King C C, Chen C J, You S L, Chuang Y C, Huang H H, Tsai W C
Department of Microbiology, Soochow University, Taipei, Taiwan, Republic of China.
Int J Epidemiol. 1989 Mar;18(1):254-60. doi: 10.1093/ije/18.1.254.
An outbreak of typhoid fever occurred in Chu-Tung township, Taiwan, with dates of onset from 6 July to 8 August, 1983. Fifty-four cases were hospitalized, of which 52 were laboratory confirmed. A chloramphenicol-resistant strain of Salmonella typhi was isolated from patients' blood samples. A community survey of 2772 people selected from 490 households by stratified systematic cluster sampling, presented an attack rate of 9.4 per 1000 and a case reporting rate of 10%. The attack rate was higher in males than females for persons younger than ten years, but was greater in females than in males aged 40 years and older. The only consistent characteristic of the early outbreak cases was drinking of tapwater (10/10, 100% versus 319/490, 65% of the controls). None of the early cases but 36% (13/36) of the late cases had drunk stream or river water. Households of early cases had better hygienic conditions than those of late cases. Laboratory examination of environmental specimens indicated Escherichia coli contamination of tapwater, well water and all stream foci associated with human activities. The epidemiological data combined with laboratory results suggested that the epidemic might be due to repeated contamination of some common source (such as municipal tapwater) and/or a variety of other vehicles.
1983年7月6日至8月8日，台湾竹东镇爆发了伤寒热。54例患者住院治疗，其中52例经实验室确诊。从患者血样中分离出一株对氯霉素耐药的伤寒沙门氏菌。通过分层系统整群抽样从490户家庭中选取2772人进行社区调查，发病率为每1000人中有9.4例，病例报告率为10%。10岁以下人群中男性发病率高于女性，但40岁及以上人群中女性发病率高于男性。早期爆发病例唯一一致的特征是饮用自来水（10/10，100%，而对照组为319/490，65%）。早期病例中无人饮用溪水或河水，而晚期病例中有36%（13/36）饮用过。早期病例家庭的卫生条件优于晚期病例家庭。环境样本的实验室检查表明，自来水、井水以及所有与人类活动相关的溪流源头均受到大肠杆菌污染。流行病学数据与实验室结果表明，此次疫情可能是由于某个共同来源（如市政自来水）和/或多种其他传播媒介的反复污染所致。
