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目的 通过描述和分析 2 0 0 1年 6月初 ,明光市出现的原因不明的发热病人的流行病学和临床特征 ,探讨其发病原因及流行特征。方法 通过大疫情报告系统收集发病资料 ;进行个案调查获得病人的临床特征和流行病学资料 ;进行病原分离与鉴定和血清抗体检测为明确疫情的性质提供依据。结果 疫情主要发生在 2 9个乡镇中的 2 7个乡镇 ,发病以 10岁以下儿童为主 ,男多于女。 79例个案调查显示 ,大部分患者接种过乙脑疫苗 ,主要临床表现为发热、部分病人有呕吐、头痛、咽红 ,类似上感 ,实验室检查 6 7.8%的病人血液白细胞升高 ,94 .1%的病人脑脊液异常 ,表现为白细胞数增多、潘氏试验阳性。 2 2份早期病人粪便和 15份脑脊液中分别有 12份和 5份分离到CoxB5型病毒 ,阳性率分别为 5 4 .5 %和 33.3%。结论 此起疫情为一起主要由柯萨奇B5型病毒感染所致的脑膜脑炎的爆发流行。
Objective To describe and analyze the epidemiological and clinical characteristics of fever patients with unknown causes in Mingguang City in early June 2001 and to explore the causes and epidemic characteristics. Methods The epidemic situation information was collected through the large epidemic reporting system. The clinical features and epidemiological data of patients were obtained through case investigation. The isolation and identification of pathogens and the detection of serum antibodies provided the basis for clarifying the nature of the epidemic. Results The outbreak mainly occurred in 27 townships and townships in 29 townships. The incidence was mainly children under 10 years old, more than males. In the 79 case studies, the majority of patients were vaccinated with Japanese encephalitis B vaccine. The main clinical manifestations were fever. Some patients had vomiting, headache, and throat flushing. Similar findings were noted in laboratory tests, with elevated leukocytes in 7.8% of the patients in the laboratory. 1% of patients with cerebrospinal fluid abnormalities, manifested as an increase in white blood cell count, Pan test positive. Twelve out of 22 patients with early-stage disease and 15 from 15 cerebrospinal fluid and 5 CoxB5-positive isolates were found, with positive rates of 54.5% and 33.3%, respectively. Conclusion This outbreak is an outbreak of meningoencephalitis caused mainly by coxsackievirus B5 infection.