43
疫疫疫疫疫疫疫 疫疫疫疫 疫疫疫疫疫疫疫 疫疫疫疫疫 疫疫疫疫疫疫疫疫 () 2002. . 19 . 岡岡岡岡岡岡 岡岡岡岡 [email protected] kayama.jp

疫学初級者研修 疫学概論 アウトブレイク(集団発生)調査の基本ステップ

  • Upload
    vian

  • View
    101

  • Download
    0

Embed Size (px)

DESCRIPTION

疫学初級者研修 疫学概論 アウトブレイク(集団発生)調査の基本ステップ. 2002. 2 . 19 . 岡山市保健所 中瀬克己 [email protected]. 関東地域 EHEC 急増調査. 例年よりの増加分 関東を中心とした事例を含む. 日本でも 複数県集団発生の影響は大きい. 米国の動き 1. PFGE など新しい検査法による 調査の質向上 食品 由来集団発生     非喫食 者へ拡大 食品由来感染コントロールの 複雑・困難化 広域 集団発生の存在. 米国の動き 2. - PowerPoint PPT Presentation

Citation preview

  • 2002... [email protected]

  • EHEC

  • Graph1

    1510

    21713

    31114

    41616

    5129

    6348

    7198

    82019

    91615

    101731

    111821

    12538

    131041

    214103

    11488

    181940

    182124

    133119

    333034

    544044

    417346

    625060

    766497

    7576144

    9316487

    10412526

    9214527

    12112628

    1188829

    13913530

    11212631

    11217432

    15112933

    18721034

    16818535

    16818736

    11416837

    7116438

    9311539

    818640

    647441

    949142

    728543

    595644

    547045

    516946

    397047

    313948

    193949

    234050

    181051

    91852

    1999

    2000

    2001

    EHEC1999.162001.26

    Sheet1

    IDsystem ver.No.

    3G232300057200101200100102001010521995011520001227200012282001010420010130111572122112271112281136020010110 17:02

    3G1111000742001012001000420010105119900718200101012001010320010105200101200012253011VT2212213336020010110 17:02

    3G13130006120010220010001200101092198404052000123120010103200101062001013011 212211137020010119 11:00

    3G13130006320010220010001200101091199011282000122820010103200101092001023011 212211137020010119 11:00

    3G131300027200102200120022001011411957090620010114200101142001023011 VT H212221137020010119 11:00

    3G131300027200102200120012001011421965080120010114200101142001023011 VT()212221137020010119 11:00

    3G232300054200103200100022001011521952022720010115200101152001033011212221136020010124 19:02

    3G131300027200103200120032001011621946032320010116200101162001033011O157 vT()212221137020010215 17:03

    3G14140004120010320010001200101182194501272001011520010117200101172001033011212223336020010222 17:05

    3G23230005320010320010010200101182196504082001011820010118200103200101053011-15721212+21136020010124 19:02

    3G29290005320010320010001200101191199212112001011420010115200101192001033011212211336020010123 15:01

    3G232300054200103200100032001012011986040820010117200101202001033011212221136020010124 19:02

    3G23230005520010420010001200101241198305242001011420010116200101222001043011O157 VT2(+)112O157 VT2(+)211/161/171136020010131 15:01

    3G2727000622001042001000320010125219981130200101232001012320010125200104200101153011212211136020010309 17:01

    3G222200058200105200100012001013121967060520010130200101302001053011O157VT2212221136020010206 17:03

    3G13130006520010520013001200101311199411132001012420010125200101312001053011-+212211137020010216 09:00

    3G29290005420010520010001200102022197807102001012620010129200102022001052001012530122121VT11236020010207 11:01

    3G14141301620010620011601200102061197609072001012820010202200102062001063011212211137020010214 15:04

    3G1212100312001062001000220010207219931219200102012001020220010206200106200101283011212211136020010213 17:01

    3G34340003620010720010002200102172194709202001021420010215200102172001073011 212211136020010222 15:04

    3G34340003620010820010003200102201197604042001021820010218200102202001083011212211136020010228 11:01

    3G14141000620010820010009200102222194312042001021720010219200102212001083011o-157+212211137020010306 11:01

