2013-2019年浙江省腹泻疫情流行病学特征分析

蔡剑 孙继民 丰燕 缪梓萍 秦淑文 陈奕娟 曹艳丽 史俐熠 凌锋

蔡剑, 孙继民, 丰燕, 缪梓萍, 秦淑文, 陈奕娟, 曹艳丽, 史俐熠, 凌锋. 2013-2019年浙江省腹泻疫情流行病学特征分析[J]. 疾病监测.
引用本文: 蔡剑, 孙继民, 丰燕, 缪梓萍, 秦淑文, 陈奕娟, 曹艳丽, 史俐熠, 凌锋. 2013-2019年浙江省腹泻疫情流行病学特征分析[J]. 疾病监测.
Cai Jian, Sun Jimin, Feng Yan, Miao Ziping, Qin Shuwen, Chen Yijuan, Cao Yanli, Shi Liyi, Ling Feng. Epidemiological characteristics of diarrhea in Zhejiang, 2013–2019[J]. Disease Surveillance.
Citation: Cai Jian, Sun Jimin, Feng Yan, Miao Ziping, Qin Shuwen, Chen Yijuan, Cao Yanli, Shi Liyi, Ling Feng. Epidemiological characteristics of diarrhea in Zhejiang, 2013–2019[J]. Disease Surveillance.

2013-2019年浙江省腹泻疫情流行病学特征分析

详细信息
    作者简介:

    蔡剑, 男, 浙江省丽水市人, 硕士,主任医师, 主要从事急性传染病防控工作,Email:jcai@cdc.zj.cn

    通讯作者:

    凌锋,Tel: 0571-87115327, Email:fengl@cdc.zj.cn

  • 中图分类号: R211;R51

Epidemiological characteristics of diarrhea in Zhejiang, 2013–2019

More Information
  • 摘要:   目的  了解浙江省腹泻疫情的流行病学特征,为疫情的调查处置提供参考。  方法  收集浙江省2013-2019年报告的有腹泻病例的暴发疫情,分析其发生时间、空间、罹患率、持续时间、病例临床特征、病原学检测等信息,进行描述性分析并比较其差异。  结果  在851起报告事件中,共发现317起暴发疫情有报告腹泻病例,涉及16种疾病,按事件报告数,依次为诺如病毒性急性胃肠病、霍乱、流感、登革热、沙门菌胃肠炎、腺病毒感染、致泻性大肠埃希菌感染、札如病毒性急性胃肠炎、发热伴血小板减少综合征、空肠弯曲菌感染、副溶血弧菌食物中毒、金黄色葡萄球菌感染、疑似预防接种异常反应、食入毒蘑菇中毒、手足口病和水痘。腹泻疫情在3-5月和10-12月各有一个高峰,在浙江省11个市均有分布,其中264起(83.28%)发生在学校。平均罹患率>10%的事件有诺如病毒性急性胃肠病、霍乱、流感、腺病毒感染、沙门菌胃肠炎、致泻性大肠埃希菌感染;平均持续时间>1周的有流感、登革热、腺病毒感染、空肠弯曲菌感染和发热伴血小板减少综合征。病例发生呕吐、腹痛、发热的腹泻疫情分别占87.38%(277起)、71.61%(227起)和65.93%(209起)。  结论  出现腹泻病例的聚集性疫情包括胃肠道传播和其他传播途径疾病。在疾病监测和暴发疫情调查处置时,应根据临床症状,结合当地传染病流行特征做出科学判断。
  • 图  1  2013-2019年浙江省腹泻疫情月分布

    注:只显示起数>5的腹泻疫情

    Figure  1.  Monthly distribution of diarrhea outbreaks in Zhejiang, 2013-2019

    表  1  2013—2019年浙江省突发公共卫生事件报告数

    Table  1.   Number of public health emergencies reported in Zhejiang, 2013-2019

    年份总起数总发病数(例)有腹泻病例疫情腹泻疫情
    疫情数(起)构成比(%)发病数(例)构成比(%)
    2013 38 1168 1026.32 51744.26
    2014 41 1278 1229.27 70755.32
    2015 46 1584 1634.78 82752.21
    2016 53 1416 1528.30 48534.25
    2017 78 3781 2329.49 225059.51
    2018 86 2541 2124.42 91836.13
    201950917 34422043.22 550631.75
    合计85129 11231737.2511 21038.51
    下载: 导出CSV

    表  2  2013-2019年浙江省腹泻疫情疾病种类

    Table  2.   Diseases causing diarrhea outbreaks in Zhejiang, 2013-2019

    疾病种类腹泻疫情腹泻疫情病例
    事件数
    (起)
    构成比
    (%)
    发病数
    (例)a
    构成比
    ( %)
    诺如病毒性急性胃肠病21969.09 6 61959.05
    霍乱278.52 280.25
    流感257.89 1 94117.31
    登革热82.52 1 18710.59
    沙门菌胃肠炎72.21 4944.41
    腺病毒感染72.21 3262.91
    致泻性大肠埃希菌感染61.89 2382.12
    札如病毒性急性胃肠炎41.26 280.25
    发热伴血小板减少综合征20.63 50.04
    空肠弯曲菌感染20.63 590.53
    副溶血弧菌10.32 500.45
    金黄色葡萄球菌感染10.32 280.25
    疑似预防接种异常反应10.32 10.01
    食入毒蘑菇中毒10.32 70.06
    手足口病10.32 350.31
    水痘10.32 170.15
    不明原因41.26 1471.31
    合计317100.00 11 210100.00
      注:a.指疫情中的全部发病人数
    下载: 导出CSV

