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预防医学  2017, Vol. 29 Issue (2): 113-116    DOI: 10.19485/j.cnki.issn1007-0931.2017.02.002
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浙江省某地登革热聚集性疫情发现延迟原因分析
吴瑜燕,凌锋,龚震宇,郭颂,任江萍,陈恩富
浙江省疾病预防控制中心,浙江杭州 310009
An analysis on the reasons for the delay indiscovering dengue fever outbreak in Zhejiang Province
WU Yu-yan, LING Feng, GONG Zhen-yu, GUO Song, REN Jiang-ping, CHEN En-fu
The Center for Disease Control and Prevention of Zhejiang Province, Hangzhou , Zhejiang, 310009, China
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摘要 目的 分析浙江省某地一起登革热暴发疫情未及时发现的原因,为完善传染病疫情监测提供依据。方法 在疫情流行现场开展病例搜索和流行病学个案调查,对所有病例的流行病学资料、临床资料及就诊行为进行流行病学描述,分析疫情发现延迟的状况及原因。结果 该起登革热暴发疫情共发现临床诊断病例46例,未发现首发病例,报告前已出现二代病例,其中疫情报告前已发生36例,占全部病例的78.28%。可追溯的首例病例发病时间为7月15日,距疫情病原确诊日(9月10日)迟了57 d。46例临床诊断病例的医院就诊率为95.65%(44/46),其中发病3 d内的就诊率为91.30%(42/46)。疫情报告前36例病例发病3 d内的就诊率为91.67%(33/36),与疫情报告后的病例发病3 d内就诊率90.00%(9/10)比较,差异无统计学意义(P=1.00)。按症状是否典型分类,典型病例8例,非典型病例38例,典型病例发病当天就诊率为75.00%(6/8),与非典型病例的50.00%(19/38)比较,差异无统计学意义(P=0.26)。结论 本次疫情发现延迟与当地医疗系统诊断敏感性不高和病例不典型有关,应加强医护人员登革热等传染性疾病知识培训,提高疫情防控意识和诊断能力。
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吴瑜燕
凌锋
龚震宇
郭颂
任江萍
陈恩富
关键词 登革热疫情监测就诊行为    
AbstractObjective To learn the timeliness and reasons for the delay in discovering outbreaks via a dengue fever outbreak in Zhejiang Province, and try to improve our disease monitoring system. Methods Epidemic and clinic data were collected by searching cases and epidemiological investigation, and clinic behavior of cases in dengue fever outbreak were described, then the risk factors involved in the delay in discovering outbreak were analyzed. Results Totally 46 cases were found in this outbreak, among which 36 (78.28%)cases were infected before.The onset date of the first case we found was on July 15 th, 57 day before the outbreak confirmation. According to the results, 95.65% of cases see a doctor after their sickness, and the rate of three day hospital visiting was 93.36%(42/46), among which the rate of three day hospital visiting before pathogen confirmation was 91.67%(33/36),and there was no statistic significance in diagnostic rate before and after pathogen confirmation(P=1.00). Conclusion Cases in this dengue outbreak presented high and timely outpatient rate. Thus, the delay confirmation of dengue fever outbreak was caused by the low sensitivity of doctors in all levels of hospital. More training on dengue fever diagnosis for doctors should be carried out in the future to control and prevent dengue fever more efficiently.
Key wordsDengue fever    Disease surveillance    Clinic behavior
收稿日期: 2016-05-31      出版日期: 2017-11-21
ZTFLH:  R512.8  
通信作者: 陈恩富,E-mail:enfchen@cdc.zj.cn   
作者简介: 吴瑜燕,硕士, 医师,主要从事病媒生物防制工作
引用本文:   
吴瑜燕,凌锋,龚震宇,郭颂,任江萍,陈恩富. 浙江省某地登革热聚集性疫情发现延迟原因分析[J]. 预防医学, 2017, 29(2): 113-116.
WU Yu-yan, LING Feng, GONG Zhen-yu, GUO Song, REN Jiang-ping, CHEN En-fu. An analysis on the reasons for the delay indiscovering dengue fever outbreak in Zhejiang Province. Preventive Medicine, 2017, 29(2): 113-116.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn1007-0931.2017.02.002      或      http://www.zjyfyxzz.com/CN/Y2017/V29/I2/113
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