目的 了解上海市金山区肠道病毒71型(enterovirus 71,EV71)灭活疫苗接种水平及其对该区手足口病(hand-food-mouth disease,HFMD)流行病学和病原谱变化的影响,为改进该区HFMD防控策略提供依据.方法 收集上海市金山区免疫规划信息综合管理系统中2016-2019年EV71灭活疫苗接种资料,描述接种特征;提取"中国疾病监测报告信息系统"中2013-2019年金山区HFMD病例资料,获取同期该区HFMD病原监测信息,比较接种前后HFMD发病率、病原阳性检出率等的差异性.结果 2016年11月-2019年12月,金山区共接种EV71灭活疫苗63 521剂次,第1针接种率为22.57％,全程接种率为21.05％,两剂次基础免疫完成率为94.65％.不同年份、月份、现住址、年龄、户籍等接种率存在差异性(P均＜0.05),第1针接种率2018年最高(33.45％),全程接种率2017年最高(30.78％),5-8月份接种量较大,6～11月龄接种率最高,1岁以上接种量最大,本市儿童接种率高于流动儿童.接种前后HFMD发病率差异无统计学意义(x2=0.427,P=0.513),接种后重症发病率、EV71阳性检出率、EV71感染HFMD估算发病率均显著降低(x2分别为15.312、41.431和432.342,P均＜0.001).结论 接种EV71灭活疫苗降低了金山区HFMD EV71感染和重症发生,但接种率水平较低,还需关注HFMD病原谱变化,预防其他肠道病毒感染.建议加强宣传和信息化手段提高接种率,加快联合疫苗研发,提供更多抗体保护.

[目的]研究上海市金山区海产品牡蛎中副溶血性弧菌的污染现状,并对其可能引发的风险进行评估,为相关部门提供防控依据.[方法]2017年7—10月采用随机抽样的方法在金山区农贸市场、超市、餐饮店中随机采集带壳未加工牡蛎样品40份,参照国家标准检测方法检测牡蛎中副溶血性弧菌含量,并结合2012—2013年上海市金山区居民膳食与健康状况监测结果,应用Risk Ranger软件进行半定量风险评估分析.[结果]40份牡蛎样品中副溶血性弧菌的总体阳性检出率为80.0％(32/40).以农贸市场检出率最高为85.7％(12/14),其次是餐饮饭店和超市.生食牡蛎,副溶血性弧菌污染的风险分值为63,属于高风险,预计消费者患病的概率为6.85×10-4,预计金山区居民每年因生食牡蛎感染副溶血性弧菌致病的发病率为1247.8/10万.[结论]金山区海产品牡蛎中副溶血性弧菌污染情况较严重.生食海产品牡蛎为高风险,建议消费者减少或不生食牡蛎.食用牡蛎前有效加工是降低副溶血性弧菌食源性疾病发生的有效方法,同时进一步加强海产品流通环节的监测和管理.

目的 对上海市金山区2016年-2017年667份初筛阳性样本进行确证实验,对确证阳性样本进行免疫印迹试验(WB)条带分析,提高实验室HIV抗体检测能力,增强对WB实验结果的分析判断能力.方法 对金山区各艾滋病筛查实验室送检的HIV抗体初筛阳性样品,WB确证检测.结果 667份筛查阳性标本WB阳性482份(72.26％),不确定84份(12.59％),阴性101份(15.14％);确证阳性病例主要来自自愿咨询检测和医疗机构就诊检测,不同送检来源的样品阳性率差异无统计学意义(P＞0.05);确证阳性样品带型以全带型及次全带型为主.结论 HIV感染的确证依赖于WB实验,WB带型的阳性判读应严格按照《全国艾滋病检测技术规范》(2015版)及试剂盒说明书,参考实际情况,谨慎判定;随着宣传力度的加大,艾滋病的自愿咨询检测得以推广,艾滋病自愿咨询检测及医疗机构检测已经成为发现HIV感染者的主要方式.

目的 分析上海市母婴麻疹抗体水平及其影响因素,为控制初免前小儿麻疹发病提供依据.方法 采用横断面研究方法,调查上海市某城区422例孕妇和200例新生儿,以及173例＜2岁儿童血清麻疹IgG抗体水平,分析低月龄儿童麻疹抗体消长规律及其与母体的相关性.结果 新生儿出生时抗体阳性率85.50％ (171/200),保护率41.00％ (82/200);随着月龄增长,3～7月龄分别锐减到14.29％ (5/35)和2.86％ (1/35);8～12月龄时首剂次疫苗接种率仅为51.52％ (17/33),抗体阳性率75.76％ (25/33),保护率达66.67％ (22/33);1～2岁时完成二剂次疫苗接种达94.67％ (71/75),抗体阳性率92.00％ (69/75)、保护率76.00％ (57/75);母婴抗体水平高度相关(r=0.893,P＜0.01),孕妇抗体水平阳性率86.97％ (367/422),保护率36.02％ (152/422),免疫史不详达73.22％ (309/422).结论 初免前母传抗体消失以及首剂次疫苗及时接种率低可能是导致＜1岁儿童麻疹高发的根本原因,应逐步推进育龄妇女的强化免疫工作,加强预防接种管理,提高首剂疫苗接种率.

诺如病毒(Norovirus,NoV)是引起人类非细菌性急性胃肠炎的重要病原体.为评价一起养老院胃肠炎暴发疫情处置效果,本研究对采集的既往病例及院内环境样本进行NoV检测,探讨疫情暴发处置后期既往病例病毒携带及环境污染情况,为今后养老院内NoV胃肠炎暴发的防控提供依据。

OBJECTIVE To understand the maternal syphilis infection of Jinshan District in Shanghai,and provide a basis for the prevention and treatment of syphilis.METHODS We calculated and analyzed the information of 4 541 pregnant women who had been in hospital for prenatal care in Jinshan District of 2009,including Syphilis antibody test results and maternal personal information.RESULTS The syphilis antibody positive rate was 3.30‰(15/4 541).It was statistical significance that the syphilis antibody positive rate of less educated pregnant women was higher.The rates of unemployed pregnant women and the pregnant women with multiple pregnancies were higher as well.CONCLUSION The widespread public awareness and education should be actively advocated to strengthen the sense of maternal self-care and to minimize neonatal syphilis infection.

Objective To analyze the cause of acute gastroenteritis outbreak in a nursing institution of Shanghai. Methods Stool samples were collected to detect enteric pathogens and RV.NoVs were detected by real-time RT-PCR and conventional RT-PCR.The PCR products were purified and sequenced,and then compared the sequences of the PCR products in GenBank using on line server BLAST and the sequences were aligned by using Clustal W.MEGA 4.1 program was employed to construct the phylogenetic trees,and SimPlot3.5.1 program was employed to indentify the recombinant NoV strain. Results All the stool samples were negative to enteric pathogens and RV,19 of 21 stool samples were positive to NoV,which included 11 stool samples of the old patients and 8 stool samples of the staff.The NoV shared 99% nucleotide sequence identity with Hu/NSW696T/2006/AUS(EF684915). Conclusions By comparing the nucleotide sequence,this acute gastroenteritis outbreak was caused by GⅡ.4 norovirus strain,which may supply important information to study the norovirus in the elderly.