自然疫源性疾病流行因素分析及对策

The epidemic factors analysis of natural focus diseases and their countermeasures

目的总结和分析我国1991-2006年重点自然疫源性疾病的流行现状和分布情况,探讨新时期疫情的影响因素,提出加强自然疫源性疾病监测建议。方法收集1991-2006年全国鼠疫、肾综合征出血热(HFRS)、狂犬病、流行性乙型脑炎(乙脑)、钩端螺旋体病(钩体病)、布鲁氏菌病(布病)、登革热、疟疾等重点自然疫源性疾病的疫情监测资料并进行统计分析。结果1991-2006年全国鼠疫、HFRS、狂犬病、乙脑、钩体病、布病、登革热、疟疾等报告病例1 859 295例,死亡39 028例,发病比例由20世纪90年代初期的7%左右降至2%,下降近70%,死亡比例则由50%降至目前的40%左右,所占比重依然较大;疫情主要集中在我国南方温带和亚热带地区,呈现出南多北少的特点。全球气候变暖、媒介和宿主动物入侵与耐药性、生态环境变化以及畜牧养殖业和其相关产品加工产业的高速发展等因素是目前自然疫源性疾病疫情的影响因素。结论在监测工作中重点加强预警监测、免疫接种和防制策略的效果评价以及媒介生物和宿主动物综合治理等的研究。

Objective To profile and analyze the epidemic and distribution of natural focus diseases from 1991 to 2006 in China, and to explore the influencing factors at present so as to provide information for natural focus diseases surveillance. Methods National data on the prevalence of important natural focus diseases, such as plague, hemorrhagic fever with renal syndrome, rabies, epidemic encephalitis type B, leptospirosis, brucellosis, dengue fever, and malaria from 1991 to 2006 were collected and analyzed. Results From 1991 to 2006, the annual reported cases were 1 859 295 and fatality were 39 028. In 2006, the proportion of morbidity in the reported cases decreased 70 percent from 7 percent in the early 90＇s to 2 percent. The proportion of fatality in the reported cases decreased from 50 percent in the early 90＇s to 40 percent, which still poses a higher level. The cases mainly located in the warm temperate zone and subtropical zone of China, i.e. more in the southern and less in the northern in China. Increasing floating populations, global warming, inbreak and pesticide resistance of vectors and animal host, changes of ecological environment, and the rapid growth of husbandry and related product processing might serve as important factors influencing on natural focus diseases. Conclusion We suggest strengthening research on early warning monitoring, evaluation of efficacy for strategy of inoculation and disease prevention and control, and integrated management of vectors and animal hosts in China.