    3G42420006620010820010268200102231193802172001021620010217200102232001083011212211136020010307 15:03

    3G23230006420011020010001200103051197906162001021920010222200103052001103011212111138020010323 19:00

    3G27270006620011020010002200103072199602032001022820010302200103072001103011O1572121211338020010323 11:01

    3G12120006820011020010001200103102198001102001030520010307200103102001103011212211138020010319 15:00

    3G2727000662001112001000320010312119710313200103052001030920010312200111200102283011212111138020010329 15:01

    3G27270006520011120010008200103161195004162001031520010313200103152001113011212221138020010329 15:01

    3G27270006520011120010006200103161197006182001031520010313200103152001113011212213/7-3/101138020010329 15:01

    3G27270006520011120010009200103161197106022001031420010312200103152001113011212213/141138020010329 15:01

    3G27270006520011120010007200103161197907072001031220010313200103152001113011212213/123/141138020010329 15:01

    3G111100054200111200100012001031711970112120010313200103172001113011VT2212221136020010321 19:02

    3G13130005220011220010050200103192199609302001031220010314200103172001113011- () ()21221() 1138020010402 13:00

    3G11110007120011120010001200103172199809062001030820010308200103172001113011VT2212221136020010321 19:02

    3G13130005220011220010051200103192199811182001031220010313200103172001113011- () ()21221() 1138020010402 13:00

    3G1414100062001122001002120010319119751030200103132001031520010319200112200103133011O-157212211138020010329 13:01

    3G33330003320011220010002200103231199408062001031920010321200103232001123011O157 VT2212211136020010329 09:00

    3G232310014200112200100012001032421974011820010319200103242001123011212211138020010328 15:01

    3G42420006820011320010001200103302199711132001032420010326200103302001133011112211136020010404 17:03

    3G27270006520011420010010200104072199905102001040220010405200104072001143011 212211138020010419 17:00

    3G24240005420011420010001200104081199904132001033020010406200104082001143011212211238020010411 11:02

    3G141413016200115200116032001040911958032120010406200104092001153011212221138020010417 17:01

    3G27271002020011520010017200104091199304302001040420010406200104092001153011O1572121VT211138020010424 13:01

    3G24240005420011520010003200104112199610082001040920010407200104092001153011PCRO157 VT2212221238020010417 17:01

    3G24240005420011520010002200104102196809252001040820010409200104102001153011PCRO157 VT2212221238020010417 17:01

    3G35350003120011520010001200104102198112172001040620010407200104102001153011212211136020010418 13:00

    3G272710018200115200100182001041221944092720010410200104122001153011O1572121VT221138020010424 13:01

    3G35350003120011520010002200104121198404032001040720010409200104122001153011212211136020010418 13:00

    3G27270006320011520010006200104121199508062001041020010410200104122001153011O-157VT2212211138020010419 13:01

    3G27270006320011520010007200104122199511202001040920010410200104122001153011O-157VT2212211138020010419 13:01

    3G27270006320011520010004200104122199606082001040220010410200104122001153011O-157VT2212211138020010419 13:01

    3G272700063200115200100052001041211996063020010410200104122001153011O-157VT2212221138020010419 13:01

    3G27270006320011520010003200104122199701152001040820010410200104122001153011O-157VT2212211138020010419 13:01

    3G27270006320011520010002200104122199907032001032020010410200104122001153011O-157VT2212211138020010419 13:01

    3G29290005320011520010003200104132194803272001041020010411200104132001153011112211138020010417 17:01

    3G27270006320011520011001200104131197909022001040820010410200104132001153011O-157VT2212211138020010419 13:01

    3G272700063200115200100132001041311995052620010411200104132001153011O-157VT2212221138020010419 13:01

    3G27270006320011520010012200104132199602032001041120010411200104132001153011O-157VT2212211138020010419 13:01

    3G272700063200115200100102001041321996101820010411200104132001153011O-157VT2212221138020010419 13:01

    3G272700063200115200100112001041321997022220010411200104132001153011O-157VT2212221138020010419 13:01

    3G27270006320011520010008200104132199707312001040720010411200104132001153011O-157VT2212211138020010419 13:01

    3G272700063200115200100092001041311997111220010411200104132001153011O-157VT2212211138020010419 13:01

    3G272700063200115200100172001041421995092120010412200104142001153011O-157VT2212221138020010419 13:01

    3G272700063200115200100162001041421996040920010412200104142001153011O-157VT2212221138020010419 13:01

