Objective:To analyze the epidemiological characteristics of clustered epidemics of hand, foot, and mouth disease (HFMD) in Changping district of Beijing from 2018 to 2021.Methods:The epidemiological and etiological data of HFMD cluster epidemics in Changping district of Beijing from 2018 to 2021 were collected, and the descriptive epidemiological methods were used to analyze the distributions and pathogen constituents.Results:A total of 271 epidemics (including 266 clusters and 5 outbreaks) were reported from 2018 to 2021 and the average incidence rate was 11.04%. The median values of were both 2 d. The number of patients were positively correlated to the interval between epidemic on-set and reporting and to the duration of epidemics, with the correlation coefficients of 0.682 and 0.145, respectively (all P<0.05). The cases were mainly in the age group ≤ 5 years old, accounting for 77.67% (619/797). The epidemic mainly occurred in kindergartens, accounting for 78.97% (214/271). The top three number of epidemics occurred in Beiqijia town (51 epidemics), Huilongguan region (43 epidemics) and Dongxiaokou town (37 epidemics). The trend of epidemics reported was consistent with that of sporadic cases with the peak from May to July, and the second peak in September and November in some years. The main pathogens were coxsackievirus A 16 (CV-A16) and CV-A6. Conclusions:Clustered epidemic was the dominant type of epidemics in Changping District. Children under 5 years, kindergartens, the urban and rural fringe with dense population and large floating population are the key populations, places and areas for HFMD epidemic prevention and control. respectively. Early detection and reporting of the epidemic are the keys for prevention and control.

目的:了解北京市昌平区居民恶性肿瘤死亡状况及趋势,为预防和控制恶性肿瘤提供科学依据.方法:对昌平区18年来恶性肿瘤死亡资料进行统计分析,计算死亡率、标化死亡率、死因构成及年度变化百分比(annual percent change,APC)等指标.结果:2003-2020年全区恶性肿瘤死亡共13295人,占总死亡人数的21.97％,平均死亡率为134.45/10万,标化死亡率为105.39/10万,死亡率呈逐年上升趋势(P<0.05).男性死亡率高于女性(χ2=632.82,P<0.05);死亡率随年龄增长而上升,65岁前、后年龄组段人群的恶性肿瘤死亡比较差异有统计学意义(χ2=34154.01,P<0.05).在恶性肿瘤的死亡顺位中居前10位的依次为肺癌、肝癌、肠癌、胃癌、食管癌、胰腺癌、乳腺癌、白血病、膀胱癌和脑癌,占恶性肿瘤死亡总数的81.16％.结论:2003-2020年北京市昌平区恶性肿瘤死亡呈上升趋势,死亡率随年龄增长而上升,男性恶性肿瘤死亡率高于女性,肺癌位于恶性肿瘤死亡的首位,女性乳腺癌呈上升趋势,女性食管癌呈下降趋势.建议应加强健康教育和健康促进,采取有效的干预措施,减少恶性肿瘤的发生及其引起的死亡,提高期望寿命,促进居民健康.

目的 分析北京市昌平区诺如病毒感染性腹泻的流行病学特征,为进一步制定有效的防控措施提供依据.方法 用现场流行病学调查方法和描述分析方法,对2017-2020年北京市昌平区诺如病毒腹泻疫情报告和个案资料进行回顾性分析.结果 2017年1月-2020年12月,共报告疫情168起,累计病例1 876例,其中实验室诊断病例575例(30.65％),临床诊断病例1 799例(95.90％),无死亡病例.疫情以中小学(51.79％)为主要场所,其次是幼儿园(38.69％);时间上呈双峰分布;病例以3～17岁儿童为主(95.74％).不同年度发病人数构成比在疫情发生场所(x2=18.770,P=0.005)、年龄组(x2=22.215,P＜0.001)、性别(x2=7.864,P=0.049)和职业(x2=204.93,P＜0.001)间比较,差异有统计学意义.结论 诺如病毒感染引起的急性胃肠炎疫情发生场所以中小学校和幼儿园为主,发生时间段集中在学生开学期间,进入假期后大幅减少,学校应加强晨午检工作,及时停班并规范处置疫情,加强学校在传染病疫情处置方面的培训,做好疫情监测、健康教育宣传指导,降低传染病发病率.

