Oswego- CDC FETP-J 1
PART I 1940 4 19 4 18 80 75 46 2
75 46 24 75 46 1 An OutbreakAn Epidemic An Outbreak An Epidemic Endemic for the region Seasonal variation Random variation 3
10 : 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 4
2430 20 () O1 non-o1 () : 5
vehicle/vector / vector vehicle /vector reservoir ()6
Demographic Information 7
8
ID 9
2 ID YN 10
ID 11
PART II XY 12
A) B) 13
14
1 New York Oswego 1940 4 1819 30 New York Oswego 1940 4 1819 15
3 Point Source Transmission 25 20 15 10 5 0 1 3 5 7 9 11 13 15 17 19 20 15 10 5 0 1 3 5 7 9 11 13 15 17 19 16
17
curve, AEpidemic 18
AEpidemic curve, 4 5, 6/1-7/8n=18, 6/1-7/8 n=47 19
20
PART III : = 3 = 7 = 4 (2211/12) = 4 21
22
23
1 1-2 12-74 8-16 (2-4 ) 6-24 12-72 2-5 2-36 V. vulnificus S. faecium (S. arizonae ) Vibrio parahaemolyticus (?) Aeromonas hydrophila Plesiomonas shigelloides (01-01 ) V. vulnificus V. fluvialis 3-5 1-6 1-24
3-6 1 *** / () () 1-6 2-6 72 1 ( ) Chlorinated () aches 4-28 7-28 10-13 25
10-50 / - () ( ) 0.5-2 2-5 3-4 ( ) 30 2-3 (dinophysis toxin, okadaic acid, pectenotoxin, yessotoxin) 24 () - 48 () (domoic acid) 26
11 2-4 2-4 14 27
1. 2. 3. 1. 2. 3. 2 4. 22 a b a+b a/a+b c d c+d c/c+d a+c b+d t=a+b+c+d a/a+b c/c+d 5a. 2 2 =3.84 p=0.05 t( ad-bc -t/2) 2 2 (a+b)(c+d)(a+c)(b+d) 5b. 95CIRRexp1.96/W W = 28
() () 29 17 46 63 % 17 12 29 59 % 1.1 26 17 43 60 % 20 12 32 63 % 1.0 23 14 37 62 % 23 14 37 62 % 1.0 18 10 28 64 % 28 19 47 60 % 1.1 16 7 23 70 % 30 22 52 58 % 1.2 21 16 37 57 % 25 13 38 66 % 0.86 18 9 27 67 % 28 20 48 58 % 1.2 2 2 4 50 % 44 27 71 62 % 0.81 19 12 31 61 % 27 17 44 61 % 1.0 13 11 24 54 % 33 18 51 65 % 0.83 27 13 40 68 % 19 16 35 54 % 1.3 43 11 54 80 % 3 18 21 14 % 5.7 25 22 47 53 % 20 7 27 74 % 0.72 4 2 6 67 % 42 27 69 61 % 1.1 1. 80 2. 14 43/4693 43 11 54 79.6% 3 18 21 14.3% 46 29 75 61.3% 79.6%/14.3%=5.6 Yates 2 1 2 24.5 p=7x10-7 Taylor 95 1.9 16.0 29
3 3 RR=1.3 RR=0.7 27 25 25 80 27 30
: A. 1. 2. B. C. 1530 3050 (15% - 40% D. E. 40 72 88( 70% 87%). 31
1 7 6 2 4 5 3 32
A. B. C. D. E. 2. 33
34 PART IV - 417 18:00 418 5140g 2 385g 1 1 2 S. albus S. albus S. albus 4 1718 3
519 524 1811 CDC ELISA FDA Reference Gross MB. Oswego County revisited. Public Health Reports 1976;91:160-70. 35