渝东北某避暑区饮水污染引起急性胃肠炎疫情流行特征分析
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摘要
目的分析渝东北一起农村避暑居民区饮用水质被粪水污染引起急性胃肠炎罹患情况及流行特征。方法于2017年7月24—27日对疫情发生地开展现场卫生学调查,对出现的急性胃肠炎病人开展流行病学个案调查,以腹泻≥3次/日者作为病人判定依据,应用SPSS 17.0软件对其疫情资料进行统计分析。结果其居民罹患率为56.52%,以腹泻、腹痛、腹胀、恶心、呕吐、头痛、头晕、乏力和里急后重为主要临床表现。7月24日发病最多,占44.62%;40～岁组发病最多,占38.46%;农民发病最多,占50.77%;不同时间、不同年龄和不同职业发病差异均有统计学意义(χ~2=12.446,P=0.006、χ~2=10.788,P=0.026和χ~2=8.032,P=0.045)。实验室检测出厂水及末梢水各1件,总大肠菌群、耐热大肠菌群、大肠埃希氏菌和菌落总数均超标,尤以耐热大肠菌群超标严重(>1 600 MPN/100 mL)。结论此起疫情发生在农村避暑居民区,罹患率较高,以中年农民发病为主要人群,切断饮水污染途径,发病情况呈较快下降趋势或停止发病。
OBjECTIVE To study and analyze the prevalence and epidemiological characteristics of an acute gastroenteritis caused by the contamination drinking water in rural summer residential areas in northeast Chongqing. METHODS Field environmental hygiene survey and case investigation for acute gastroenteritis patients were conducted on epidemic area on July 24-27,2017. A case of diarrhea ≥3 beats/day was selected as the basis for the patients' judgment,and SPSS17.0 was used to conduct the statistical analysis. RESULTS The attack rate was 56.52%. The main clinical manifestations were diarrhea,abdominal pain,abdominal distension,nausea,vomiting,headache,dizziness,weakness and tenesmus. The incidence of morbidity on July 24 accounted for 44.62%. The morbidity of age group more than 40 was 38.46%. The morbidity of farmers was 50.77%. The differences of morbidity incidence among times,age groups and occupations had significantly statistics(χ~2=12.446,P=0.006;χ~2=10.788,P=0.026;χ~2=8.032,P=0.045). The factory water and terminal water were tested,which the total coliform,heat-resistant coliform,Escherichia coli,and total number of colonies exceeded the standard,especially the heat-resistant coliform group heavily exceeded the standard(>1 600 MPN/100 mL). CONCLUSION The outbreak occurred in rural summer residential areas with high attack rate,and middle-aged farmers as the main population with higher morbidity incidence. The incidence would present a rapid decline in the trend or stop the disease after cutting off the polluted approach of drinking water.
OBjECTIVE To study and analyze the prevalence and epidemiological characteristics of an acute gastroenteritis caused by the contamination drinking water in rural summer residential areas in northeast Chongqing. METHODS Field environmental hygiene survey and case investigation for acute gastroenteritis patients were conducted on epidemic area on July 24-27,2017. A case of diarrhea ≥3 beats/day was selected as the basis for the patients' judgment,and SPSS17.0 was used to conduct the statistical analysis. RESULTS The attack rate was 56.52%. The main clinical manifestations were diarrhea,abdominal pain,abdominal distension,nausea,vomiting,headache,dizziness,weakness and tenesmus. The incidence of morbidity on July 24 accounted for 44.62%. The morbidity of age group more than 40 was 38.46%. The morbidity of farmers was 50.77%. The differences of morbidity incidence among times,age groups and occupations had significantly statistics(χ~2=12.446,P=0.006;χ~2=10.788,P=0.026;χ~2=8.032,P=0.045). The factory water and terminal water were tested,which the total coliform,heat-resistant coliform,Escherichia coli,and total number of colonies exceeded the standard,especially the heat-resistant coliform group heavily exceeded the standard(>1 600 MPN/100 mL). CONCLUSION The outbreak occurred in rural summer residential areas with high attack rate,and middle-aged farmers as the main population with higher morbidity incidence. The incidence would present a rapid decline in the trend or stop the disease after cutting off the polluted approach of drinking water.
