1992年秘鲁特鲁希略的霍乱流行：临床病例定义的效用及霍乱弧菌O1血清型的转变

Epidemic cholera in Trujillo, Peru 1992: utility of a clinical case definition and shift in Vibrio cholerae O1 serotype.

作者信息

Vugia D J, Rodriguez M, Vargas R, Ricse C, Ocampo C, Llaque R, Seminario J L, Greene K D, Tauxe R V, Blake P A

机构信息

Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

Am J Trop Med Hyg. 1994 May;50(5):566-9. doi: 10.4269/ajtmh.1994.50.566.

DOI:10.4269/ajtmh.1994.50.566

PMID:8203704

Abstract

Epidemic cholera continues in Peru. Since 1991, cholera surveillance in Peru has been based mainly on clinical recognition. To determine the proportion of reported cholera patients who actually have cholera and to evaluate the clinical case definition used in surveillance, we cultured rectal swabs from patients presenting with acute diarrhea in March 1992 in Trujillo, Peru. Of 197 patients meeting the clinical case definition, 174 (88%) had confirmed Vibrio cholerae O1 infection. In this epidemic setting, watery diarrhea of sudden onset in a person of any age presenting for treatment is highly predictive of cholera. Of note, 90% of the current V. cholerae O1 El Tor isolates were of serotype Ogawa, while a year earlier, all were of serotype Inaba.

摘要

秘鲁仍有霍乱疫情。自1991年以来，秘鲁的霍乱监测主要基于临床诊断。为确定报告的霍乱患者中实际患有霍乱的比例，并评估监测中使用的临床病例定义，我们对1992年3月在秘鲁特鲁希略出现急性腹泻的患者的直肠拭子进行了培养。在符合临床病例定义的197名患者中，174名（88%）确诊为霍乱弧菌O1感染。在这种疫情背景下，任何年龄前来就诊且突发水样腹泻的患者极有可能感染霍乱。值得注意的是，目前的霍乱弧菌O1埃尔托生物型分离株90%为小川血清型，而一年前全部为稻叶血清型。