1999‒2015年红塔区伤寒与副伤寒流行特征和气象变量的研究

目的 分析1999‒2015年红塔区伤寒与副伤寒（typhoid and paratyphoid fever,TPF）地方病区域流行特征和气象变量的关系,为TPF监测控制和危险因素评价提供科学依据。方法 采用描述流行病学方法和自主研发计算机软件建立中国疾病预防控制信息系统红塔区TPF病例分布与流行特征数据库,用Pearson相关分析和多元线性逐步回归分析研究TPF发病和气象变量关系。结果 1999‒2015年报告TPF病例数为8 398例,1999、2015年分别报告23、44例。1999‒2015年期间每年3~5月、6~10月、11月~次年2月分别为发病上升期（月均增长率63.8%）、高峰期（月均降低率2.0%）和下降期（月均降低率25.7%）,每年度病例数都呈现3月~10月季节性升高和11月~次年2月季节性降低;2000年8月至2010年12月每月病例数都大于8例,2000‒2002、2004‒2005、2005‒2007、2007‒2008、2008‒2010年出现五个高强度流行峰,峰期范围是12～24个月,周期范围是11～40个月;2001、2004、2006、2007、2009年五个高峰年度6~10月病例数范围分别为86～217、67～215、125～216、97～131、63～95例;1999、2000、2002、2003、2005、2008、2010、2015年八个低峰年度6月~10月病例数范围分别为1～3、1～17、32～60、30～43、46～55、43～78、22～61、2～11例。单因素分析TPF月平均发病率与月平均降雨量（r=0.825,P<0.01）、月平均气温（r=0.797,P<0.01）和月平均相对湿度（r=0.706,P<0.05）呈正相关;经多元逐步回归分析建立TPF月平均发病率（Y）与月平均降雨量（X）的拟合模型方程Y=4.563+0.051X。结论 红塔区TPF发病呈现季节性升高与降低、周期性流行、长期趋势特点;发病率与降雨量、气温、相对湿度呈正相关;传染源积累、重污染源形成、暴露人群增加驱动着流行特征与气象变量关系;相应规律、机制、政策、评估有助TPF的监测控制。     

Surveillance for typhoid fever in Matsuyama city during 1974-1981 and detection of Salmonella typhi in sewage and river waters

Eighty-two cases of typhoid fever were found in Matsuyama city in the period from 1974 to 1981. Seventy-six cases were found to be infected with Salmonella typhi other three with Salmonella paratyphi A, and the remaining three were diagnosed only clinically. The strains of S. typhi isolated from these patients showed such a variety of Vi-phage types as D1, D2, E1, M1, 53 and degraded Vi-positive strain (DVS). The concurrent survey of the city sewage and river waters for typhoid bacilli was conducted with total 578 samples taken therefrom. S. typhi was isolated from 120 of those samples. The Vi-phage types of the isolates were closely related with those of the isolates from the patients. The periodical examinations of the city sewage and the draining river may serve as a useful means for the controlling typhoid fever epidemics.     

Enteroviral aseptic meningitis in Japan, 1981-1991. A report of the National Epidemiological Surveillance of Infectious Agents in Japan.

In Japan, aseptic meningitis cases due to enterovirus infections increase every summer in various degrees with an incidence peak usually in July. During the past 11 years from 1981 through 1991, a total of 8,595 enterovirus isolations from aseptic meningitis cases were reported from 54 participating laboratories. Eight enterovirus types caused large epidemics; more than 100 isolations of each type from aseptic meningitis cases were reported for every epidemic year of the respective type. They were coxsackievirus (C) types B3 and B5, echovirus (E) types 4, 6, 7, 9, 18 and 30. Among these, the highest meningitis-associating frequency was reported for E30, representing 82.6% of the total isolations reported for the type during this period, followed by E4, 71.1%. The frequencies of E9, E7, E6 and CB5 were in a range from 54.5% to 44.4%, while that of E18 was 37.7% and that of CB3 21.0%. During the epidemics, enterovirus-associated meningitis was most frequently reported among children of 4-7 years of age. High frequencies were also shown in infants less than 1-year of age in some types. A total of 4,240 enteroviruses were isolated from cerebrospinal fluid of aseptic meningitis cases, representing 49.3% of the cases with enterovirus isolation.     

Epidemiological studies on Japanese encephalitis in Kyoto City area, Japan. I. Evidence for decrease of vector mosquitoes.

