目的 分析2019年8月黄冈市黄州区发生的湖北省首起输入登革热病例引起本地感染暴发疫情流行特征,评价疫情处置效果,为今后防控登革热提供参考.方法 依据病例定义回顾性搜索病例,检测患者血清IgM、IgG、NS1抗原和登革病毒核酸,应用双层叠帐法监测成蚊密度,应用布雷图指数法监测蚊幼密度.结果 此起疫情自6月21日首例(输入)病例发病至9月11日末例病例发病,累计发现病例50例,流行高峰为8月20日至9月1日,无重症和死亡病例,主要临床表现依次为发热(94.00％)、乏力(78.00％)、头痛(48.00％)、肌肉关节痛(37.00％)、皮疹/出血点(26.00％).病例分布于1个街道(禹王街道)内相邻的2个村(韦家凉亭村49例、樊家湾村1例).病例男女性别比为0.85:1,发病年龄以50岁及以上人群为主,占89.10％.职业分布以农民和家务及待业为主,各占26.10％,其次为工人13.00％.疫情家庭聚集性较为明显.有8例病例检测登革病毒核酸为阳性,基因分型为Ⅰ型登革病毒.应急响应启动后,黄州区各乡镇(街道)的村居环境均得到明显改善,BI均降至5以下.结论 这是一起输入性登革热病例引起的本地暴发疫情,医务人员诊断识别能力不足、环境卫生差、蚊密度高是导致该起登革热疫情暴发的主要原因,防控重点是传染源的早期发现和规范管理,蚊媒孳生环境的制理和快速杀灭成蚊.

目的 2018年9月对湖北省某市某小学1起胃肠炎暴发疫情进行流行病学调查,分析暴发原因,为制定防控措施提供依据.方法 制定病例定义,开展病例搜索,进行现场流行病学调查及实验室检测,采用回顾性队列研究探索暴发原因.结果 搜索到病例117例,罹患率为3.75％(117/3 119).主要临床表现为呕吐(97.46％)、恶心(33.33％)、发热(21.37％)等症状.共采集28份标本进行诺如病毒核酸检测,7份检测出诺如病毒GⅡ型核酸阳性.导致暴发的原因为校外配送早餐蛋糕被诺如病毒污染(9月17、18日)(RR=25.71,95％CI:6.28～105.29;RR=9.80,95％CI:1.3272.81).结论 此次疫情为诺如病毒GII型引起的暴发疫情,可能为校外配送早餐(蛋糕)被蛋糕店作坊人员(隐性感染者)制作过程中污染引起.在加强校内食品安全的同时,不能忽视校外配送食品的安全工作.

目的 冷原子吸收法测定尿中汞的不确定度进行评定,保证检测工作的准确性.方法 结合日常检测,根据测量不确定度的评定理论和检测方法进行评定,确定和计算测量过程中各不确定度分量,并对测定结果进行完整描述.结果 合成标准不确定度为0.0410,对于尿汞含量为0.139 μg的样品,其扩展不确定度为0.0112 μg.结论 该法的不确定度主要来源于样品处理、标准溶液配制和曲线线性等方面.

