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目的通过对陕西省安康、宝鸡、渭南3个地区病毒性脑炎的监测,了解病毒性脑炎流行病学特征及流行性乙型脑炎(乙脑)发病情况。方法采用ELISA法检测乙脑IgM;由监测医院报告病例,县级疾病预防控制中心进行个案调查。结果398例病例中,乙脑IgM阳性病例76例,占19.10%。在发病7 d内、7 d后采集的血标本、脑脊液标本阳性率分别为26.24%,18.18%和20.59%,其阳性率差异无统计学意义。发病7 d内与7 d后采集的血标本与脑脊液检测结果一致率分别为86.67%和80.00%。病毒性脑炎发病6~9月较高,与乙脑IgM阳性病例时间分布基本一致,11月病毒性脑炎病例出现一个小高峰;病毒性脑炎病例中15岁以下占73.62%,乙脑IgM阳性病例中0~5岁最高占36.84%,其他病毒性脑炎5~10岁组最高占40.68%;乙脑IgM阳性病例中散居儿童和农民占比例较高为71.05%,其他病毒性脑炎学生占比例较高为56.83%;未接种及接种史不详在乙脑IgM阳性病例中占76.31%;出院时转归,乙脑IgM阳性病例和其他病脑治愈比例分别为67.11%,83.23%,病死率分别为9.21%,3.11%。结论乙脑病例在发病7 d内和7 d后采血进行IgM检测对乙脑诊断均有意义。应提高乙脑疫苗接种率,在作好儿童乙脑防治的同时,加强对成人乙脑防控工作。
Objective To understand the epidemiological features of viral encephalitis and the incidence of Japanese encephalitis (JE) by monitoring the viral encephalitis in three districts of Ankang, Baoji and Weinan in Shaanxi Province. Methods The IgM of JE was detected by ELISA, and the cases reported by the monitoring hospital and the CDC were investigated by the CDC. Results Among the 398 cases, IgM positive cases were detected in 76 cases (19.10%). The positive rates of blood samples and cerebrospinal fluid collected within 7 days after onset were 26.24%, 18.18% and 20.59%, respectively, within 7 days after onset. There was no significant difference in the positive rates between the two groups. The consistent rate of blood samples and cerebrospinal fluid collected within 7 days and 7 days after onset was 86.67% and 80.00% respectively. The incidence of viral encephalitis was higher from June to September, which was basically consistent with the time distribution of IgM-positive cases of Japanese encephalitis. A small peak appeared in cases of viral encephalitis in November; the cases of viral encephalitis accounted for 73.62% under 15 years of age, IgM-positive cases accounted for 36.84% of the patients aged 0-5 years and 40.68% of those of other encephalitis aged 5-10 years. The proportion of scattered children and peasants in IgM-positive cases was 71.05% The proportion of non-inoculated and vaccinated children was 76.31% in IgM-positive cases of JE; the discharge rate at the time of discharge was 67.11% and 83.23% respectively for IgM-positive cases and other cases, The case fatality rates were 9.21% and 3.11% respectively. Conclusion The detection of IgM in JE cases on day 7 and 7 days after the onset of JE has significance for the diagnosis of JE. Should increase the rate of Japanese encephalitis vaccination, while doing children’s prevention and treatment of Japanese encephalitis at the same time, strengthen the prevention and control of adult JE work.