目的 了解2006-2019年北京市昌平区布鲁氏菌病发病特征,为制定布鲁氏菌病预防和控制措施提供依据.方法 收集整理2006-2019年昌平区布鲁氏菌流行病学个案调查信息和重点行业人群血清学监测信息,采用描述流行病学方法分析数据.结果 2006-2019年昌平区共报告布鲁氏菌病患者90例,年发病率波动在0～ 1.3/10万;2-6月和12月为布鲁氏菌病发病高峰;男女性别比为3.3:1,40～ 59岁组发病居多、占报告病例的62.3％,以农民和家务及待业人员为主、占报告病例的65.6％;感染动物以羊为主、占87.8％,在养殖过程中感染占47.8％;共采集重点行业人员静脉血样2 505份,阳性64份、阳性率2.6％,年阳性率呈先升后降趋势,2015年阳性率最高为10.5％.结论 昌平区人间布鲁氏菌病疫情处于散发状态,感染与牛羊养殖密切相关;应继续做好疫情监测,加强养殖人员健康教育,改变不利于健康的传统生产、生活方式,自觉采取有效措施,预防并减少布鲁氏菌病的危害.

目的 了解北京市昌平区8～10岁儿童碘营养状况,为儿童碘缺乏病防治提供科学依据.方法 2017-2019年每年从本区随机抽取5所小学,每所小学随机抽取40名8～10岁儿童,收集其尿样和家中食用盐样测定尿碘水平和盐碘含量,并对儿童甲状腺进行B超检查.结果 采集600名儿童尿样,尿碘中位数为164.5μg/L;不同年份儿童尿碘水平差异有统计学意义(H=40.484,P＜0.01),呈逐年下降趋势(x2=-37.715,P＜0.01);尿碘水平男性儿童高于女性儿童(Z=-2.289,P＜0.05),农村高于城市(Z=.-4.281,P＜0.01).2017-2019年共检测食用盐样600份,盐碘中位数为20.4 mg/kg,碘盐覆盖率和合格碘盐食用率分别为87.5％和84.3％,各年份间盐碘水平差异有统计学意义(H=206.624,P＜0.01);不同年份碘盐覆盖率和合格碘盐食用率比较,差异均有统计学意义(x2=8.320、6.232,均P＜0.05),且均为上升趋势(x2=-6.595、6.120,均P＜0.05).B超检查600名儿童甲状腺容积,甲状腺肿大率为5.3％,不同年份、性别和年龄的儿童甲状腺肿大率比较差异无统计学意义(P＞0.05),农村儿童甲状腺肿大率高于城市儿童(x2=-6.376,P＜0.05).结论 2017-2019年北京市昌平区8～10岁儿童碘营养状况整体比较适宜,甲状腺肿大率高于国家标准,合格碘盐食用率低于国家消除碘缺乏病标准,建议对城市和农村采取因地制宜的措施以提高合格碘盐食用率,并定期评估儿童碘营养状况.

目的 了解1998-2020年北京市昌平区肾综合征出血热(HFRS)的流行特征,为做好防控工作提供依据.方法 收集1998-2020年北京市昌平区的HFRS疫情信息和宿主动物监测资料,采用SPSS 21.0软件进行描述性分析.结果 1998-2020年北京市昌平区累计报告HFRS病例145例,死亡1例,年平均发病率1.34/10万、病死率0.69％,95.17％的病例为原发性病例;报告病例主要分布在2007年之前,冬春季为发病高峰;青壮年发病居多,男女性别比为3.68∶1,以农民工、农民及工人为主;81.34％的病例有明确鼠接触史或居住/办公场所有鼠类活动痕迹;宿主动物监测显示优势鼠种为褐家鼠,平均鼠带毒率为1.04％.结论 北京市昌平区HFRS以直接或间接接触史者发病多见,应继续落实HFRS监测、防鼠灭鼠、临床诊治及健康教育等综合性防制措施.

