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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。
Objective To carry out an epidemiological investigation of an outbreak of water-borne diarrhea in order to find out the factors and sources of exposure to the outbreak and provide the basis for taking appropriate control measures. Methods The definition of the case was established, and the patients were randomly selected to compare the difference between the control group and the clinically diagnosed and confirmed cases of drinking water and hygiene habits. To carry out hygiene survey, a clear reason for the outbreak. Results A total of 48 cases were searched (attack rate 2.3%). Drinking raw water is a risk factor (OR = 9.6, 95% CI = 2.5 -43), and showed a significant dose-response relationship with increasing drinking water ratio (OR 1.0, , 19,87, X ~ 2 = 40, P = 0.000). Recessive infection rate was 12% (11/94). The three schools use the same water well, total well water total Escherichia coli> 16 × 10 ~ 4 / L, the water pipe across a well stream surface water, water leakage at the interface, rainy stream submerged pipe can cause pollution. 3d before the peak incidence of heavy rains. Conclusions The three schools are outbreaks of bacillary dysentery with the common water source of Song Nei’s disease, mainly caused by the water leakage of the pipes, the up-pumping of sewage when pumping rainy days, the diversion of water pipes, the intensification of disinfection and the promotion of drinking water.