广西SARS流行敏感区的确认及其控制模式探讨

SARS sensitive endemic area confirmation and control strategies

目的确认广西SARS流行敏感区,探讨其预防控制技术策略。方法收集与SARS流行的相关资料进行分析;采用统一设计的SARS调查表进行调查,对早期病例资料进行整理,统计分析各市、县上报数据资料;采用ELISA法和RT-PCR方法检测野生动物血清及其他标本;启动广西“三网”疫情监测系统,采取“围、堵、追”技术措施进行预防控制。结果广西3年来报告SARS病例共22例,均发生于2003年,患者主要是在广东务工返乡民工,以青壮年为主,患者有明显的流行区生活史。80%以上患者发生在2003年1～4月两个高峰期。在部分鸟纲和爬行纲的野生动物的血清中查出阳性血清标本,果子狸未检测出阳性。2004年和2005年广西没有出现SARS新疫情。结论广西是SARS流行敏感区,所采用的预防控制技术策略体现了以社会性、群体性及个体健康相结合的现代预防控制模式,该模式在SARS流行敏感区效果显著。

Objective To determine the SARS sensitive endemic area and to explore preventive strategies against SARS in Guangxi. Methods The SARS epidemiological data from each county and city were collected and analyzed, which included the medical records of SARS cases reported in the early period of outbreak. The sera and other specimens of wild animals were examined by ELISA and RT-PCR for detecting the SARS-associated coronavirus. ＂The Three Networks＂ diseases surveillance systems was initiated in Guangxi. The measurements of ＂isolating persons in the foci, blocking exotic cases and active tracing the possibly infected persons＂ were carried out. Results Within 3 years of surveillance 22 cases of SARS were found in Guangxi and all cases were reported in the year of 2003. Most of the cases were adult farmers returning home from Guangdong province. They had histories of living in the endemic areas. Eighty percent of cases were reported during the two peak periods, January and April of 2003. The positive rates of coronavirus in reptiles and birds were 20% and 22.2%, respectively while all masked civets and monkeys checked were virus negative. The local outbreak of SARS in 2003 was successfully controlled and there was no new cases reported in 2004 and 2005. Conclusion Guangxi is a sensitive area for SAILS. The new model of combination of social, community and personal health behavior managements is an effective control strategy in the sensitive area for SARS.