Halliday M L, Kang L Y, Zhou T K, Hu M D, Pan Q C, Fu T Y, Huang Y S, Hu S L
Department of Preventive Medicine and Biostatistics, Faculty of Medicine, University of Toronto, Canada.
J Infect Dis. 1991 Nov;164(5):852-9. doi: 10.1093/infdis/164.5.852.
An epidemic of hepatitis A in 1988 in Shanghai had an overall attack rate of 4083/100,000 population (292,301 cases). The epidemic curve showed three peaks in January and February. A case-control study of 1208 matched pairs supported that clams were the vehicle for the virus (summary odds ratio, 9.47; P less than .001). Analysis of subsets who had eaten clams indicated that only 3.5% with hepatitis A had cooked their clams compared with 18.1% without hepatitis A, and those with the disease consumed more clams. A historical cohort study indicated that approximately 31.7% of the population had eaten clams one or more times between 9 December 1987 and 3 January 1988. The estimated attack rates in those who had and had not eaten clams were 11.93% and 0.52%, respectively (relative risk, 22.94; attributable risk, 11.41%). The three peaks in the consumption curve correlated with those in the epidemic curve. Hepatitis A virus was demonstrated in clams taken from the Shanghai markets and from the catching area.
1988年上海发生甲型肝炎流行，总发病率为4083/10万人口（292301例）。流行曲线在1月和2月出现三个高峰。一项对1208对匹配病例对照研究支持蛤蜊是病毒传播媒介（汇总比值比为9.47；P<0.001）。对食用蛤蜊的亚组分析表明，甲型肝炎患者中只有3.5%的人将蛤蜊煮熟，而无甲型肝炎者为18.1%，且患病者食用的蛤蜊更多。一项历史性队列研究表明，在1987年12月9日至1988年1月3日期间，约31.7%的人口曾食用过蛤蜊一次或多次。食用和未食用蛤蜊者的估计发病率分别为11.93%和0.52%（相对危险度为22.94；归因危险度为11.41%）。消费曲线中的三个高峰与流行曲线中的高峰相关。从上海市场和捕捞区采集的蛤蜊中检测到甲型肝炎病毒。
