青海省玉树县地震灾区重点传染病风险初步评估
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摘要
目的分析青海省玉树县地震灾区重点传染病的发生、传播风险,为震区灾后的传染病防控工作提供有针对性的建议。方法采集2004-2010年(截至4月15日)灾区的甲乙丙类传染病报告数据,进行历史疫情分析;查询文献和咨询专家意见,分析地震灾害对灾区传染病发生、传播可能产生的影响;对灾区重点传染病的发生和传播划分风险等级,并提供防控建议。结果 2004年以来,玉树县的主要报告病种为乙型病毒性肝炎和肺结核,丙型病毒性肝炎、包虫病、梅毒等亦报告较多,淋病、炭疽、流行性脑脊髓膜炎等偶有报告。灾后可能对传染病发生、传播造成影响的因素包括安置点卫生条件差、疫源动物和媒介昆虫的活动改变、人群流动性加大和抵抗力下降以及医疗卫生服务可及性降低等。综合评估麻疹、流行性感冒、肺结核等呼吸道传染病,细菌性痢疾、感染性腹泻病等肠道传染病在灾区传播增强的风险较高,鼠疫、炭疽等发生、传播风险中等,狂犬病、性传播疾病等发生、传播风险较低。结论震区灾后传染病防控工作应重视保护水源和饮用水安全,加强食品卫生和食品供给,努力恢复免疫规划和结核病控制等防控项目,加强鼠疫、包虫病、麻疹等疾病的防控,做好安置点管理等。
Objective To analyze the risk factors to the incidence and spread of communicable diseases and find out the epidemic-prone diseases after the earthquake in Yushu county,Qinghai province,and provide guidance for taking more effective prevention and control measures of communicable diseases in quake hit area.Methods The data of communicable diseases reported from January 1,2004 to April 15,2010 in quake hit area were analyzed.Based on the literature review and consultation of experts,the risk factors which might increase communicable disease transmission and the list of main epidemic-prone diseases were described.Results The major diseases reported in Yushu since 2004 were hepatitis B and pulmonary tuberculosis,followed by hepatitis C,echinococcosis and syphilis.Gonorrhoea,anthrax and meningococcal meningitis were less reported.The factors which might increase communicable disease transmission included temporary resettlement with poor sanitary condition,increased exposure to host animals and vectors,increased population movement,increased susceptibility to disease,and limited access to health services.Respiratory infectious diseases-measles,influenza and pulmonary tuberculosis and intestinal infectious diseases-bacillary dysentery and diarrhea were with high transmission potential.The transmission potential of plague and anthrax was moderate,and the transmission potential of rabies and STD was low.Conclusion The post disaster measures to prevent and control communicable diseases in Yushu should focus on water and food safety,environment sanitation,resuming immunization and TB control programs,strengthening the prevention and control of plague,echinococcosis and measles.The management of resettlement points should be strengthened too.
Objective To analyze the risk factors to the incidence and spread of communicable diseases and find out the epidemic-prone diseases after the earthquake in Yushu county,Qinghai province,and provide guidance for taking more effective prevention and control measures of communicable diseases in quake hit area.Methods The data of communicable diseases reported from January 1,2004 to April 15,2010 in quake hit area were analyzed.Based on the literature review and consultation of experts,the risk factors which might increase communicable disease transmission and the list of main epidemic-prone diseases were described.Results The major diseases reported in Yushu since 2004 were hepatitis B and pulmonary tuberculosis,followed by hepatitis C,echinococcosis and syphilis.Gonorrhoea,anthrax and meningococcal meningitis were less reported.The factors which might increase communicable disease transmission included temporary resettlement with poor sanitary condition,increased exposure to host animals and vectors,increased population movement,increased susceptibility to disease,and limited access to health services.Respiratory infectious diseases-measles,influenza and pulmonary tuberculosis and intestinal infectious diseases-bacillary dysentery and diarrhea were with high transmission potential.The transmission potential of plague and anthrax was moderate,and the transmission potential of rabies and STD was low.Conclusion The post disaster measures to prevent and control communicable diseases in Yushu should focus on water and food safety,environment sanitation,resuming immunization and TB control programs,strengthening the prevention and control of plague,echinococcosis and measles.The management of resettlement points should be strengthened too.
引文
[1]Qinghai provincial government.Level7.1earthquake in Yushucounty,Qinghai province[EB/OL].http://www.qh.gov.cn/html/31/133180.html.(in Chinese)青海省人民政府网.青海省玉树县发生7.1级地震,震源深度33千米[EB/OL].http://www.qh.gov.cn/html/31/133180.html,available at2010-04-26.
[2]Qinghai provincial government.The disaster losses of Yushuearthquake[EB/OL].http://www.qh.gov.cn/html/837/134300.html.(in Chinese)青海省人民政府网.青海玉树7.1级地震监测和灾害损失调查情况[EB/OL].http://www.qh.gov.cn/html/837/134300.html,available at2010-04-26.
[3]Zeng G,Feng ZJ.Situation analysis and prospect of infectiousdisease in Wenchuan area[J].Chinese Journal ofEpidemiology,2008,29(6):521.(in Chinese)曾光,冯子健.汶川地震灾区传染病疫情形势估计与展望[J].中华流行病学杂志,2008,29(6):521.
