現(xiàn)場(chǎng)流行病學(xué)的基石——病例定義-閱讀頁
2025-08-04 02:05本頁面
【正文】 f the following characteristics – 咳嗽持續(xù) 2周或 2周以上 Continues for 2 or more weeks – 陣發(fā) With paroxysms – 咳嗽后嘔吐 Posttussive vomiting 病例定義應(yīng)用實(shí)例 Applying case definitions 舉例：人狂犬病監(jiān)測(cè)病例定義的標(biāo)準(zhǔn) Example criteria for a case definition for human rabies for surveillance ? 臨床標(biāo)準(zhǔn) Clinical: – 腦炎 Encephalitis – 發(fā)病后 10天內(nèi)死亡 Death within 10 days of onset ? 實(shí)驗(yàn)室標(biāo)準(zhǔn) Laboratory: – 頭發(fā)毛囊、角膜或者腦組織免疫熒光抗體染色陽性 Direct FA of hair follicle, cornea or brain – 抗狂犬病毒 IgG或 IgM抗體陽性（未經(jīng)免疫者） Antirabies IgG or IgM in an unvaccinated person ? 流行病學(xué)標(biāo)準(zhǔn) Epidemiological: – 被已知宿主動(dòng)物咬傷 Bite from a known reservoir animal species – 被患狂犬病的動(dòng)物咬傷 Bite from a rabid animal 舉例：狂犬病病例定義 Example rabies case definition ? 疑似病例 Suspect – 患腦炎并于 10天內(nèi)死亡 Encephalitis with death in ≤10 days ? 可能病例 = 疑似病例＋ Possible = suspect and – 動(dòng)物咬傷 animal bite ? 臨床診斷病例 = 疑似病例＋ Probable = suspect and – 被患狂犬病的動(dòng)物咬傷 bite from rabid animal ? 確診病例 =疑似病例、可能病例或者臨床診斷病例＋ Confirmed = suspect, possible or probable – 免疫熒光抗體檢測(cè)狂犬病毒 陽性 Rabies virus by direct FA from cornea, hair follicle, or brain – 或者抗狂犬病毒 IgM抗體陽性（未經(jīng)免疫者） Or antirabies IgM in an unvaccinated person 根據(jù)以下報(bào)告的狂犬病例數(shù)據(jù)，哪些病例符合病例定義？Some data from reported rabies cases. Which fit the case definitions? Clinic al Death Bite Vacc ine FA IgM E Y R N ND ND E Y O Y CI E Y N N ND + E N O Y ND + E Y N N Br+ + E=腦炎 encephalitis Y = 是 Yes N = 否 No R =患狂犬病的動(dòng)物 Rabid Animal O= 其它動(dòng)物 other animal ND =沒有檢測(cè) Not done CI = 角膜印跡 Corneal Impression Br = 腦組織 Brain 腮腺炎性腦膜腦炎 Mumps meningoencephalitis ? 臨床標(biāo)準(zhǔn) Clinical – 腦膜炎或腦炎癥狀并發(fā)熱大于 Symptoms of meningitis or encephalitis with fever ( C) – 腦脊液白細(xì)胞計(jì)數(shù)大于 50個(gè) /ml、葡萄糖大于 3,0 um/L CSF with 50 leucocytes/ml y glucose 3,0 um/L – 前 2周內(nèi)患有流行性腮腺炎 Mumps disease within 2 weeks before ? 流行病學(xué)標(biāo)準(zhǔn) Epidemiologic – 發(fā)病前一個(gè)月與流行性腮腺炎患者面對(duì)面接觸 過 Facetoface contact with a mumps case in the month before onset ? 實(shí)驗(yàn)室確診 標(biāo)準(zhǔn) Laboratory confirmation – 抗腮腺炎病毒 IgM抗體 Antimumps IgM – 分離到腮腺炎病毒 Isolation of mumps virus 流行性腮腺炎性腦膜炎 Mumps Meningitis ? 疑似病例 Suspect – 癥狀加接觸 Symptoms plus contact ? 可能病例 Possible – 癥狀加流行性腮腺炎 Symptoms plus mumps disease ? 臨床診斷病例 Probable – 疑似或者可能病例加腦脊液檢查 Suspect or possible with patible CSF ? 確診病例 Confirmed – 上述三種病例 Suspect, possible or probable – 急性期或恢復(fù)期檢測(cè)到 IgM抗體或分離到腮腺炎病毒 Antimumps IgM or isolation of mumps virus during acute illness or convalescence 根據(jù)以下病例一覽表判定哪些病例符合病例定義 Can you apply the case definition to this linelisting of patients? Cli ni ca l Mum ps Conta ct CSF Gluc os e CSF Leu. Lab Mamp。E N Y 4,5 um/L 1200 IgM + E Y Y 5,1 um/L 63 Pend in g M N N 1,1 um/L 245 Pend in g Mamp
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