CAJ | 학술논문

目的查明此次水痘疫情暴发的传染来源、传播途径和感染危险因素,为有效防控疫情提供科学依据.方法本次暴发调查的病例定义为:2010年11月7日以来,尼玛县吉瓦乡四村当贡自然村的村民中,出现发热(腋下温度≥37.3℃或自述发热者)伴有皮疹者.应用调查问卷搜集病例信息,主要内容包括基本信息(年龄、性别、住址)、发病时间、临床症状、就诊情况、疾病史和疫苗接种史等.采用酶联免疫吸附法(ELISA)检测3份健康者血清和8份现症病例血清水痘IgM抗体.结果此次疫情共发现15例病例,罹患率为20.5％,其中成人发病10例,罹患率为17.9％.死亡病例3例,病死率为20.0％,均为成人病例且出现呼吸困难等并发症.3例死亡病例均有10年以上结核病史,其他病例无相关疾病史,所有病例均无水痘疫苗接种史.3份健康者血清水痘IgM抗体均为阴性,8份现症病例血清中7份为阳性.结论易感性积累、水痘疫苗覆盖率低可能是此次疫情暴发的原因,而结核病导致的机体免疫力低下、严重并发症以及未及时有效治疗可能是导致成年病例死亡的主要原因.
목적 사명차차수두역정폭발적전염래원、전파도경화감염위험인소,위유효방공역정제공과학의거.방법 본차폭발조사적병례정의위:2010년11월7일이래,니마현길와향사촌당공자연촌적촌민중,출현발열(액하온도≥37.3℃혹자술발열자)반유피진자.응용조사문권수집병례신식,주요내용포괄기본신식(년령、성별、주지)、발병시간、림상증상、취진정황、질병사화역묘접충사등.채용매련면역흡부법(ELISA)검측3빈건강자혈청화8빈현증병례혈청수두IgM항체.결과 차차역정공발현15례병례,리환솔위20.5％,기중성인발병10례,리환솔위17.9％.사망병례3례,병사솔위20.0％,균위성인병례차출현호흡곤난등병발증.3례사망병례균유10년이상결핵병사,기타병례무상관질병사,소유병례균무수두역묘접충사.3빈건강자혈청수두IgM항체균위음성,8빈현증병례혈청중7빈위양성.결론 역감성적루、수두역묘복개솔저가능시차차역정폭발적원인,이결핵병도치적궤체면역력저하、엄중병발증이급미급시유효치료가능시도치성년병례사망적주요원인.
Objective To indentify the source of the outbreak,mode of transmission and risk factors for outbreak of varicella.Methods A probable case was one with fever and rash since November 7 in 2010.The cases were investigated on demographic information,dates of onset,clinical symptoms,history of disease and varicella vaccination.Enzyme-linked immunosorbent assay was implied to test the IgM antibody of the serum of three healthy people and eight new cases.Results We found 15 cases,and the attack rate was 20.5％.10 of them were adult cases,and the attack rate was 17.9％.There were 3 dealths,and they were all adult patients with the serious complications.The three dealths had the history of tuberculosis,but not in the others.All cases had no history of varicella vaccination.The IgM antibody of the serum of 3 healthy people were negative,and 7 of the 8 eight new cases were positive.Conclusion The accumulation of susceptibility,low level of coverage rate of varicella vaccination might be the reasons for the outbreak.Hypoimmunity caused by tuberculosis,serious complications and having no effective treatment should be the reasons for dealth in adult cases.