例“发热、头痛、呕吐、皮疹”为主要表现的病人,部分病例“肥达氏”试验抗“O”及抗“H”抗体滴度明显升高,疑为“伤寒”爆发流行。但同时作登革热的抗体检测,检出多例登革热抗体IgM或IgG阳性。进一步的调查在病例的血标本中分离出5株登革I型病毒,同时用RT—PCR的方法从8份标本中检出4份登革I型病毒阳性,与同期广州市登革热流行的病毒型别一致;取患者的恢复期血清作肥达氏反应,结果抗“O”、“H”的滴度与第一份血相比,均显著下降。结论根据现场流行病学和实验流行病学的调查结果,可以确认发生在增城市石滩镇郭屋社的传染病疫情是一起登革热爆发流行。经当地政府、卫生防疫部门采取以整治环境卫生、清除积水、防蚊灭蚊、隔离治疗病人为重点的登革热防治综合措施后,郭屋社的疫情在较短时间内得到了控制,1周后已无病例发生。
Objective To analyze the characteristics of an outbreak of an outbreak of infectious disease characterized by fever and rash occurring in Guangzhou and provide evidence for the differential diagnosis and control of the outbreak. Methods Epidemiological investigation, serological detection and virological separation of outbreak were carried out by a combination of field epidemiological investigation and experimental epidemiological investigation. Results In September 2002, many patients with “fever, headache, vomiting and rash” appeared in the past two months in Guo Wu She, Shitan Town, Zengcheng City, Guangzhou City. Some cases of “Widal” And anti-“H” antibody titers increased significantly, suspected “typhoid” outbreak epidemic. However, at the same time, Dengue antibody was detected, and multiple positive cases of dengue antibody IgM or IgG were detected. Further investigation of 5 strains of Dengue I virus isolated from the blood samples of the cases and 4 positive samples of Dengue I virus from 8 samples by RT-PCR, The type of the same; take the patient’s recovery serum Wadal response, the results anti-“O”, “H” titers compared with the first blood were significantly decreased. Conclusion Based on the field epidemiological and experimental epidemiological findings, it is possible to confirm that the outbreak of infectious diseases in Guo Wu She She, Shitan Town, Zengcheng City is a epidemic of dengue fever. After the local government and health and epidemic prevention departments took the comprehensive measures of prevention and control of dengue to focus on remediation of environmental hygiene, removal of stagnant water, mosquito and mosquito, isolation and treatment of patients, Guo Wu She’s outbreak was controlled within a relatively short period of time. One week No case occurred after.