【摘要】 目的对一起水源性痢疾暴发进行流行病学调查,以查明疫情的暴露因素和来源,为采取相应控制措施提供依据。方法建立病例定义,随机选择对照,比较对照组与临床诊断和确诊病例喝生水及卫生习惯的差异。开展卫生学调查,明确暴发原因。结果共搜索病例48例(罹患率2．3％)。喝生水是危险因素(OR=9．6,95％CI=2．5 -43),并呈明显剂量反应关系,随着喝生水比例增大(OR值为1．0、3．3、19、87,X~2=40,P=0．000)。隐性感染率高12％(11/94)。三所学校使用同一口水井,井水总大肠杆菌＞16×10~4/L,水管横过井水旁一小溪水面,接口处漏水,雨天小溪淹过水管可致污染。发病高峰前3d有大降雨。结论三所学校为一次共同水源性宋内氏细菌性痢疾暴发,主要由于水管漏水,雨天抽水时倒吸污水引起,通过水管改道、加强消毒和提倡喝开水等控制疫情。更多还原

【Abstract】 Objective To identify the source and factors associated with the outbreak of water-borne dysentery.Methods Identification of suspected cases,probable case clinical diagnosed cases and confirmed cases.Hygienic survey was conducted and the factors associated with the infections were analyzed.Results Totally 48 cases were identified with incidence of 2.3 %.Drinking unboiled water was the risk factors(OR=9.6,95 % CI:2.5-43)and the OR increased from 1.0 to 3.3 to 19 to 87 along with the increase of the rate of drinking unboiled water(P＜0.01,x~2 for trend=40),showing obvious dose-response relationship.Latent in- fection was accounted for 12%.The three schools shared the same well and the total E.coli was＞16×10~4/L in the well water. There was a leakage in the water pipeline and it was contaminated after a big rain three days before the outbreak of the dysentery. Shigella sonnei was detected from the stool of 11 of the 94 students.Conclusion This outbreak dysentery is due to contamination of the drinking water by Shigella sonnei.Effective measures such as repair the pipeline,sterilization of water and drinking boiled water, be taken.更多还原