987例炭疽病例资料分析-第三军医大学学报.DOC

84个炭疽暴发案例流行病学调查文献系统评价 许汝福林辉李亚斐(400038重庆，第三军医大学军事预防医学院军队流行病学教研室) 探讨炭疽暴发案例流行病学特征，分析感染原因，为炭疽防控提供依据。方法检索电子数据库中符合纳入标准的84个炭疽暴发案例流行病学调查文献资料进行系统评价。结果84个炭疽暴发案例均发生在农村或牧区，涉及患者990例，治愈970例，死亡20例，男女比为4.21，1560岁占87.2%，农牧民占92.4%，西北、西南和华南占79.5%，59月份占87.8%；最短潜伏期中位数2，最长潜伏期中位数8；首发病例诊断时间中位数4；病畜、病死畜肉接触患者占98.%，屠宰病死家畜者的相对危险度显著高于食用病死畜肉者(RR=55.47，95% CI=26.03～118.21，P0.000 01)。77个案例的疫情控制中位数时间10。结论炭疽暴发疫情多发生在农村和牧区，青壮年及农牧特征明显；屠宰病死家畜或病死畜肉是感染的主要原因。 关键词炭疽；暴发；流行特征；潜伏期；相对危险度Epidemiology of 84 anthrax outbreak cases: A systematic review of its related literature Xu Rufu, Li Hui, Li Yafei, Xiang Ying, Xu Bin, Zhang Yao, Huang Guorong (Teaching and Research Section of Military Epidemiology, College of Military Preventive Medicine, Third Military Medical University, Chongqing 400038, China) [Abstract] Objective To provide the evidence for prevention and control of anthrax by studying the epidemiological characteristics of anthrax outbreak cases and analyzing the causes of anthrax infection in china. Methods Papers on epidemiology of 84 anthrax outbreak cases retrieved from Chinese Biomedical Literature Database and Chinese Science and Technology Journals Database were systematically reviewed. Results The 84 anthrax outbreak cases occurred in rural or pastoral areas. Of the 990 anthrax patients with a male to female ratio of 4.2:1, 970 were cured and 20 died, 87.2% aged 15-60 years, 92.4% were farmers and herdsmen, 79.5% were located in West and South China, 87.8% occurred in May- September. The median shortest incubation time was 2 days, the median longest incubation time was 8 days, the median diagnosis time of the first patient was 4 days, and 98.3% of the patients contacted with the affected or died animals or their meat. The relative risk was significantly higher for slaughters than for those who ate the meat (RR=55.47, 95% CI=26.03-118.21, P0.00001). The median epidemic control time for the 77 cases was 10 days. Conclusion Anthrax outbreak usually occurs in rural or pastoral areas. Young ad