目的 评估北京市昌平区第三次碘盐标准调整前后,儿童和孕妇碘营养水平变化,发现可能存在的碘缺乏风险,以便采取更加适宜的补碘策略.方法 按照《北京市碘盐监测实施方案》和《北京市碘缺乏病监测方案》开展监测,收集昌平区2009-2019年碘缺乏病监测数据,分碘盐标准调整前后和过渡期3个阶段对盐碘及尿碘数据进行分析.结果 2009-2019年共监测居民户食用盐3 252份,8～10岁儿童尿碘2 712份,孕妇尿碘2730份.碘盐标准调整前、过渡期和调整后盐碘中位数分别为31.2 mg/kg、25.4 mg/kg和22.3 mg/kg,3个阶段盐碘水平差异有统计学意义(H=1 362.155,P＜0.01),呈显著下降趋势;碘盐标准调整前、过渡期和调整后儿童尿碘中位数分别为266.7 μg/L、162.1μg/L和175.3 μg/L,3个阶段儿童尿碘水平差异有统计学意义(H=325.791,P＜0.01),由WHO推荐碘营养超过适宜量降至碘适宜量;碘盐标准调整前、过渡期和调整后孕妇尿碘中位数分别为181.1 μg/L、150.3 μg/L和139.8 μ.g/L,3个阶段孕妇尿碘水平差异有统计学意义(H=101.111,P＜0.01),由WHO推荐的碘营养适宜量下降到不足量.结论 碘盐标准调整后我区学龄儿童碘营养状况更趋于适宜、合理;但孕妇碘营养不足,应通过加强健康教育使孕妇有意识增加含碘丰富的食物摄入,以改善碘不足的现状.

目的 了解2018年北京市昌平区手足口病的流行特征及经济负担状况,为科学防控提供依据.方法 采用描述流行病学方法分析手足口病流行特征,采用SPSS 22.0统计分析手足口病经济负担.结果 北京市昌平区为手足口病高流行区,人群以散居及托幼儿童为主,季节特性呈夏季单峰流行,人群密集、外来人口聚集的地区,尤其是城乡接合部是手足口病的高发地区,重症病例和聚集性疫情的时间分布与流行高峰吻合.病原学以肠道病毒柯萨奇A组6型(CoxA6)和其他肠道病毒为主,重症病例以CoxA6为主.调查的158例手足口病患者总经济负担为426 645.18元,人均2 700.29元,轻症病例总经济负担358 846.04元,人均2 315.14元,重症病例总经济负担67 799.14元,人均22 599.71元.结论 北京市昌平区手足口病具有明显的人群、地区及时间分布特征,手足口病经济负担较重.CoxA6成为手足口病的主要病原体且在重症病例间发生.开展CoxA6病原学监测及经济负担的影响因素研究、加强托幼机构卫生监管,宣传手足口病的防控知识,落实消毒隔离等于预措施,以减少手足口病的传播和流行,从而降低手足口病的经济负担.

