地震灾区紧急状态下的疾病监测与传染病流行风险评估
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摘要
目的评估四川省平武县南坝镇地震灾区传染病流行风险,并对相关疾病症状进行监测,为制定灾区卫生防疫工作策略提供依据。方法采用入户调查、收集各医疗点门诊登记资料等方法分别对灾区进行症状和病例监测,采用查阅资料、目测观察法、访谈等方法对灾区进行传染病流行风险评估。结果2007年(灾前)平武县法定传染病年报告发病率为558.31/10万,发病率前5位依次为流行性腮腺炎、病毒性肝炎、感染性腹泻、肺结核病及细菌性痢疾。灾后灾区环境破坏严重,水和食物受到污染,水源性和食源性传染病(感染性腹泻、伤寒、痢疾、甲肝等)暴发的风险极高;灾民生活条件差,密切接触及飞沫传播疾病风险较大;发生狂犬病与破伤风的风险增大;短期内暂不会发生乙型脑炎和鼠疫等病媒传染性疾病流行。建立9个症状监测点,共监测14 527人次。2008年5月18—28日共报告腹泻72例、感冒72例、皮疹110例、发热19例、其他9例,灾民罹患率分别为0.36%~1.12%、0.18%~1.53%、0.09%~9.31%、0.10%~0.28%、0.17%~0.28%,均维持在较低水平。结论通过快速评估,灾后南坝镇传染性疾病流行的主要风险为水源性、食源性传染病、密切接触及飞沫传播疾病等,疾病监测发现,灾区灾后未出现重大传染性疾病暴发的迹象。
Objective To evaluate potential risks of the infection disease transmission in emergent status after earthquake in Nanba Town of Pingwu County,and to conduct symptom-based surveillance to guide effective control measures to prevent epidemics.Methods In-door interview was applied to obtain symptom-based surveillance data and out-patient daily visiting registration information in clinics was collected as case-based surveillance data.Field survey methods such as observation,face to face interview,and historical document review were adopted to evaluate the risk of infected disease in disaster area.Results The annually incidence rate of infected disease was 558.31/100 000 in 2007(before earthquake) in Pingwu County and the top five incidence rates were parotitis,virus hepatitis,infectious diarrhea,pulmonary tuberculosis and bacillary dysentery in turn.Since the environment was severely damaged by earthquake,and the water and food were polluted in disaster,the risks of the disease transmission(such as infectious diarrhea,typhoid fever,dysentery and hepatitis A) by water and food were very high.The earthquake victims lived in badly condition and had high risks of disease transmission through close contact or droplet,and increasing risks of hydrophobia and tetanus.However,there would be no risks of encephalitis B and plague in the present period.Total 9 surveillance sites were established and 14 527 person-time were interviewed.As a result,72 cases of diarrhea,72 cases of cold,110 cases of tetter,19 cases of fever and 9 cases of other symptoms were reported from 18 May to 28 May 2008.The prevalence rates of victims were 0.36% to 1.12%,0.18% to 1.53%,0.09% to 9.31%,0.10% to 0.28%,and 0.17% to 0.28%,respectively.All prevalence rates were at low level.Conclusion The main risks of infectiou disease transmission were water-born,food-born,close contact and droplet.According to disease surveillance result,there were no outbreak signs of major infectious disease in disaster areas after the earthquake.
Objective To evaluate potential risks of the infection disease transmission in emergent status after earthquake in Nanba Town of Pingwu County,and to conduct symptom-based surveillance to guide effective control measures to prevent epidemics.Methods In-door interview was applied to obtain symptom-based surveillance data and out-patient daily visiting registration information in clinics was collected as case-based surveillance data.Field survey methods such as observation,face to face interview,and historical document review were adopted to evaluate the risk of infected disease in disaster area.Results The annually incidence rate of infected disease was 558.31/100 000 in 2007(before earthquake) in Pingwu County and the top five incidence rates were parotitis,virus hepatitis,infectious diarrhea,pulmonary tuberculosis and bacillary dysentery in turn.Since the environment was severely damaged by earthquake,and the water and food were polluted in disaster,the risks of the disease transmission(such as infectious diarrhea,typhoid fever,dysentery and hepatitis A) by water and food were very high.The earthquake victims lived in badly condition and had high risks of disease transmission through close contact or droplet,and increasing risks of hydrophobia and tetanus.However,there would be no risks of encephalitis B and plague in the present period.Total 9 surveillance sites were established and 14 527 person-time were interviewed.As a result,72 cases of diarrhea,72 cases of cold,110 cases of tetter,19 cases of fever and 9 cases of other symptoms were reported from 18 May to 28 May 2008.The prevalence rates of victims were 0.36% to 1.12%,0.18% to 1.53%,0.09% to 9.31%,0.10% to 0.28%,and 0.17% to 0.28%,respectively.All prevalence rates were at low level.Conclusion The main risks of infectiou disease transmission were water-born,food-born,close contact and droplet.According to disease surveillance result,there were no outbreak signs of major infectious disease in disaster areas after the earthquake.
引文
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[3]王陇德.现场流行病学理论与实践[M].北京:人民卫生出版社,2004:66-76
[2]CDC.Framework for evaluating public health surveillance systemsfor early detection of outbreaks:recommendations from the CDCworking group[J].MMWR,2004,53:5.
[3]王陇德.现场流行病学理论与实践[M].北京:人民卫生出版社,2004:66-76
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