四川甘洛县霍乱流行及防控分析

Analysis of cholera prevalence,prevention and control in Ganluo County of Liangshan area

目的分析甘洛县霍乱流行特征及流行因素,为今后制定有效的防治措施提供科学依据。方法分析甘洛县1999年霍乱爆发流行疫情报告资料、现场调查及实验室检测资料,2000～2006年现场调查及监测资料,用Excel进行统计分析。结果1999年甘洛县共报告霍乱病例317例,死亡3例,罹患率10.77‰,病死率0.95%。实验室证实,病原菌为埃尔托霍乱弧菌小川血清型,对氟哌酸、环丙沙星敏感。人群普遍易感,以青壮年农民和流动人口为主。疫情呈爆发流行,8月上旬、9月下旬出现2次流行高峰,以阿尔乡、新市坝镇、普昌镇、石海乡为主·占全县发病数的74.13%。水源和外环境污染严重,8月3日后发病病例均有参加丧礼及聚餐经历。经大力开展健康教育,严格食品检疫,改善生活卫生习惯,提高卫生条件,2000～2006年无霍乱病例报告,现场检测未有阳性发现。结论不良卫生习惯和落后卫生条件是甘洛县霍乱流行的主要原因;不良风俗习惯,瞒报疫情,大办丧事、大型聚餐是甘洛县霍乱爆发流行的重要原因;改善卫生条件,加强卫生宣传,培养良好卫生习惯,建立及时通畅的疫情报告制度,是预防霍乱发病和防止霍乱流行的重要措施。

Objective To analyze the prevalent features and factors of cholera in Ganluo County, and to offer scientific basis for making available preventing and curing measures. Methods The data of epidemic outbreak of cholera in Ganluo County in 1999, as well as on-the-spot investigation and laboratory data from 2000 to 2006 were statistically analyzed using Excel. Results 317 cholera cases were reported in Ganluo County in 1999, including 3 dead cases （0.95%）. The incidence of cholera was 10.77‰. The pathogenic bacterium was confirmed to be V. cholerae EL-Tor biotype, ogawa serotype, which was sensitive to norfloxacin and ciprofloxacin. People were generally susceptible to cholera; young peasants and fluid population were more susceptible. The pestilence was characteristic of epidemic outbreak. Two prevalence peaks of the epidemic outbreak occurred in the 1st ten days in August and the last ten days in September. 74.13% of cases occurred in the town of Aer, Xinshiba, Puchang and Shihai. Water and the outer environment were severely polluted. All cases onset after 3rd August. After extensive health education, strict food medical inspection, improving health condition and health habits, no case of cholera or sample polluted by V. cholerae was reported from 2000 and 2006. Conclusion Bad health habits and poor health condition are main reasons of cholera epidemic in Ganluo County, while the ill customs, hiding the truth of pestilence, arranging large scale funeral matters, and dining together greatly enhance the outbreak of cholera. Improving health condition, keeping healthy habit, and establishing easy, smooth report system are available measures to prevent onset and prevalence of cholera.