1954—2006年青海省三江源地区鼠疫及流行病学分析

A retrospective analysis of plague in Three-River Source Region of Qinghai from 1954 to 2007

目的分析三江源地区鼠疫流行动态，为鼠疫预防控制提供依据。方法用回顾性流行病学方法对三江源地区1954—2006年鼠疫疫源地调查、鼠疫监测和人间鼠疫疫情资料进行整理、分析。结果1954—2006年三江源地区动物鼠疫流行主要分布在玉树、称多、曲麻莱、囊谦、治多、杂多6个县和格尔木市唐古拉乡。称多县还存在青海田鼠鼠疫自然疫源地。染疫动物共8科12属15种，从动物体共分离到鼠疫菌336株，其中喜马拉雅旱獭体291株，占总数的86．60％（29／336）；藏系绵羊13株，占3．87％（13／336）；青海田鼠10株，占2．98％（10／336）。从各类媒介昆虫体内共分离出鼠疫菌114株，其中，从斧形盖蚤体内分离出46株，占4035％（46／114）；谢氏山蚤38株，占33．33％（38／114）。1960—2006年共发生人间疫情85起，发病238例，死亡134例，病死率为56.30％（134／238）；流行季节为5—11月份，8、9月份为高峰期，10月份以后主要为藏系绵羊作为传染源引起的人间鼠疫。临床病型以肺鼠疫居多，占49．58％（117／238），但首发病例以腺鼠疫为主，占77．12％（91／118）。结论青海省三江源地区存在喜马托稚旱獭鼠疫和青海田鼠鼠疫两块鼠疫自然疫源地，人间鼠疫病例由旱獭型菌株引起．尚未发现田鼠型菌种引起的人间鼠疫。三江源地区是青海省鼠疫流行的重点地区。

Objective To analyze plague epidemic tendency in the Three-River Region of Qinghai. Methods Using retrospective study, the Three-River Region during 1954 - 2006 year pestis epidemic focus were investigated and analyzed. Result Pestis prevailed mainly in Yushu, Chindu, Qumalai, Nangqian, Zhiduo and the Geermu,Tanghla Township. It was first found that the nature plague focus of micritus existed in Chengduo County. There are 15 kinds of 12 branches in 8 trees infected plague animals were founded, 336 Yersinia pestis were separated from the driven objects. Among them there were 291 Himalayas marmot body, account for 86.60% of the total, 13 of Tibet sheep, accounts for 3.87%, 10 of Qinghai field-mouse, accounts for 2.98%, Also there were 114 Yersinia pestis which were separated from each kind of vector insect in vivo. And, 46 pestis strains came from the axe shape of flea in vivo account for 40.35%（46/114）, 38 pestis strains separated from Xie mountain flea, account for 33.33% （38/114）. During 1960 - 2006 years there were 85 human plague eases were founded, 238 occurred, 134 died, the case fatality rate were 56.30% （134/238）, the popular seasons were started from May to November, the peak season happened in Aug and Sep. After Oct mainly due to Tibet sheep pestis which will cause as the origin of infection. The majority of sickness was pulmonary plague,account for 49.58%（117/238）, whereas the first round case caused by the gland bubonic plague, account for 77.12% （91/118）. Conclusions There are two pestis strains natural epidemic focus places in Three-River Source Region of Qinghai including the Himalayas marmot pestis strain and the Qinghai field-mouse pestis strain. The case of human pestis strain causes by the marmot strain, the field-mouse mold mushroom spawn causes human pestis strain has not yet discovered, Three-River Source Region of Qinghai is a pestis strain key popular area in Qinghai Province.