Objective To investigate the epidemiological characteristics and influential factors of severe fever with thrombocytopenia syndrome (SFTS) I Huanggang City, and provide scientific basis for the development of prevention and control measures. Methods Descriptive epidemiological methods were used to analyze the data of SFTS in Huanggang during 2010-2017. Results A total of 1 210 SFTS cases and 85 deaths were reported in Huanggang during 2010-2017. The reported incidence was generally on the rise (trend χ2=206.84, P=0.00) and the cases were mainly in the northern mountainous area of Huanggang City. 96.03％ of the cases mainly occurred between April and October. The age of onset was concentrated in the 45-74 years old group, and the incidence rate of females was higher than that of males (χ2=9.62, P=0.00). The mortality rate of male SFTS was higher than that of females (χ2=5.18, P=0.02). 80.9％ of the patients were farmers. The average time interval from onset to final diagnosis was 20.6 days. Older cases had a higher mortality rate than younger cases (χ2=3.59, P=0.00). The incidence of ecchymosis on the skin, hematemesis and conjunctival congestion of death cases was significantly higher than that of surviving cases (χecchymosis on the skin2=9.95, P=0.00;χhematemesis 2=5.15, P=0.02;χconjunctival congestion 2=12.33, P=0.00). In the case of a clustering epidemic, the patient 3 was most likely to be exposed to the blood and secretions of the patient 2 and become infected. Conclusion It is critical to strengthen the prevention and control of SFTS in mountainous areas, and improve the ability of medical personnel to identify and diagnose SFTS at the earliest stage to reduce the mortality rate. It is necessary to strengthen publicity and education to promote the self-protection awareness and ability of the public, especially farmers and herdsmen. At the same time, the density control of medium of tick in the living environment of mountain farmers should be strengthened.

Objective To analyze the epidemiological characteristics of 8 imported cases in our city,and provide practical experiences for prevention and control measures of dengue fever.Methods A retrospective analysis was made on 8 cases of data by descriptive epidemiology.Results All 8 cases were imported cases.There were 3 cases derived from Indonesia,4 cases from Guangdong Province and 1 cases from Hainan Province among all 8 patients.All the cases occurred from July to October.The male to female ratio was 3∶1.The age of onset was 24 to 61,and the occupational structure dominated by migrant workers.The average intervals from onset to diagnosis were 5.63 days.There were 50.0％ patients (4 cases) by the village or township level medical institutions by referral to the municipal or provincial medical institutions was confirmed.Conclusions The key measures to prevent the epidemic of imported dengue fever is to strengthen the entry and exit port quarantine and to increase the awareness of the basic medical and health institutions on dengue fever.

目的 分析黄冈市甲型病毒性肝炎(甲肝)流行特征和发病趋势,为今后的防制工作提供依据.方法 采用描述流行病学分析方法,对黄冈市2005-2014年间1 751例甲肝病例进行分析,率的比较采用x2检验.结果 黄冈市甲肝发病率从2005年的4.65/10万下降到2014年的0.75/10万,呈逐渐下降的趋势(x2趋势=426.25,P＜0.01);全年散发,无明显季节性,英山县(7.83/10万)和浠水县(5.40/10万)高发;男性发病率(3.54/10万)明显高于女性(1.58/10万)(P＜0.05);病例主要集中在30岁以上人群,75.47％的病例是农民,农民、工人及民工发病数逐年稳步下降;实验室诊断病例比例从2005年的16.67％逐年上升到2014年的72.34％(x2趋势=167.32,P＜0.01).结论 黄冈市甲肝进入低流行状态,今后在进一步提高儿童甲肝疫苗接种率的同时,要做好其他重点人群的预防控制工作.

目的 分析黄冈市脊灰疫苗补充免疫活动开展情况,评价实施效果.方法 收集黄冈市11家县级疾病预防控制中心填报的脊灰疫苗补充免疫接种情况汇总表,将数据录入数据库后进行统计分析.结果 全市常住儿童和流动儿童脊灰疫苗补充免疫报告接种率和评估接种率均达到90％以上;未免疫儿童中,1岁以内儿童所占比例高于1岁以上儿童,流动儿童所占比例高于本地儿童(x2=11.31、12.36,P＜0.01).结论 黄冈市脊灰疫苗补充免疫活动效果较好,但仍需加强未免疫儿童特别是1岁以内儿童和流动儿童的查漏补种,进一步提高脊灰疫苗接种率,维持无脊灰状态.