    3G272700063200115200100142001041411996101420010412200104142001153011O-157VT2212221138020010419 13:01

    3G272700063200115200100152001041411996112120010412200104142001153011O-157VT2212221138020010419 13:01

    3G353500061200115200100012001041511946081520010413200104152001153011212221136020010418 13:00

    3G27270006320011520010018200104152195907012001041020010413200104152001153011O-157VT2212211138020010419 13:01

    3G353500061200115200100022001041511982061720010413200104152001153011212221136020010418 13:00

    3G272700063200115200100192001041511995102820010413200104152001153011O-157VT2212221138020010419 13:01

    3G272710018200116200100192001041611941040620010413200104162001163011O1572121VT221138020010425 15:03

    3G272700063200116200100222001041611966090520010414200104162001163011O-157VT2212221138020010425 19:01

    3G272700063200116200100212001041611968092820010414200104162001163011O-157VT2212221138020010425 19:01

    3G272700063200116200100232001041621969022220010414200104162001163011O-157VT2212221138020010425 19:01

    3G27270006520011620010012200104172199611242001040220010405200104162001163011212211138020010425 19:01

    3G35350003120011620010003200104171197906162001041320010414200104172001163011212211138020010425 15:03

    3G272700063200116200100262001041711989041920010415200104172001163011O-157VT2212221138020010425 19:01

    3G22220006120011620010001200104172199307222001041220010413200104172001163011212211138020010424 17:05

    3G272700063200116200100252001041711997022120010415200104172001163011O-157VT2212221138020010425 19:01

    3G31310005420011620010003200104192192604282001041520010416200104182001163011212211138020010426 09:00

    3G27270006320011620010027200104182195808242001041520010416200104182001163011O-157VT2212211138020010425 19:01

    3G2121000582001182001000120010501219521017200104122001041420010419200116200104123011 212211138020010508 19:00

    3G20200005120011620010001200104192197901222001041220010416200104192001163011O-157,VT2212211238020010425 15:03

    3G222200061200116200100022001041911990063020010419200104192001163011212221138020010424 17:05

    3G353500058200116200100022001042011952062220010418200104202001163011212121138020010425 15:03

    3G13130009620011620010007200104201198406282001040520010420200104202001163011212211138020010426 17:01

    3G23230003220011620010023200104211199905022001041420010416200104212001163011VT-2212211138020010425 17:01

    3G13130009220011720010002200104252196012222001041720010419200104232001172001041130112122112119 38020010511 13:01

    3G20200005120011720010002200104231197511192001042020010423200117200104133011O-157,VT2212221138020010502 19:05

    3G27270006320011720010028200104241195105182001041520010421200104242001173011O-157VT2212211138020010510 19:00

    3G13130006020011720010120200104252197502142001041120010424200104242001172001041130112122111(38020010511 13:01

    3G23230003220011720010024200104241197504022001041220010418200104242001173011VT-2(+)212211138020010502 17:04

    3G232300032200117200100252001042421975052020010418200104242001173011 VT-2()212221138020010502 17:04

    3G272710018200117200100202001042711997033020010425200104272001173011O1572121VT221138020010511 13:01

    3G110008420011720010001200104281193304042001042220010422200104282001173011112211138020010502 19:05

    3G28281001220011720010004200104292198407302001041920010426200104292001173011O157VT2+212211138020010516 11:05

    3G29290005420011920010007200105102191109062001042520010428200105012001183011212111138020010515 19:01

    3G292900054200119200100052001051021913062520010427200105012001183011212121138020010515 19:01

    3G292900054200119200100062001051021918100320010428200105012001183011212121138020010515 19:01

    3G29290005420011920010003200105101192311012001042419380424200105012001183011212111138020010515 19:01

    3G292900054200119200100042001051011924120120010427200105012001183011212121138020010515 19:01

    3G292900054200119200100082001051021929010320010428200105012001183011212121138020010515 19:01

    3G29290005420011920010009200105102191206022001042220010429200105022001183011212111138020010515 19:01

    3G292900054200119200100102001051021958051320010429200105022001183011212121138020010515 19:01

    3G27270006820011820010006200105022197406112001042720010429200105022001183011212211138020010517 15:02

    3G2727100142001182001002120010502219930922200104192001042020010502200118200104173011O1572121VT211138020010511 13:01

    3G26260005220011920011002200105122197204022001050720010508200105112001192001050730122121o157vt21,,1136020010515 15:01