[4]Ministry of Health.Strengthen plague control in Yushu area afterearthquake[EB/OL].http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohwsyjbgs/s3578/201004/47023.htm,availableat2010-04-26.(in Chinese)卫生部网站.卫生部要求切实做好青海省玉树地震灾区鼠疫防控工作[EB/OL].http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohwsyjbgs/s3578/201004/47023.htm,available at2010-04-26.
[5]Wang H,Chai JJ,Liu FJ,et al.A study on ecological-epidemiology of two hydatid disease in Qinghai[J].ChineseJournal of Parasitic Disease Control,2002,15(5):284-286.(in Chinese)王虎,柴君杰,刘凤洁,等.青海省包虫病的生态流行病学研究[J].中国寄生虫病防治杂志,2002,15(5):284-286.
[6]Abroad K.Saving lives in the aftermath of Pakistan’s earthquake[J].Lancet,2005,366(9495):1423-1424.
[7]Roy N,Shah H,Pard V,et a1.Surgical and psychosocialoutcomes in the rural injured:a follow-up study of the2001earthquake victims[J].Injury,2005,36(8):927.
[8]Peng BB,Tong QY,Yang ZC.A study of spectrum of diseasein mobile hospital after Jogjakarta earthquake[J].MedicalJournal of the Chinese People s Armed Police Forces,2006,17(10):785-786.(in Chinese)彭碧波,仝青英,杨造成.印尼日惹地震救援中流动医院疾病谱分析[J].武警医学,2006,17(10):785-786.
[9]Zhang YQ,Yang ZC,Peng BB,et al.An analysis of diseaseincidence in Balakot area after earthquake[J].Medical Journal ofthe Chinese People s Armed Police Forces,2006,17(2):154-155.(in Chinese)张永青,杨造成,彭碧波,等.巴拉考特地震灾区发病状况分析[J].武警医学,2006,17(2):154-155.
[10]Liu AB,Wang HY,Hao QF,et al.Stages of medical rescueafter disaster based on clinical features and their significance[J].Chinese Journal of Emergency Medicine,2006,12(15):1063-1066.(in Chinese)刘爱兵,王海燕,郝钦芳,等.从疾病谱变化规律划分灾难医学救援阶段及其意义[J].中华急诊医学杂志,2006,12(15):1063-1066.
[2]Qinghai provincial government.The disaster losses of Yushuearthquake[EB/OL].http://www.qh.gov.cn/html/837/134300.html.(in Chinese)青海省人民政府网.青海玉树7.1级地震监测和灾害损失调查情况[EB/OL].http://www.qh.gov.cn/html/837/134300.html,available at2010-04-26.
[3]Zeng G,Feng ZJ.Situation analysis and prospect of infectiousdisease in Wenchuan area[J].Chinese Journal ofEpidemiology,2008,29(6):521.(in Chinese)曾光,冯子健.汶川地震灾区传染病疫情形势估计与展望[J].中华流行病学杂志,2008,29(6):521.
[4]Ministry of Health.Strengthen plague control in Yushu area afterearthquake[EB/OL].http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohwsyjbgs/s3578/201004/47023.htm,availableat2010-04-26.(in Chinese)卫生部网站.卫生部要求切实做好青海省玉树地震灾区鼠疫防控工作[EB/OL].http://www.moh.gov.cn/publicfiles/business/htmlfiles/mohwsyjbgs/s3578/201004/47023.htm,available at2010-04-26.
[5]Wang H,Chai JJ,Liu FJ,et al.A study on ecological-epidemiology of two hydatid disease in Qinghai[J].ChineseJournal of Parasitic Disease Control,2002,15(5):284-286.(in Chinese)王虎,柴君杰,刘凤洁,等.青海省包虫病的生态流行病学研究[J].中国寄生虫病防治杂志,2002,15(5):284-286.
[6]Abroad K.Saving lives in the aftermath of Pakistan’s earthquake[J].Lancet,2005,366(9495):1423-1424.
[7]Roy N,Shah H,Pard V,et a1.Surgical and psychosocialoutcomes in the rural injured:a follow-up study of the2001earthquake victims[J].Injury,2005,36(8):927.
[8]Peng BB,Tong QY,Yang ZC.A study of spectrum of diseasein mobile hospital after Jogjakarta earthquake[J].MedicalJournal of the Chinese People s Armed Police Forces,2006,17(10):785-786.(in Chinese)彭碧波,仝青英,杨造成.印尼日惹地震救援中流动医院疾病谱分析[J].武警医学,2006,17(10):785-786.
[9]Zhang YQ,Yang ZC,Peng BB,et al.An analysis of diseaseincidence in Balakot area after earthquake[J].Medical Journal ofthe Chinese People s Armed Police Forces,2006,17(2):154-155.(in Chinese)张永青,杨造成,彭碧波,等.巴拉考特地震灾区发病状况分析[J].武警医学,2006,17(2):154-155.
[10]Liu AB,Wang HY,Hao QF,et al.Stages of medical rescueafter disaster based on clinical features and their significance[J].Chinese Journal of Emergency Medicine,2006,12(15):1063-1066.(in Chinese)刘爱兵,王海燕,郝钦芳,等.从疾病谱变化规律划分灾难医学救援阶段及其意义[J].中华急诊医学杂志,2006,12(15):1063-1066.
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