目的 评定原子荧光光度法测定人体尿液中砷的测量不确定度. 方法 结合实际日常检测工作,评价原子荧光光度法测定尿中砷的测量不确定度,建立数学模型,查找该试验过程中测量不确定度来源,分析标准物质溶液转移、稀释定容、样品的前处理、曲线拟合以及仪器等影响不确定度的分量. 结果 影响样品结果合成不确定度的主要分量是样品的前处理,该方法测定尿中砷的含量为(9.17±0.59)μg/L,k=2;标准溶液浓度、样品消解处理、样品加标回收率、标准曲线拟合、原子荧光光度计和尿液比重计的不确度的分量分别为0.62％、2.80％、0.69％、0.94％、0.30％和0.40％,根据各个分量计算出此方法的合成不确定度为3.20％,扩展不确定度U为6.40％. 结论 在实际工作中必须严格控制好样品前处理的各个步骤,并按照仪器的操作规程进行测定.

目的 通过对湖北省首例人感染H7N9禽流感病例的调查分析,为类似疫情调查处理提供借鉴.方法 采用现场流行病学调查和实验室检测相结合的方法,阐述病例的流行病学特征、实验室检测结果、可能的感染来源及进一步的溯源调查结果等.结果 病例在发病前一直从事禽类宰杀销售工作,并长期使用禽脱毛机,在没有效防护措施的情况下有可能经呼吸道、皮肤黏膜等途径感染,感染来源为所销售的鸡.该调查未发现人传人的现象.结论 活禽或活禽交易市场暴露史是H7N9禽流感病例的关键风险因素,应广泛开展H7N9禽流感防治知识的宣传教育,同时扩大禽类暴露高危人群的监测,提高基层医疗机构医生的诊疗水平,以做到早发现、早报告、早诊断和早治疗,从而有效控制疫情发展.

目的：分析黄冈市国家免疫规划疫苗接种率调查情况，评价实施效果。方法全市10个县(市、区)全部参与调查，采用批质量保证抽样方法（LQAS），每个乡（镇、街道）入户调查42名2～3岁儿童的国家免疫规划疫苗接种情况，采用描述流行病学方法进行分析。结果全市适龄儿童基础免疫疫苗接种率乡镇达标率较高（84.92%以上），加强免疫疫苗接种率乡镇达标率偏低（40.48%以下），特别是新增扩大国家免疫规划疫苗的A群流脑疫苗、乙脑疫苗和甲肝疫苗接种率乡镇达标率较低（76.98%以下），乙肝首针及时接种率乡镇达标率偏低（34.92%），通过疫苗接种率乡镇达标率可以间接反映出疫苗接种率情况。结论黄冈市加强免疫疫苗接种率、新增扩大免疫规划疫苗接种率和乙肝首针及时接种率有待进一步提高。

目的 分析黄冈市2015年一起麻疹暴发疫情的调查情况,为今后麻疹疫情防控积累资料和提供参考.方法 收集黄冈市2015年麻疹疫情防控和处置资料,采用描述流行病学方法进行分析.结果 黄冈市2015年麻疹暴发疫情持续约3个月,共报告实验室确诊病例19例,主要集中在浠水县巴河镇艺术幼儿园(12例).最小年龄1岁、最大年龄35岁,无死亡病例;免疫史中0剂次或不详的18例,1剂次1例.结论 适龄儿童麻疹类疫苗接种率偏低、学校晨午检制度及预防接种证查验工作落实不到位是此次麻疹疫情暴发的主要原因.

目的 探讨黄冈市病毒性肝炎流行特征,为制定肝炎防制策略提供科学依据.方法 采用描述流行病学分析方法,对黄冈市2005-2013年间86 365例病毒性肝炎病例进行分析,率的比较采用卡方检验.结果 2005-2013年黄冈市病毒性肝炎年均发病率142.5/10万,以乙肝报告病例最多,占92.07％,甲肝和未分型肝炎发病率呈现逐渐下降的趋势,丙肝和戊肝呈现逐渐上升的趋势;甲肝、乙肝和戊肝男性发病率高于女性发病率(x2甲肝=27.44,P=0.00;x2乙肝=280.2,P=0.00;x2戊肝=36.81,P=0.00);15岁以下乙肝发病的比例在2005-2013年间呈逐渐降低的趋势,乙肝病例中以农民为主,而且农民乙肝发病数除了2009和2010年之外呈现一个明显上升的趋势;学生乙肝发病数逐年稳步下降.结论 病毒性肝炎的防治应以乙肝防治为重点,在抓好新生儿、儿童乙肝疫苗、甲肝疫苗免疫接种工作的基础上,应继续扩大疫苗免疫范围,同时高度重视丙肝好戊肝的预防.