目的 了解2018年北京市昌平区诺如病毒感染疫情的流行病学特征,查找传染病防控漏洞和薄弱环节,为更好地预防和控制传染病的发生和传播提供依据.方法 采用现场流行病学调查方法,对每一起聚集性呕吐/腹泻疫情开展调查,收集疫情相关信息,采集病例、密切接触者以及相关人员的生物样品进行肠道病毒检测,并对数据进行统计分析.结果 68起疫情中聚集性疫情64起、暴发疫情4起;68起疫情中检出诺如病毒GⅠ型10起、诺如病毒GⅡ型44起、诺如病毒GⅠ型和GⅡ型混合感染12起、札如病毒2起;共采集标本376件,检出阳性标本198件,阳性率为52.66％;疫情报告病例数581例,波及5 748人,罹患率范围为4.21％～73.15％,平均罹患率为10.11％;≤12、13～18和≥19岁3个年龄组的呕吐、腹泻发病率比较,差异有统计学意义(x2=55.78、295.72,均P＜0.01).结论 中小学校和托幼机构是诺如病毒感染引起的急性胃肠炎疫情高发场所,应加强晨午检工作,对病例早发现、早隔离,及时停班并开展规范的消毒处置工作,对校医及班主任在传染病疫情处置方面加强培训,对学生和家长关于传染病防控方面加大宣传,多方联手做好传染病防控工作.

目的:了解北京市昌平区成年人急性感染性腹泻的病原菌谱及流行特征。方法:收集2014－2017年北京市昌平区中医医院肠道门诊腹泻患者检测粪便标本，进行肠道常见致病菌和病毒核酸检测。结果:1 520例腹泻病例中，共检出阳性样本483份，检测阳性率为31.8%；其中细菌样本360份，阳性率23.7%，病毒样本123例，阳性率8.1%。细菌性病原体中，副溶血弧菌最高(22.2%)、其次致泻性大肠埃希菌(21.9%)和沙门菌(19.7%)；病毒性病原体中，诺如病毒(15.7%)和轮状病毒(9.7%)检测阳性率较高；各年龄组中以21～30岁患者病原体检出率最高(30.8%)；疾病主要流行于夏春季；大肠埃希菌以肠致病性大肠埃希菌(EPEC)最高(67.0%)；沙门菌以肠炎沙门菌(44.2%)为多；志贺菌以宋氏志贺菌(86.5%)为多。结论:2014－2017年北京市昌平区感染性腹泻致病菌以副溶血弧菌及致泻性大肠埃希菌为主，沙门菌感染也是腹泻常见病原菌；病毒以诺如病毒感染为主；应加强感染性腹泻致病菌常规监测，在流行季节做好重点人群健康宣教工作，以指导感染性腹泻的防控工作。

目的 调查昌平区恙虫病的感染现状及危险因素,为制定全区恙虫病的防控策略提供依据.方法 2017年10-12月,在昌平区8个镇随机抽取常住人口开展恙虫病血清流行病学调查并进行危险因素分析.分别采用独立x2检验、分层x2检验及趋势性x2检验进行组间感染率分析.结果 本次调查共检测480份血清样本,其中55份恙虫病IgG抗体阳性,阳性率为11.45％;不同年龄(x2=57.712,P＜0.001)、教育程度(x2=35.257,P＜0.001)、职业(x2=17.222,P＜0.001)和地区(x2=69.469,P＜0.001)人群阳性率的差异有统计学意义.田间劳作(OR=3.03,95％CI:1.31～6.98)和草地行走(坐卧)(OR=3.18,95％CI:1.07～9.46)分别是农民和在职人员感染的危险因素.涂抹防虫剂(OR=0.45,95％CI:0.21～0.98)和外出后洗澡换衣(OR=0.48,95％CI:0.25～0.93)是保护因素.结论 北京市昌平区存在恙虫病隐性感染病例且具有显著的人群和地区差异,提示应加强监测与防控并开展进一步的调查研究.

