2010年广西突发公共卫生事件流行病学特征及处置情况分析

Epidemiological characteristics and disposal of public health emergencies occurred in Guangxi,2010

目的了解2010年广西突发公共卫生事件的流行病学特点及其处置情况,为更有效地预防和控制突发公共卫生事件的发生提供科学依据。方法收集广西各地疾病预防控制中心2010年间通过中国疾病预防控制信息系统中国家突发公共卫生事件报告管理信息系统报告的所有突发公共卫生事件和疾病预防控制部门对所有事件的调查、核实资料,并采用描述性流行病学方法对2010年广西突发公共卫生事件进行分析。结果 2010年广西报告传染病(155起)、食物中毒(22起)、职业中毒(4起)、环境因素事件(2起)和其他突发公共卫生事件(2起)共185起,发病7490例,死亡41例,传染病事件数、发病人数分别占总数的83.78%(155/185)、92.68%(6 942/7490),均居各类事件的首位。报告事件数、发病人数最多的城市均为南宁市,分别占总数的29.73%(55/185)、36.06%(2 701/7 490)。农村和乡镇的突发公共卫生事件数(119件)、发病人数(4 170例)、死亡人数(36例)均多于县城、城市,农村和乡镇与县城、城市的波及人口罹患率及死亡率差异有统计学意义(均P<0.01)。事件数最多的月份为4月份(37起),占全年的20.00%,报告病例数以9月份最多(3 116例),占全年的41.60%,事件数、发病人数较多的疾病主要有手足口病、急性出血性结膜炎、流行性腮腺炎和水痘,分别为51、28、20、15起,发病数高峰季节分别在4、9、11、12月。学校是传染病突发公共卫生事件发生的主要场所(134起),事件数、发病人数以发生在幼托机构、乡小学、乡中学、县中学的比例较高,不同类型学校之间罹患率差别有统计学意义(P<0.01)。疾病预防控制中心在接到事件报告后当天对事件进行调查处理的事件达到了89.19%,而30.81%的事件在事件的首发病例发生8 d以后才接到报告,26.45%的事件持续时间超过了21 d。事件实验室检测率、实验室阳性结果率分别为55.14%、50.81%。结论广西突发公共卫生事件以肠道、呼吸道传染病突发公共卫生事件为主,主要发生在农村及学校。提示应进一步加强肠道、呼吸道传染病的防控工作,重点放在农村和学校,应进一步提高突发公共卫生事件的及时报告率和实验室检测水平。

Objective To understand the epidemiological characteristics and control of public health emergencies occurred in Guangxi in 2010, and to provide scientific basis for improving their prevention and control effectively. Methods We collected data of all public health emergencies occurred in 2010 including their survey, confirmation and control, which were dealt with by different centers for diseases pre- vention and control （CDCs） throughout Guangxi and reported by these CDCs via National Information Management System of Public Health Emergency Report in China Information System for Diseases Control and Prevention. The data were analyzed using a descriptive epidemiologic method. Results A total of 185 public health emergencies were reported, including infectious diseases （155 events）, food poisoning （22 events） , occupation poisoning （4 events） , environmental factor （2 events） and other public health events （2events）. There are 7 490 cases and 41 deaths caused by these events. The numbers of the events andcases caused by infections diseases accounted for 83.78% （155/185） and 92.68% （6 942/7 490） of all reported events and cases, respectively, ranking first in all events. Nanning City had the most events and cases, accounting for 29.73% （55/185） and 36.06% （2 701/7 490） , respectively. The number of pub- lic health emergencies （119 events）, cases （4 170） and deaths （36） caused by the events occurred in countryside and towns is significantly higher than that in cities （ P 〈 0.01 ）. The month with most events was April, accounting for 20.00% of the 12 months of a year. The month with most cases was September, accounting for 41.60% of the whole year. Diseases with more events and cases were hand-foot-mouth disease （51 events ）, acute hemorrhagic conjunctivitis （28 events） , mumps （20 events） and chickenpox （ 15 events）. The seasona~ peaks of cases was April, September, November and December, respectively. The major sites of the public events were schools （ 134 events）. The proportion of events and cases occurred in kindergartens, town primary schools, town middle schools and county middle schools were higher. The attack rates between different schools were significantly different （P 〈 0. 01 ）. Up to 89.19% events were disposed by CDCs on the same day as informed. While 30.81% events were informed 8 days after the first case occurred. 26.45% events last over 21 days. The events tested and confirmed by laboratory accounted for 55.14% and 50.81% , respectively. Conclusion The major public health emergencies occurred in Guangxi in 2010 was enteric and respiratory infectious diseases. Most of them occurred in countryside and schools, suggesting that the prevention and control should be focused on enteric and respiratory infectious diseases in countryside and schools, and the timely rate of reporting events and laboratory test ability should be increased.