    表  3  2013-2019年浙江省腹泻疫情罹患率和持续时间

    Table  3.   Attack rate and duration of diarrhea outbreaks in Zhejiang, 2013-2019

    疾病疫情
    起数
    罹患率±标
    准差(%)a
    持续时间
    (d)
    诺如病毒性急性胃肠病21910.66±13.044.52±4.59
    霍乱2710.18±11.170.29±1.46
    流感2512.57±20.8513.22±8.9
    登革热89.40±17.7721.04±36.91
    腺病毒感染715.18±9.819.03±5.48
    沙门菌胃肠炎731.33±19.782.55±1.73
    致泻性大肠埃希菌感染610.19±7.582.73±1.41
    札如病毒性急性胃肠炎42.64±1.883.07±2.59
    不明原因43.78±4.163.29±2.89
    空肠弯曲菌感染24.29±4.258.31±6.39
    发热伴血小板减少综合征25.34±4.2311.39±16.11
      注:a.为发病数/波及人数×100%;表中只示出起数≥2的疫情
    下载: 导出CSV

    表  4  2013—2019年浙江省腹泻疫情中不同临床症状病例的构成

    Table  4.   Composition of cases with different clinical symptoms in diarrhea outbreaks in Zhejiang, 2013-2019

    疾病疫情总
    起数
    发热病例腹痛病例呕吐病例腹泻病例
    占比(%)b
    腹泻发生
    率(%)c
    疫情起数构成比
    (%)a
    起数构成比
    (%)a
    起数构成比
    (%)a
    诺如病毒性急性胃肠病21914867.5818785.39219100.0037.872.29
    流感2525100.00312.001040.0014.513.35
    登革热88100.00225.00450.0036.896.14
    沙门菌胃肠炎77100.007100.007100.0084.5721.06
    腺病毒感染77100.00114.29457.1418.921.86
    致泻性大肠埃希菌感染6466.676100.00583.3388.525.30
    发热伴血小板减少综合征22100.00150.002100.0087.504.79
    札如病毒性急性胃肠炎4250.00375.004100.0053.972.04
    空肠弯曲菌感染22100.002100.002100.0091.363.62
    不明原因4250.00375.004100.0074.793.00
    手足口病11100.0000.0000.002.860.40
    副溶血弧菌食物中毒11100.001100.001100.00100.0013.62
    金黄色葡萄球菌感染100.001100.001100.00100.005.36
    霍乱2700.00933.331244.44100.009.81
    食入毒蘑菇中毒100.0000.001100.0057.1450.00
    水痘100.0000.001100.005.882.22
    疑似预防接种异常反应100.001100.0000.00100.00100.00
    总计31720965.93 22771.61 27787.38 46.484.47
      注:a.指出现相应症状病例的事件占腹泻疫情事件数的比例;b.腹泻病例数/发病例数×100%;c.为该类事件腹泻病例数/波及人数×100%
    下载: 导出CSV

    表  5  2013-2019年浙江省不同传播途径腹泻疫情比较

    Table  5.   Comparison of diarrhea outbreaks with different transmission routes in Zhejiang, 2013-2019

    传播途径自变量系数B标准误WaldP比值比及其95%置信区间
    胃肠道/呼吸道均可传播持续时间0.3100.1029.2560.0021.364(1.117~1.665)
    罹患率0.0020.0070.0820.7751.002(0.988~1.016)
    发生年份0.4860.14910.5920.0011.626(1.213~2.179)
    发生月份−0.0700.0750.8700.3510.933(0.805~1.080)
    无腹痛1.4150.9362.2840.1314.117(0.657~25.805)
    无呕吐−1.5061.0372.1110.1460.222(0.029~1.691)
    无发热−0.5430.5371.0220.3120.581(0.203~1.665)
    不在学校发生−3.5610.79120.259<0.0010.028(0.006~0.134)
    呼吸道传播持续时间0.4700.11317.212<0.0011.600(1.281~1.997)
    罹患率0.0030.0080.1450.7031.003(0.987~1.020)
    发生年份1.2090.4856.1990.0133.349(1.293~8.670)
    发生月份−0.2360.1243.6430.0560.789(0.619~1.006)
    无腹痛3.8331.21110.0170.00246.183(4.302~495.745)
    无呕吐1.9191.3921.9020.1686.817(0.445~104.330)
    无发热−2.7371.3074.3830.0360.065(0.005~0.840)
    不在学校发生−3.2551.6064.1110.0430.039(0.002~0.897)
    下载: 导出CSV
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