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1988 - 1989年佛罗里达州甲型肝炎社区范围内的爆发与日托中心的儿童有关,且在年轻成年男性中传播增加。

Community wide outbreak of hepatitis A linked to children in day care centres and with increased transmission in young adult men in Florida 1988-9.

作者信息

Desenclos J C, MacLafferty L

机构信息

Division of Field Epidemiology, Centers for Disease Control, Atlanta, GA.

出版信息

J Epidemiol Community Health. 1993 Aug;47(4):269-73. doi: 10.1136/jech.47.4.269.

DOI:10.1136/jech.47.4.269
PMID:8228760
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1059791/
Abstract

STUDY OBJECTIVE

To investigate a community wide outbreak of hepatitis A (HA).

DESIGN

Description of the outbreak, with a case-control study to assess transmission.

SETTING

A Florida county, USA, 1988-9.

SUBJECTS

A total of 311 cases of HA.

MEASUREMENTS AND MAIN RESULTS

A 13 month outbreak of HA is described. Most of the 311 cases (95%) were residents of a large metropolitan area (attack rate per 10,000 population (AR) = 3.7) and two smaller cities (AR = 61.5 and AR = 6.4). The ARs were greater for males than females and for residents aged 25-34 years (9.7) and < 5 years (8.3). Altogether 37% of cases were linked to day care centres, independent of the city of residence. A household case-control study showed an increased risk of HA in households in which a child attended a day care centre (p = 0.02), and centres that could take more than 50 children had an increased risk of HA introduction than smaller ones (p = 0.05).

CONCLUSIONS

Day care centres were an important source of HA in the community, and the need for timely surveillance and immunoglobin prophylaxis is emphasised. Homosexual transmission may have played an important role in this outbreak.

摘要

研究目的

调查甲型肝炎(HA)在社区范围内的暴发情况。

设计

对暴发情况进行描述,并开展病例对照研究以评估传播情况。

地点

美国佛罗里达州某县,1988 - 1989年。

研究对象

共311例甲型肝炎病例。

测量指标及主要结果

描述了一次持续13个月的甲型肝炎暴发。311例病例中的大多数(95%)是一个大都市地区的居民(每10000人口发病率(AR)= 3.7)以及两个较小城市的居民(AR分别为61.5和6.4)。男性和年龄在25 - 34岁(9.7)以及5岁以下(8.3)的居民发病率更高。总计37%的病例与日托中心有关,与居住城市无关。一项家庭病例对照研究显示,家中有儿童在日托中心的家庭患甲型肝炎的风险增加(p = 0.02),且可容纳50名以上儿童的日托中心引入甲型肝炎的风险比规模较小的日托中心更高(p = 0.05)。

结论

日托中心是社区中甲型肝炎的一个重要来源,强调了及时监测和注射免疫球蛋白进行预防的必要性。同性传播可能在此次暴发中起了重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3c2/1059791/a159f7ace5e5/jepicomh00205-0020-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3c2/1059791/a159f7ace5e5/jepicomh00205-0020-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3c2/1059791/a159f7ace5e5/jepicomh00205-0020-a.jpg

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