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目的 在全国抗非典取得阶段性胜利的情况下 ,对上海市传染性非典型肺炎的流行病学调查情况作一总结。方法 阐述传染病的感染和传播的基本模式 ,分析现场流行病学调查的基本原理和策略。并对上海市开展流行病学调查的组织结果、流调程序、流调与临床的衔接等问题进行了介绍。结果 上海市非典的流行病学的调查表明2 0 0 3年 3月至 7月 2 0日 ,全市 19个区县报告临床诊断病例 8例、疑似病例 82例。留院观察病例 12 69例。共开展流行病学调查 4165次 ,参加 2 5 888人次 ,平均对每例临床诊断病人进行流调 9 88次 ,每次参与的流调人员为 12人次 ;疑似和留观病人参加流调数为 5 5 1次数和 2 80次数 ,每次分别为 8 10人次和 5 87人次。追踪密切接触者 3 3 0 0 0余人 ,其中确诊病人密切接触者 3 3 3人 ,疑似和留观病人密切接触者分别为 3 2 3 7人和 2 964 5人。确诊病人、疑似病人和留观病人与密切接触者之比为 1∶41 6、 1∶3 9 5、 1∶2 3 4。上海市SARS病人发病至初诊的平均时间为 1 3d ,初诊至隔离的平均时间为 1 5d。SARS病例诊断与卫生部诊断标准的基本符合。参考实验室辅助诊断结果 ,排除SARS的疑似病例中 60 98%为确诊肺炎 ,其次为上感 10 98%。留观病人排除后 ,主要鉴别诊断为肺炎 (66 5 1% )
Objective To summarize the epidemiological investigation of SARS in Shanghai with the phased victory over SARS in China. Methods The basic patterns of infection and transmission of infectious diseases were expounded and the basic principles and strategies of epidemiological investigation in the field were analyzed. And introduced the organizational results, epidemic procedures, rhetoric and clinical convergence of epidemiological investigation in Shanghai. Results The epidemiological survey of atypical pneumonia in Shanghai showed that from March 2003 to July 20, 2003, there were 8 clinical cases and 82 suspected cases in 19 districts and counties in the city. 12 69 cases were observed in hospital. A total of 4165 epidemiological surveys were conducted to participate in 25888 person-times. On average, 88 cases of clinical diagnoses were performed in each case, with 12 participants for each intervention. The number of suspected and observed patients was 5 5 1 and 2 80 times, each of 8 10 and 5 87 respectively. More than 3,300 close contacts were followed, of whom 3333 were closely contacted and 3,237 and 2,964,5 respectively were suspected and closely watched. The ratio of confirmed, suspected and apparent patients to close contacts is 1:41 6, 1:3 9 5, 1: 2 3 4. The average time for SARS patients to newly diagnosed in Shanghai was 1 3d, and the average time between first visit and isolation was 15d. SARS case diagnosis and the Ministry of Health diagnostic criteria of the basic line. According to the results of laboratory aided diagnosis, 60 98% of the suspected SARS cases were diagnosed as pneumonia, followed by 98% of the cases. After looking at the patient excluded, the main differential diagnosis of pneumonia (66 5 1%)