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中華公共衛生雜誌

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篇名 1993年臺閩地區恙蟲病流行病學調查報告
卷期 14:4
作者 李淑芳蔡淑芬施清河趙秀琳吳聰能
頁次 334-341
關鍵字 恙蟲病焦痂Scrub typhusTsutsugamushi diseaseEscharTSCI
出刊日期 199508

中文摘要

     本調查報告的目的在了解臺閩地區恙蟲病發生情形、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。結果顥示近十幾年來,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 %, 有淋巴病變者佔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, 發現有 23 例具有上述之臨床症狀, 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。

英文摘要

     Tsutsugamushi disease is one of the endemicrickettsial infections in the Taiwan area. The number of reported has shown anincreasing trend since 1989, and case numbers reached a climax in 1993 (231reported cases and 58 confirmed cases). The main purpose of this investigationwas to illustrate the epidem-iological characteristics of Tsutsugamushi Diseasein Taiwan. The endemic areas are mainly mountainous areas and isolated islands,such as Taitung County. Hualien County, Penghu County, Kinmen County andLienkiang County, The seasonal trend showed the disease pre-dominated in thesummer 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 twoof above three symptoms, 98% of the 58 seroconfirmed cases, presented clinicalsypmtoms consistent with Tsutsugamushi disease, and the positive predictionvalue was estimated as 98.28%. In contrast, only 23 of 60 serologicalindeterminant cases (39%) met the clinical symptoms.

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