1993年臺閩地區恙蟲病流行病學調查報告

Tsutsugamushi Disease in Taiwan, 1993

李淑芳(Shu-Fang Lee) ； 蔡淑芬(Su-Fen Tsai) ； 施清河(Cheng-Ho Shih) ； 趙秀琳(Show-Lin Chao) ； 吳聰能(Trong-Neng Wu)

《中華公共衛生雜誌》 14卷4期 (1995/08) Pp. 334-341

https://doi.org/10.6288/CJPH1995-14-04-04

摘要

本調查報告的目的在了解臺閩地區恙蟲病要生情形、感染地區、季節分佈，並探討恙蟲病確定病例臨床症候等之流行病學特質。結果顯示近十幾年來，臺灣地區恙蟲病報告與確定病例數有逐年增加的趨勢，至1993年達到最高峰，共有231例報告病例。確定病例自1989年始有區分，亦自該年的10例增至1993年的58例。以感染地來看，主要分佈在臺東縣、澎湖縣、花蓮縣與金門縣、連江縣等偏遠山區；以發病月份來看，五至九月為尖峰季節。另調查58例確定病例中，出現皮膚焦痂者佔70.69%，有林巴病變者佔89.66%，發生高燒者佔89.66%。如選擇具有此三項中之二項臨床症狀為判別標準，則可達98.28%的陽性預測值。另對未完成血清判讀的60名病例，進行個案調查，在完成調查的34例個案中，今現有23例具有上迷之臨床症狀，如這些病例確屬確定病例，則1993年的恙蟲病十萬人口罹病率將從每十萬人口的0.28人增為0.40人。

關鍵字

恙蟲病 ； 焦痂

並列摘要

Tsutsugamushi disease is one of the endemic rickettsial infections in the Taiwan area. The number of reported has shown an increasing trend since 1989, and case numbers reached a climax in 1993 (231 reported cases and 58 confirmed cases). The main purpose of this investigation was to illustrate the epidem-iological characteristics of Tsutsugamushi Disease in Taiwan. The endemic areas are mainly mountainous areas and isolated islands, such as Taitung County. Hualien County, Penghu County, Kinmen County and Lienkiang County, The seasonal trend showed the disease pre-dominated in the summer and early autumn. Of the 58 confirmed cases, 70.69% showed skin eschar, 89.66% had lymphadenopathy, and 89.66% presented with fever. After applying two of above three symptoms, 98% of the 58 seroconfirmed cases, presented clinical sypmtoms consistent with Tsutsugamushi disease, and the positive prediction value was estimated as 98.28%. In contrast, only 23 of 60 serological indeterminant cases (39%) met the clinical symptoms.

並列關鍵字

Scrub typhus ； Tsutsugamushi disease ； Eschar