目的 建立原子荧光快速测定尿砷的方法.方法 采用硝酸和双氧水消解样品,不赶酸直接用去离子水定容,优化仪器条件,采用标准曲线法,用原子荧光测定人尿中砷的浓度.结果 样品前处理改进后节省了时间,此方法检出限为0.101 μg/L,加标回收率为94.8％ ～ 101.6％,相对标准偏差为1.94％.结论 本法结果准确、耗时少、用酸量少、操作简单,可以作为日常检测人尿中砷的有效方法.

Objective To analyze the epidemic trends of notifiable communicable diseases in Huanggang from 2004 to 2014,and understand the epidemic pattern in order to provide evidence for the prevention and control of communicable diseases.Methods Descriptive epidemiology was applied to analyze notifiable communicable diseases in Huanggang from 2004 to 2014.Results From 2004 to 2014,271 625 cases of 30 kinds of notifiable communicable diseases were reported in Huanggang.The annual incidence was 374.77/100 000 with 524 deaths from 13 disease types resulting in an annual mortality rate of 0.72/100 000.Blood-borne and sexually transmitted diseases were the main disease types,occupying 53.63％ of class B notifiable communicable diseases,followed by respiratory infectious disease accounting for 38.99％,and intestinal infectious diseases accounting for 7.01％,and natural focal diseases and insect borne infectious disease accounting for 0.16％.The four most prevalent in the class B notifiable communicable diseases were viral hepatitis,pulmonary tuberculosis,dysentery and syphilis;hand-foot-mouth disease ranked the third in notifiable communicable diseases.The five diseases with the highest mortality rate were AIDS,rabies,pulmonary tuberculosis,fever with thrombo-cytopenia syndrome and hepatitis.Conclusion Viral hepatitis,pulmonary tuberculosis,hand-foot-mouth disease and syphilis were the primary infectious diseases in Huanggang;AIDS,rabies,pulmonary tuberculosis and fever with thrombocytopenia syndrome (emerging communicable disease) were the main causes death by communicable diseases.It is necessary to further strengthen the prevention and the control of these communicable diseases.

目的 分析黄冈市手足口病重症病例的流行病学特征,为进一步制定防控措施提供科学依据.方法 应用描述流行病学方法对黄冈市2009～2013年手足口病重症病例的流行病学特征进行分析,率的比较采用卡方检验.结果 2009～2013年黄冈市共报告手足口病重症病例64例,重症发生率为0.2％,重症病例病死率为9.38％.轻症手足口病患儿中男性比女性更容易进展为手足口病重症患儿(x2=4.42,P=0.035),98.4％(63/64)的重症病例发生在＜ 3岁组婴幼儿中;不同年龄组间重症发生率差异也有统计学意义(x2=117.01,P=0.000),且随着年龄上升,重症发生率有下降的趋势(趋势x2=57.48,P=0.000).散居儿童重症发生率高于幼托和学生(x2=6.73,P=0.01).全市有7个县有重症病例报告,浠水县报告最多(68.75％);79.7％的重症病例集中在6月和7月.重症病例以EV71型为主(59.4％),6例死亡病例中EV71阳性5例.结论 黄冈市手足口病疫情逐年升高,应对高发地区、高发人群及高发季节采取针对性的宣传教育工作,以降低手足口病重症发生率.