    3G424200034200119200100012001051111980051720010503200105062001051120011930111572212211136020010516 15:02

    3G47470005620011920010001200105111199809042001050220010502200105112001193011212211138020010516 19:01

    3G4545000312001192001000120010512219930802200105072001051020010512200119200105053011212211138020010516 09:00

    3G161600054200120200100012001051711964031720010514200105172001203011112121138020010523 13:01

    3G1313000032001202001000120010518119650621200105182001051820010518200120200105183011212221138020010524 13:01

    3G13130005720012020010001200105182196711292001051520010518200120200105093011VT2212221138020010524 13:01

    3G282810012200120200100062001051821976022020010518200105182001203011O157H7VT2(+)212221138020010523 09:03

    Sheet2

    200120

    15O157433

    217O2646

    359O11111

    10934

    11581

    1211420

    13221595

    209

    2135

    222

    316

    335

    9994

    ()20

    595

    Sheet2

    0

    0

    0

    0

    0

    0

    2001120

    Sheet4

    199920002001

    1510

    21713

    31114

    41616

    5129

    6348

    7198

    82019

    91615

    101731

    111821

    12538

    131041

    14214103

    1511488

    16181940

    17182124

    18133119

    19333034

    20544044

    21417346

    22625060

    23766497

    247576144

    259316487

    26104125

    2792145

    28121126

    2911888

    30139135

    31112126

    32112174

    33151129

    34187210

    35168185

    36168187

    37114168

    3871164

    3993115

    408186

    416474

    429491

    437285

    445956

    455470

    465169

    473970

    483139

    491939

    502340

    511810

    52918

    2850362010297499

    Sheet4

    1999

    2000

    2001

    EHEC1999.162001.26

    Sheet3

    2001

    1818

    2323

    3

    4242

    5252

    6363

    7373

    8383

    9494

    10101010

    11451145

    1214012140

    13391339

    14401440

    151151

    16101610

    174174

    18

    19

    205205

    212212

    22112211

    23232323

    245245

    25132513

    26262626

    27612761

    28172817

    29172917

    30

    312312

    321321

    33113311

    34213421

    357357

    362362

    37

    384384

    39

    40194019

    41

    42154215

    431431

    445445

    452452

    465465

    473473

    595

    595

    MBD000D2407.unknown

  • PFGE

  • PFGE

  • O157

  • 7

    2

    5

    4

    1

  • PFGE

  • 9

  • Field Epidemiology Training Program

  • 1999 15 03-5285-1111

  • 1999-2001

  • ()

  • () ,,

    ,,

  • O157

  • 7

    2

    5

    4

    1

  • 2

    4

    8

    8

    11

    28

    33

    20

    22

    7

    5

    4

    2

    1

    0

    2

    0

    2

    40

    80

    80

    110

    280

    330

    202

    225

    72

    56

    44

    210

    17

    01

    237

    012

    21

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    2

    5

    2

    6

    4

    10

    7

    1

    37

    12

    1

    00

    10

    10

    10

    40

    80

    80

    110

    280

    330

    202

    225

    72

    56

    44

    210

    17

    01

    237

    012

    21

    36,70236,70336,70436,70536,70636,70736,70836,70936,71036,71136,71236,71336,71436,715

    25264107137121011

    36,69200

    36,69310

    36,69410

    36,69510

    36,69640

    36,69780

    36,69880

    36,699110

    36,700280

    36,701330

    36,702202

    36,703225

    36,70472

    36,70556

    36,70644

    36,707210

    36,70817

    36,70901

    36,710237

    36,711012

    36,71221

    Sheet2

    Sheet3

  • Sheet:

    East

    Sheet:

    0-4

    '5-14

    '15-44

    '45-64

    '64+

  • Graph2

    252

    1237

    56813

    170315

    204633

    141036

    76057

    42884

    15182

    137103

    8489

    82103

    6391

    5468

    6184

    5572

    5575

    5068

    3752

    2939

    2530

    2126

    2215

    278

    O157N=9268

    Sheet1

    36,715252

    36,7161237

    36,71756813

    36,718170315

    36,719204633

    36,720141036

    36,72176057

    36,72242884

    36,72315182

    36,724137103

    36,7258489

    36,72682103

    36,7276391

    36,7285468

    36,7296184

    36,7305572

    36,7315575

    36,7325068

    36,7333752

    36,7342939

    36,7352530

    36,7362126

    36,7372215

    36,738278

    801612529268

    Sheet1

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    00

    5O157N=9268

    Sheet2

    Sheet3

  • ??%

    Graph1

    12

    0

    0

    0

    0

    21.3

    2.3

    19

    0

    9.7

    17.5

    9

    26.3

    5

    AR%

    Sheet1

    AR%

    (N=191)12

    (N=?)0

    (N=?)0

    (N=?)0

    (N=?)0

    (N=89)21.3

    (N=44)2.3

    (N=21)19

    (N=37)0

    (N=134)9.7

    (N=57)17.5

    (N=133)9

    (N=38)26.3

    (N=20)5

    Sheet2

    Sheet3

  • 1424 3O157VT2424O157VT

  • ??

  • 0.55
  • O SRSV CDC,Epidemic Intelligence Service Conference 20004