【摘要】 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。更多还原

【Abstract】 Objective Analyzing an outbreak of infectious disease characterized with fever and rash to provide evidences for differentiated diagnosis and taking control measures. Method Field epidemiology and experimental epidemiology investigation were conducted on the outbreak centre. Results In the recent 2 months, from August to September 2002, a number of residents living in Guowu village of Zengcheng county of Guangzhou developed symptoms such as fever, headache, emesis and rash etc. The rises of anti O and anti H antibodies to typhoid fever were detected by Fidals reaction in blood samples of such people, so it was strongly suggested to be an outbreak of Typhoid fever. But further investigations showed that the Typhoid bacillus culture of the blood serum and swab of anus of the cases as well as the water from the habitation were negative. The titers of anti O and anti H antibodies to typhoid of the convalescent serum were dropped compared with the first diagnosis performed two weeks ago. Meanwhile many cases were diagnosed to be sero positive of anti dengue virus. Dengue I virus were also isolated from five cases. RT PCR test also indicated 4 out of 8 samples contained dengue I virus, which was the same type of dengue virus found in the epidemic areas in Guangzhou at the same time of outbreak. Conclusions Based on the above investigation, it was confirmed to be an outbreak of dengue fever in Guowu village. After the control measures such as environment cleaning, elimination of retaining water, riddance of mosquito and isolation of cases had been taken, the spread of the disease was quickly under control. No new case was reported subsequently.更多还原