引文
[1]吕萍萍,黄正,陶勇,等.饮用水常规指示菌与介水传染病相关性研究[J].环境与健康杂志,2017,34(3):225-228.
[2]原国家卫生部,国家家标准化管理委员会.生活饮用水卫生标准检验方法GB/T5750-2006[S].2016-12-29.
[3]罗华,赵怡楠,马宗成,等.一化粪池管道破裂污染农村居民饮用水的应急处置[J].现代预防医学,2018,45(9):1706-1709.
[4]王强,赵月朝,陈晓东,等.1996-2006年我国生活饮用水污染突发公共卫生事件分析[J].环境与健康杂志,2010,27(4):328-331.
[5]NICHOLS G.infection risks from water in natural and man-made environmerts[J].Euro Surveill,2006(11):76-78.
[6]罗华,张太敏.某农村学校饮水水源污染调查及应急处置情况分析[J].中国农村卫生事业管理,2016,36(1):60-62.
[7]甄国新,谈敦芳,高梁平,等.一起农药污染生活饮用水事件调查[J].首都公共卫生杂志,2009,3(4):182.
[8]梁锡念,黄隽,何伦发,等.建筑给水的卫生安全保障研究[J].环境与健康杂志,2011,28(7):644-645.
[9]罗华,杨万进,赵怡楠,等.重庆市万州区农村分散式供水面上监测点卫生学调查[J].中国农村卫生事业管理,2018,38(3):332-335.
[10]陈学敏,杨克敌,衡正昌,等.环境卫生学(5版)[M].北京:人民卫生出版社,2003:12.
[11]张琦,魏海春,李洪兴,等.农村饮用水水质卫生管理现状及发展[J].环境与健康杂志,2013,30(3):253-265.
[12]董晓静,单爱兰,王新刚,等.一起传入性副伤寒介水暴发的流行病学调查[J].环境与健康杂志,2010,27(8):728-729.
[2]原国家卫生部,国家家标准化管理委员会.生活饮用水卫生标准检验方法GB/T5750-2006[S].2016-12-29.
[3]罗华,赵怡楠,马宗成,等.一化粪池管道破裂污染农村居民饮用水的应急处置[J].现代预防医学,2018,45(9):1706-1709.
[4]王强,赵月朝,陈晓东,等.1996-2006年我国生活饮用水污染突发公共卫生事件分析[J].环境与健康杂志,2010,27(4):328-331.
[5]NICHOLS G.infection risks from water in natural and man-made environmerts[J].Euro Surveill,2006(11):76-78.
[6]罗华,张太敏.某农村学校饮水水源污染调查及应急处置情况分析[J].中国农村卫生事业管理,2016,36(1):60-62.
[7]甄国新,谈敦芳,高梁平,等.一起农药污染生活饮用水事件调查[J].首都公共卫生杂志,2009,3(4):182.
[8]梁锡念,黄隽,何伦发,等.建筑给水的卫生安全保障研究[J].环境与健康杂志,2011,28(7):644-645.
[9]罗华,杨万进,赵怡楠,等.重庆市万州区农村分散式供水面上监测点卫生学调查[J].中国农村卫生事业管理,2018,38(3):332-335.
[10]陈学敏,杨克敌,衡正昌,等.环境卫生学(5版)[M].北京:人民卫生出版社,2003:12.
[11]张琦,魏海春,李洪兴,等.农村饮用水水质卫生管理现状及发展[J].环境与健康杂志,2013,30(3):253-265.
[12]董晓静,单爱兰,王新刚,等.一起传入性副伤寒介水暴发的流行病学调查[J].环境与健康杂志,2010,27(8):728-729.