頁籤選單縮合
題名 | 2007年11月臺中市某國小水源性桿菌性痢疾流行事件調查=A Waterborne Shigellosis Outbreak in a Primary School, Tai-Chung City, November 2007 |
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作者 | 趙雁南; 黃頌恩; 邱乾順; 蔡韶慧; 林千惠; 李品慧; Chao, Yen-nan; Huang, Angela Song-en; Chiou, Chien-shun; Tsai, Shao-hui; Lin, Chien-hui; Lee, Pin-hui; |
期刊 | 疫情報導 |
出版日期 | 20081000 |
卷期 | 24:10 2008.10[民97.10] |
頁次 | 頁769-779+左740-752 |
分類號 | 415.13 |
語文 | chi、eng |
關鍵詞 | 桿菌性痢疾; 水源性疫情流行; 地下水; Shigella sonnei; Waterborne outbreaks; Groundwater; |
中文摘要 | 桿菌痢疾主要是藉由人與人接觸的方式傳染,遭?染的水源或食物也可能引發大規模的流行。本研究目的在探究2007年11月台中市某國小因痢疾桿菌(Shigella sonnei)藉由水源污染而引發群聚事件的始末。本研究採取病例對照研究法(case-control study),於2007年11月22日以該學校學生為對象,病例組是指調查開始前四週內,發生腹瀉或有發燒、噁心、裡急後重、腹痛等症狀中至少二種的學生。我們運用問卷收集資料,包括個人基本資料、手部清潔習慣、午餐的內容、喝水來源、學校指派的清潔工作等,也實際調查學校環境。我們對病例組學生及其接觸者均採集肛門塗片檢體,將這些塗片與水源樣本等檢體送實驗室培養並以脈衝場凝膠電泳法(pulsed-field gel electrophoresis,以下簡稱PFGE)作基因分型的檢查。本調查發現有271位疑似病例,流行期結束總計共有57位確定病例。結果發現,上廁所後不良的洗手習慣與與疾病發生的相關性具統計意義,罹病勝算比(odds ratio)為1.64,95%信賴區間為1.07-2.52, p值 <0.05。環境調查顯示此學校六棟教室建築中有四棟的廁所水源被化糞池污水污染,而教室位在此四棟建築物中的學生之感染率16.7%,也明顯高於另兩棟的學生的感染率8.2%,p值 <0.001。水源樣本檢體檢出為Shigella sonnei,並且與由學生身上採檢到的檢體,以PFGE分離出來的基因型別相同。此為一水源性桿菌痢疾群聚事件,且在給予感控措施後仍持續2週,所幸疫情並未漫延至社區。在此事件之後,台中市政府全面禁止學校使用地下水,並增加預算舖設自來水系統,也要求學校應每學期進行水源品質檢驗。 |
英文摘要 | Shigellosis is mainly transmitted from person-to-person. Contaminated water or foods can also cause large outbreaks. This study was to evaluate the transmission route and to find the possible common source associated with a waterborne outbreak caused by Shigella sonnei in a primary school in Tai-Chung City, Taiwan, in November 2007. We conducted a case-control study of students in the school on November 22nd, 2007. Cases were defined as illness on students who had diarrhea or at least two of the following symptoms: fever, vomiting, tenesmus, or abdominal pain. We used questionnaire included information about demographic data, hand hygiene, type of lunch, drinking water, and school cleaning assignments. Rectal swabs were collected from suspect cases and their contacts. We also inspected the school environment. Stool and water samples were sent for cultures and pulsed-field gel electrophoresis (PFGE). There were 271 suspect cases occurred during the 4 weeks before investigation. A total of 57 confirmed cases were found in the end of outbreak. Poor hand hygiene after toilet was associated with illness (OR: 1.64; 95% CL: 1.07-2.52). Environmental investigation revealed that groundwater for lavatory-use in four of the six school buildings was contaminated by a damaged sewer connection. Students whose classrooms located in the four buildings had higher attack rate in the study. (16.7% vs. 8.2%, p < 0.001). The water sample yielded Shigella sonnei which was identical to human isolates in PFGE pattern. Conclusion. It was a shigellosis waterborne outbreak and lasted for another two weeks after carrying out the control measures. It did not spread to the community. Tai-Chung City government then prohibited any groundwater use in schools and increased the budget for them to access piped water system. Water quality examination should also be done in each semester. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。