Usera M A, Echeita A, Aladueña A, Alvarez J, Carreño C, Orcau A, Planas C
Sección de Enterobacterias, CNMVIS, Instituto de Salud Carlos III. Majadahonda, Madrid.
Enferm Infecc Microbiol Clin. 1995 Oct;13(8):450-4.
Typhoid fever incidence in Spain, and particularly in Catalonia has decreased significantly since 1985. Water borne outbreaks can affect large numbers of people. These two reasons make specially interesting to study all suspected typhoid fever outbreaks, like the one that happened in March 1994 in Bages county (Barcelona).
Epidemiological questionnaires were conducted to investigate the origin of the outbreak, the presence of related cases in the same area, and the household contacts of cases S. typhi isolates were characterized by serotyping, biotyping, phage-typing, ribotyping and pulsed field gel electrophoresis analysis of DNA.
Nine cases were identified. All cases were treated with antibiotics, with clinical success. There were not secondary cases. The possible origin was a drinking fountain. All the strains had the same epidemiological marker patterns.
Breaking of the sewer pipes near to the drinking fountain was probably the origin of the contamination. It can be concluded the importance of keeping a good epidemiological control system to investigate and prevent outbreaks. It is also important to control the drinking fountains to prevent its contamination. Finally it is necessary to highlight the utility of epidemiological markers to fully characterized the involved strains.
自1985年以来,西班牙,尤其是加泰罗尼亚的伤寒热发病率显著下降。水源性疫情可影响大量人群。这两个原因使得研究所有疑似伤寒热疫情变得特别有意义,比如1994年3月在巴格斯县(巴塞罗那)发生的那起疫情。
开展流行病学问卷调查,以调查疫情的源头、同一地区相关病例的情况以及病例的家庭接触者。通过血清分型、生物分型、噬菌体分型、核糖体分型和DNA脉冲场凝胶电泳分析对伤寒沙门氏菌分离株进行特征鉴定。
确认了9例病例。所有病例均接受抗生素治疗,临床治疗成功。无二代病例。可能的源头是一个饮水机。所有菌株具有相同的流行病学标记模式。
饮水机附近的污水管破裂可能是污染的源头。可以得出结论,保持良好的流行病学控制系统对于调查和预防疫情很重要。控制饮水机以防止其受到污染也很重要。最后,有必要强调流行病学标记对于全面鉴定所涉菌株的效用。