A community-based gastroenteritis outbreak after Typhoon Haiyan, Leyte, Philippines, 2013
A community-based gastroenteritis outbreak after Typhoon Haiyan, Leyte, Philippines, 2013
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DOI：
10.2471/wpsar.2014.5.1.010
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发表时间：
2015-01-01
影响因子：
1
通讯作者：
Tayag, Enrique
中科院分区：
文献类型：
--
作者：
Ventura, Ray Justin;Muhi, Edzel;Tayag, Enrique
背景：台风海燕发生三周后，莱特岛卡南加报告的急性胃肠炎病例数量不断增加，该地区的疏散居民在灾后两天返回家园。进行了暴发调查，以确定与胃肠炎增加相关的来源和危险因素。方法：病例定义为2013年11月11日至2013年12月10日期间卡南加发生急性腹泻（≥3次/24小时）并出现以下任何症状：发烧、恶心、呕吐或腹痛的任何人。通过审查病历积极发现病例，并进行病例对照研究。对直肠拭子和水样进行细菌学检查。结果：确诊105例。多变量分析显示，饮用未经处理的饮用水与疾病相关（调整后的比值比：18.2）。直肠拭子和城市水样的嗜水气单胞菌检测结果均呈阳性。经检查市政供水系统，发现供水管道破裂，部分管道淹没在河水中。结论：本次急性胃肠炎疫情很可能是由嗜水气单胞菌引起，并通过受污染的水源传播。这项研究强调，受灾害影响较小、不需要持续疏散中心的地区仍然可能爆发急性胃肠炎。在救灾期间，应监测所有受影响的地区，而不仅仅是那些设有疏散中心的地区。还应建议所有受灾害影响的地区对水进行煮沸或氯化处理。
Background: Three weeks after Typhoon Haiyan, an increasing number of acute gastroenteritis cases were reported in Kananga, Leyte, an area where evacuated residents had returned home two days after the disaster. An outbreak investigation was conducted to identify the source and risk factors associated with the increase of gastroenteritis.Methods: A case was defined as any person in Kananga who developed acute diarrhoea (>= 3 times/24 hours) and any of the following symptoms: fever, nausea, vomiting or abdominal pain from 11 November 2013 to 10 December 2013. Active case finding was conducted by reviewing medical records, and a case-control study was conducted. Rectal swabs and water samples were tested for bacteriological examination.Results: One hundred and five cases were identified. Multivariate analysis revealed that consumption of untreated drinking-water was associated with illness (adjusted odds ratio: 18.2). Both rectal swabs and municipal water samples tested positive for Aeromonas hydrophila. On inspection of the municipal water system, breaks in the distribution pipes were found with some submerged in river water.Conclusion: This acute gastroenteritis outbreak was most likely caused by Aeromonas hydrophila and transmitted through a contaminated water source. This study highlights that areas less damaged by a disaster that do not require ongoing evacuation centres can still have acute gastroenteritis outbreaks. All affected areas should be monitored during a disaster response, not just those with evacuation centres. Boiling or chlorinating of water should also be recommended for all areas affected by disaster.