目的 了解阜康市某炼铜企业年产中产生的砷对周围居民尿砷含量的影响.方法 用尿中砷的新银盐分光光度法测定阜康市某炼铜企业周围居民尿砷含量.结果 居民110人尿砷均值为(36.1 ±26.5)μg/L,95％ CI为31.1-41.1 μg/L,中位数为36.0 μg/L.结论 建议进一步开展大范围一般人群尿砷值调查.

Objective:To discuss whether the error of different analysis method of the urine cadmium has within the scope of the permit,through a comparision between different detection methods on the same research object. In order to achieve the mutual recognition of test results comparable. Method:Graphite furnace atomic absorption spectrometry was used as the standard method which was compared by the differential potentiometric stripping method. Three samples were tested by the atomic absorption spectrophotometer and differential potentiometric stripping device and the quality control samples was prepared at the same time. Then the data was analyzed and the correlation and relative deviation were calculated. Result:The analytical errors of both methods were less than 3.69%,the standard recovery rate both locate within 95.3%-104.5%, all locate within the range of allowable error. The value of the Quality control samples under each experimental condition also accord with the range of allowable error. After calculation,when t locates within-0.627-2.89,P locates within 0.715-0.914. Conclusion:The results of the experiment show that the results consistency of the two methods are favorable,which can meet the test requirements. The differential potentiometric stripping method is more suitable treating large quantities of high concentration of detection.

Objective To understand the epidemiological characteristics,trends and influencing factors of rabies during the period of six years in Huanggang city,so as to provide suggestions for the prevention and control of rabies. Methods All rabies cases in Huanggang city from 2005-2010 were analyzed by descriptive epidemiology. Results 130 cases have been reported in Huanggang city since 2005.The average annual incidence was 0.316/105 and the case fatality was 100%.The cases were distributed in all the counties of Huanggang city,while the majority was in Huangmei,Qichun and Macheng,69 patients were reported(53.08%).Most patients were in the 40～70-year-old group,accounted for 60.77 percent of the total number of incidence.Farmers were the high risk population,accounting for 71.54% of the total.Most cases were hurt by dogs.After exposure,most patients(78.37%) did not receive any treatment,or just handled simply by themselves;75.68% of the patients did not receive vaccination or anti-serum injection.Conclusions Although the incidence of rabies of Huanggang has declined in recent years,the case fatality of rabies was still as high as 100%.Therefore,it is vital to strengthen the control and prevention of rabies,especially in rural areas.

目的:了解浙江省各级疾病预防控制机构实验室管理及工作人员对实验室生物安全知识的掌握情况,为更好地开展实验室生物安全管理和培训等相关工作提供依据。方法:统一设计《浙江省实验室生物安全知识调查问卷》,对全省11个市级疾病预防控制机构和随机抽取各市下属1个县级疾病预防控制机构实验室管理及工作人员进行实验室生物安全知识调查。结果:浙江省实验室工作人员总体知晓率为74.3%,但在实验室管理知识和专业知识的知晓程度上还是存在着参差不齐的现象,不同经济水平地区的得分悬殊有统计学差异,经济水平越发达、学历、职称越高、工作年限越长的人得分情况反而低。结论:加强对知晓率低的地区及人员生物安全知识和管理知识的培训,扩大实验室生物安全知识培训的覆盖面,不断提高实验室工作人员的安全防护意识。

目的 为全面掌握新疆加碘盐生产企业的加碘质量,加速新疆合格碘盐覆盖率的提高.方法 对新疆全部加碘盐生产企业采用国家统一的抽样和检测方法,对样品的加碘合格和均匀度进行分析评价.结果 在抽的11家生产企业的11批275份样品中,10个批次273份加碘合格(99.27%),仅有1个批次的2份加碘不合格(0.73%);总的加碘盐合格率为99.27%.11批次的变异系数合格的有5家企业,占45.5%,不合格的有6家企业,占55.5%,提示加碘盐的均匀度是当前生产企业的主要质量问题.结论 新疆加碘盐生产企业的加碘合格率达到国家标准,但加碘盐的均匀度还有待加强.