培训课件--食源性疾病调查.ppt

* * * 11例患者的临床表现，调查当日91%有眼花的临床症状，82%的表现为头晕，64%有手麻表现，55%有呕吐表现。5例重症病例临床诊断横纹肌溶解症。 * 11例患者的临床表现，调查当日91%有眼花的临床症状，82%的表现为头晕，64%有手麻表现，55%有呕吐表现。5例重症病例临床诊断横纹肌溶解症。 * 这些极端值是值得仔细地检查，因为如果它们是暴发的一部分，它们不寻常的暴露可能直接地指向传染来源。 * * * * * * * Children in Kindergartens A and B drank the milk during mid-morning; children in Kindergarten C drank the milk during mid-afternoon. The average incubation period in the 3 kindergarten were 4.5 hours, 5.4 hours and 4.5 hours, respectively. * Children in Kindergartens A and B drank the milk during mid-morning; children in Kindergarten C drank the milk during mid-afternoon. The average incubation period in the 3 kindergarten were 4.5 hours, 5.4 hours and 4.5 hours, respectively. * * 通过这张图可以看出，85%（129人）病例的潜伏期在2-5小时以内。 2 3 3 14 4 77 5 35 6 16 7 6 8 0 9 0 10 1 126人在3~5小时内发病 * 食源性疾病暴发中常采用回顾性队列研究或或病例对照研究来验证假设 * 为调查可疑餐次，首先以该公司所有职工为研究对象，调阅职工暴发前72小时进食各餐次的打卡记录，按照在食堂进食某餐次与未进食某餐次进行分组，分别计算二组罹患率，并比较其差异 以参加聚餐的所有村民为研究对象，在132例病例中，随机选择50例作为病例组；在参加聚餐无任何不适症状的172例村民中，随机选择50名作为对照组，通过入户调查的方式，收集病例和对照在聚餐是食用各种食物的信息，比较聚餐的各种食物病例组食用与未食用之比与对照组食用与未食用之比的差异 * * 从就餐地点调查来看：学生共有第1、2、校外餐饮街3个就餐地点，回顾性队列调查结果显示：在第1食堂就餐风险较高，提示：第1食堂为可疑就餐地点。 * * * * Weekly pneumonia and influenza mortality as a proportion of all deaths for 121 cities – United States, January 1, 1988—December 3, 1993 Show: The endemic seasonal pattern (seasonal baseline) The Epidemic threshold (1.6 SD) The random variability around the baseline The seasonal outbreaks – none to large –different starting times Weekly pneumonia and influenza mortality as a proportion of all deaths for 121 cities – United States, January 1, 1988—December 3, 1993 Show: The endemic seasonal pattern (seasonal baseline) The Epidemic threshold (1.6 SD) The random variability around the baseline The seasonal outbreaks – none to large –different starting times * * * 维生素D是脂溶性维生素，脂溶性维生素在体内的排泄率不高，摄入过多可引起蓄积中毒。 * * * * * * * * * * * * * * * * * * * * * 特点：持续暴露于同一传染源而导致疾病的暴发，类似于点源暴露，流行曲线快速上升，达到峰值后，出现一个平台期；如果消除传染源，则曲线快速下降，如果传染源自