Objective To estimate the excess numbers of influenza-like illness (ILI) cases associated with influenza from 2012 to 2017 in Changping district. Methods The surveillance data of ILI cases from secondary medical institutions and above in Changping district was collected to estimate influenza-associated excess numbers of ILI cases in different age groups using Serfling regression model and the adjusted Serfling regression model, respectively. Results The epidemic weeks of influenza were 52nd-2ndin 2012-2013, 52nd-6thin 2013-2014, 46th-3rdin 2014-2015, 52nd-14thin 2015-2016 and 47th-6thweeks in 2016-2017. The average number of annual influenza epidemic weeks was 10 (range: 4-15). The corresponding excess numbers of ILI cases attributed to influenza were 598 (95%CI: 207-719), 1 517 (95%CI: 1 070-1 964), 2 883 (95%CI: 2 243-3 522), 5 027 (95% CI: 4 067-5 986) and 3 126 (95%CI: 2 291-3 961) respectively. The average annual excess numbers of ILI cases were 2 630 (95%CI: 1 976-3 230) by the adjusted Serfling regression model, accounting for 57.6% of total ILI cases surveyed over the same period. Serfling regression model showed that the estimated results in age groups of less than 5 years old, 5-59 years old as well as in the whole population were consistent with the adjusted Serfling regression model. Conclusions The adjusted Serfling regression model was more accurate than the traditional Serfling regression model. The annual epidemic of influenza resulted in thousands of and tens of thousands of excess ILI cases and outpatient visits in Changping distirct.

目的 探讨气象因素与北京市昌平区其他感染性腹泻发病的关系,为调整防控措施提供科学依据.方法 收集昌平区2008-2014年其他感染性腹泻周发病资料及气象资料.对可能影响其发病的气温、相对湿度、降水、气压、风速及日照时数等6项气象因素与发病数进行单因素相关分析和多元回归分析.结果 其他感染性腹泻的发病同气温、相对湿度呈正相关.单因素相关系数分别为0.689和0.608.多元回归分析显示,气温、相对湿度与感染性腹泻呈正相关,Y(发病数)=13.44+ 1.12x1(周平均气温)+0.51x2(周平均相对湿度).结论 气温、相对湿度与昌平区其他感染性腹泻的发病密切相关,气象因素可作为自变量用于发病趋势预测.

本文对北京市昌平区农村居民人体重点寄生虫病防治知识知晓率及卫生行为形成情况进行抽样调查,为制定全区寄生虫病的防控策略提供有针对性的建议.本研究采用分层随机抽样法,随机选取的4个调查点,采用全国统一设计的结构式问卷,随机调查240人.结果显示,昌平区农村居民对人体重点寄生虫病防治知识的知晓率为22.7％,其在性别、年龄、文化程度和经济水平方面的差异均有统计学意义;卫生行为形成率为91.6％,并与地区经济水平呈正相关.结果表明,昌平区农村居民对人体重点寄生虫病防治知识的知晓率较低,特别是对华支睾吸虫病,但卫生行为形成率较高.应采取有针对性的健康教育工作,加强重点人群和重点地区的健康教育力度.

北京市昌平区自1989年出现首例肾综合征出血热(HFRS)病例以来,除2012年无病例外,其他年份均有病例报告,疫情处于散发状态,发病率处于较低水平.为掌握昌平区HFRS的流行特点及宿主动物感染情况,对昌平区2010-2015年HFRS监测结果进行了分析,现将结果报告如下.

目的 了解北京市昌平区肠道传染病发病情况和流行特征,为制定防控策略提供依据.方法 通过“中国疾病预防控制信息系统疾病监测信息报告管理系统”收集北京市昌平区2005-2013年报告的肠道传染病病例资料,采用描述流行病学方法对其流行特征进行分析.结果 2005-2013年昌平区共报告肠道传染病10种,累计64 877例,占法定报告传染病病例总数的76.81％,年均报告发病率为688.85/10万,无脊髓灰质炎病例报告;死亡12例,死亡率为0.13/10万.发病数居前3位的疾病为其他感染性腹泻、手足口病和细菌性痢疾,占肠道传染病报告病例数的99.18％.每年5～8月为发病高峰,占全年发病数的59.08％.病例主要分布在流动人口聚集的城乡结合地区,占病例总数的77.82％.男女性别比为1.37∶1,男女性发病率差异有统计学意义(x2=778.59,P＜0.01).5岁以下儿童占发病总数的58.60％;以散居儿童、幼托儿童和学生为主,占发病总数的72.09％.结论 昌平区以肠道传染病为主,防控的重点为流动人口聚集地区和儿童,应加强监测,有效预防和控制肠道传染病的暴发和流行.

