肠出血性大肠杆菌0104：H4调查过程及防控策略研讨.ppt

肠出血性大肠杆菌0104：H4发现过程及防控策略 0104：H4电镜图片 EHEC bacteria, O104:H4 outbreak strain. Scanning electron microscopy. Bar: 1 μm.Source: Holland, Laue (Robert Koch Institute) 德国应对0104:H4信息流向图 德国应对0104:H4策略 Routine surveillance system Reports to the European Union and the World Health Organization Enhanced surveillance system Centralising the epidemiological information exchange Accelerating the data flow to the national level Implementing a syndromic surveillance system for bloody diarrhoea in emergency departments Assessing the capacities for HUS-treatment in Germany Initiating active laboratory surveillance 受影响的国家 HUS地区分布 Proportions of patients with bloody diarrhea among all patients visiting emergency departments, by age and sex as well as number of participating emergency departments in areas more affected by the EHEC/HUS outbreak, EHEC/HUS outbreak, Germany, May-June 2011 (n=1,021) Back projection from the daily onsets of disease to the exposure period HUS cases presented chronologically: Onset of disease, date of hospitalization, of diagnosis, of notification to health authorities, and of receipt of notification at the RKI (reporting) Results of the univariate and multivariate analysis of risk factors for the development of bloody diarrhoea in two canteens in Frankfurt am Main Recipe-Based Restaurant Cohort Study  Fruit and vegetable exposures associated with the incidence of HUS (p-value 0.1) in the univariate analysis of the raw vegetable case-control study 豆芽溯源 下萨克森州比嫩比尔特的一家农场生产的芽苗菜是这次疫情传染源头 调查人员还没有从任何食物样本中找到病原体——肠出血性大肠杆菌0104:H4，包括在这家农场以及饭馆、患者家的厨房获取的样本 在德国确认埃及一家公司的葫芦巴种子是EHEC源头 欧盟方面已于7月初宣布，到今年10月底，暂停从埃及进口葫芦巴、豆芽和油料三种作物种子 2009年至2011年期间从埃及进口的所有葫芦巴种子必须即刻从商场下架 病例数 As of July, 25th 2011; 10.00am During the outbreak period a total of 4,321 cases were reported to the RKI including 3,469 EHEC cases and 852 HUS cases In total 50 patients died, including 18 EHEC patients and 32 HUS patients As of July, 22nd 2011 According to the European Centre for Disease