Mosquito collections by using light traps have been carried out at 10 to 11 stations in Kyoto City area at intervals of about 10 days every year. Mean percent indexes (MPI), being calculated from the data of mosquito collections, were used for comparison of the annual abundance of mosquitoes. It is no doubt that Culex tritaeniorhynchus summorosus has decreased recently and this decrease is correlated with the reduction of human patients of Japanese encephalitis. Wide use of two herbicides, CNP and nitrofen, for rice plant cultivation, may probably be one of the reasons for the decrease of the mosquitoes.     

Poliovirus surveillance: isolation of polioviruses in Japan, 1980-1991. A report of the National Epidemiological Surveillance of Infectious Agents in Japan.

This report presents an overall distribution of poliovirus isolations in Japan, where poliomyelitis has been under control over two decades as a result of legal administration of two doses of the trivalent live oral poliovirus vaccine of the Sabin strains (OPV) to children under 48 months of age. During the past 12 years from 1980 through 1991, a total of 1,126 poliovirus isolations from humans and 268 isolations from sewage/river water were reported by respectively 49 and nine of the participating laboratories. Type 2 was most frequently isolated from children after administration of one dose of OPV, followed by type 1 and type 3. On the contrary, after the second dose of OPV, the rate of isolation of type 3 exceeded those of type 2 and type 1. Seasonal and age distribution of poliovirus isolations from both humans and sewage/river water paralleled the OPV vaccination schedule in Japan. One percent of the isolations were, however, from infants younger than the vaccination-scheduled ages and 5% were from children older than those ages, including one each from 15 and 16 years olds. The data indicate that the poliovirus has silently been disseminated from vaccinated children to others and the community, thus suggesting repeated transmission of the viruses. The fact that some elder children had poliovirus colonization in their alimentary tracts indicates a potential risk of infection of such a population when exposed to a wild virus and of becoming a source of transmission to others.     

Clinical and bacteriological profiles of patients with typhoid fever treated during 1975-1998 in the Tokyo Metropolitan Komagome Hospital

Patients with typhoid fever presenting to the Tokyo Metropolitan Komagome Hospital during the period 1975-1998 were retrospectively investigated. All cases were diagnosed by a positive culture for Salmonella typhi in either of their clinical specimens. Of the total number of 130 patients, 57% contracted the disease abroad; this population increased in later years as the total numbers of cases decreased. The period from disease onset to diagnosis averaged 14 days with 20% of the cases requiring over three weeks to establish a diagnosis. As for symptomatology relative bradycardia was seen in less than half of the cases, and rose spots or splenomegaly in less than one third. A positive blood culture was the most frequent test establishing the diagnosis followed by a positive stool culture. Intestinal bleeding was recognized in as many as 35 cases (27%) and even intestinal perforation occurred in two cases (1.5%). Chloramphenicol was most commonly employed during the early study period, however, during the late period it was replaced by fluoroquinolones. The clinical cure rate was 98% with regimens that include fluoroquinolones/quinolone; however it was 87% with the other antimicrobial regimens. Bacteriological relapse occurred in 25% of the non-fluoroquinolone group while only in 2.0% in the fluoroquinolone/quinolone group. Four strains of Salmonella typhi that were multi-resistant to chloramphenicol, ampicillin and cotrimoxazole were isolated in travelers from Asia. Early diagnosis by appropriate bacteriological examination regardless of classical symptomatology should be stressed and the use of fluoroquinolones is warranted in the treatment of typhoid fever.     

Secular trend in height and weight within Old American families at Harvard, 1870-1965. I. Within twelve four-generation families

Among 85 members of 12 Old American families in which four generations were measured at Harvard, there were 12 fathers, 24 sons, 30 grandsons, and 19 great-grandsons. Mean birthdates for the four generations were 1858, 1888, 1918, and 1941, and mean ages when measured were 21.9, 19.0, 18.9, and 18.8 years. There was a significant increase in height between generations I and II (2.63 cm, p<0.02), a smaller rise (1.14 cm, not significant) to generation III, and no rise at all to generation IV. Weight rose negligibly until generation III and then increased 1.9 kg (not significant) to generation IV. The ponderal index, height/\documentclass{article}\pagestyle{empty}\begin{document}$ \sqrt[{\rm 3}]{{{\rm weight}}} $\end{document}, rose slightly to generation III, then fell significantly (p<0.02) in generation IV to its original value in generation I. These findings confirm other indications that the secular increase in height has ended among economically-favored Americans. Weight, on the other hand, may still be increasing.