Objective To analyze an outbreak of hand-foot-mouth disease (HFMD) in a kindergarten, so as to provide scientific basis for effective prevention and control of HFMD epidemics.Methods A retrospective epidemiological survey was carried out on an outbreak of HFMD in a kindergarten of Changping District, and epidemiological data were described and analyzed.Results The outbreak was caused by CAV16 infections and lasted for 8 days.A total of 15 cases were reported with an attack rate 50.0％.The cases occurred mainly in the baby classes.Conclusions HFMD outbreaks are common in kindergartens,timely intervention and comprehensive measures by the disease prevention and control departments play a key role in controlling the outbreak.

[Objective]To understand the pathogenic composition and the clinical characteristics of hand-foot-and-mouth disease(HFMD) in Changping District of Beijing in 2013.[Methods]The questionnaire data and test results of HFMD patients were analyzed with descriptive epidemiological method.[Results]47 samples were positive among 98 oropharyngeal swabs,and the positive rate of CoxA6 was 44. 68%(21 /47),while the positive rate of EV71 and CoxA16 was 46. 81%(22 /47). The clinical manifestations were fever,rash /herpes,nail loss,peeling phenomenon,pigmentation,symptoms of respiratory tract and digestive tract. The proportion of patients whose body temperature was 38 ℃ or above in CoxA6-positive group was 76. 19%(16 /21),which was higher than that in non-CoxA6-positive group(χ2= 10. 58,P 0. 01). The incidence of nail loss in CoxA6-positive group was 28. 57%(6/21),which was higher than that in non-CoxA6-positive group(χ2= 18. 73,P 0. 01). The incidence of peeling phenomenon in CoxA6-positive group was 66. 67%(14 /21),which was higher than that in non-CoxA6-positive group(χ2= 49. 46,P 0. 01).[Conclusion]The pathogenic composition of HFMD has obviously changed in Changping District,and CoxA6 has gradually become the dominant strain of HFMD. Except the clinical symptoms of respiratory tract and digestive tract,there are typical nail loss,peeling phenomenon and pigmentation,and the proportion of patient whose body temperature is 38℃ or above has increased.

[Objective]To observe the changes of humoral immunity after the immunization by domestic recombinant yeast-derived( CHO) hepatitis B vaccine( 10 μg and 20 μg),and the adverse reaction of vaccination,determine the appropriate adult immunization program.[Methods]By using the double-blind randomized clinical trial,222 subjects who met the selection criteria were respectively given 10 μg and 20 μg CHO hepatitis B vaccine according to the immunization program.The blood samples were collected 1 month after the third dose,to detect the anti-HBs titer( Abbott chemiluminescence method),and the anti-HBs negative samples were tested for HBV DNA further( fluorescence quantitative PCR).[Results]The positive conversion rate of two dose groups was respectively 89.47%( 95% CI:83.75%-95.19%) and 99.07%( 95% CI:97.24%-100.00%),non-and-low response rate was respectively 39.47% and 13.89%,while the antibody geometric mean titer( GMT) was respectively 134.57 mU / ml and 921.11 mU / ml.[Conclusion]CHO hepatitis B vaccine is safe and has good immunogenicity,and dose of 20 μg has better effect than dose of 10 μg,which is the appropriate dose.

>北京市昌平区每年按照《全国碘缺乏病监测方案》对8～10岁儿童碘营养状况开展监测,但均在公立学校开展。北京市现有100多所打工子弟学校,其中昌平区有20余所,为了解此部分儿童的碘营养状况,作者在2012年调查中,除公立学校外,另选取2所打工子弟学校的儿童作为调查对象,现将调查结果报道如下。1对象与方法1.1调查对象与内容:选择昌平区北七家镇和城北街道为调查点,每个镇(街道)选择公立和打工子弟小学校各1所,每所学校抽取60名8～10岁儿童,进