地震灾区现场紧急状态下传染病风险因素与防控策略
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摘要
地震等自然灾害不仅导致人员大量伤亡,还会引起传染病暴发和流行,是灾区人们发病和死亡的主要原因。在灾区,地震造成房屋、交通、通讯、供水等基础设施严重毁坏,生态环境和居民生存条件受到极大影响,加上医疗卫生机构和公共卫生服务体系的破坏,灾民大规模的转移和安置,大量外来救援人员的涌入,物品供应和后勤工作的中断或短缺,卫生服务条件恶劣,特别是用于传染病监测和报告、预警和反应的探测系统受到严重影响,使得紧急状态下传染病预防与控制更加困难。本文主要描述地震灾区现场在紧急状态下传染病预防与控制的基本策略,包括通过快速评估灾区背景和人群面临的传染病风险因素,确定重点传染病和优先的干预策略;保持水源和环境卫生来预防传染病;加强灾民安置点和场地规划、营养不良的治疗和病例管理确保不发生传染病流行;建立和加强监测/预警和反应体系,确保及时报告病例,监测发病趋势,以便及时发现暴发并做出反应;采取重点人群免疫、病媒控制和个人防护保护易感人群,切断传播途径;通过健康教育传递基本知识和信息,提高受累人群的卫生意识和行为习惯。
Natural disaster like earthquake could make huge losses of human lives and properties.Potential infectious diseases followed with disaster always aggravate sufferings of affected people.In most earthquake affected areas,buildings,transportation,communication,and water supply systems were interrupted and medical services and public health delivery systems were destroyed,which made more difficult to implement disease prevention and control activities.This paper addressed hazards and main control measures to prevent infectious diseases in emergency conditions at earthquake affected places and identified priorities for further intervention.Ensuring clean water supply and environment health,providing adequate resident tents,timely managing and treating patients,as well as establishing and strengthening disease report and surveillance system,outbreak identification and control,target population immunization and health education were the main key solutions to prevent epidemic infectious diseases after catastrophic earthquake.
Natural disaster like earthquake could make huge losses of human lives and properties.Potential infectious diseases followed with disaster always aggravate sufferings of affected people.In most earthquake affected areas,buildings,transportation,communication,and water supply systems were interrupted and medical services and public health delivery systems were destroyed,which made more difficult to implement disease prevention and control activities.This paper addressed hazards and main control measures to prevent infectious diseases in emergency conditions at earthquake affected places and identified priorities for further intervention.Ensuring clean water supply and environment health,providing adequate resident tents,timely managing and treating patients,as well as establishing and strengthening disease report and surveillance system,outbreak identification and control,target population immunization and health education were the main key solutions to prevent epidemic infectious diseases after catastrophic earthquake.
引文
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我们一定能打赢灾后防疫这场硬仗[OL].http://www.zgjjzk.cn/more.asp?TN_NID=2008-06-02-1001
四川省汶川特大地震灾害抗震救灾最新进展情况[OL].http://scnews.newssc.org/system/2008/06/26/010921622.shtml
WHO.中国四川地震传染病风险评估和干预报告[R].2008-06
中国疾病预防控制中心.四川省地震灾区重点传染病风险初步评估报告[R].2008-06
四川省疾病预防控制中心.5.12汶川地震救灾防病情况汇报[R].2008-06-24
中国疾病预防控制中心.汶川地震灾区过渡期疾病预防与控制工作指导意见[R].2008-06
Waring SC,Reynolds KM,D′Souza G,et al.Rapidassessment of household needs in the Houston areaafterTropicalStormAllison[J].DisasterManagResponse,2002,Sep:3-9.
Connolly MA.紧急状态下传染病控制现场手册[M].周祖木,译.北京:人民卫生出版社,2006:3-20.
世界卫生组织和联合国艾滋病规划署.传染病预防和控制策略-世界卫生组织推荐[M].周祖木主译.北京:人民卫生出版社,2005:22-35.
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