汶川大地震前后四川省突发公共卫生事件监测与对策措施分析

Analyses on Monitoring and Countermeasures of Sichuan Emergent Public Health Events before and after Wenchuan Earthquake

目的研究和分析2008年汶川大地震当年及其前后各两个年度四川省突发公共卫生事件相关数据,检讨四川省卫生应急防控体系、组织实施、现状与问题,为进一步改进和完善该省监测体系、提高防控效果提供一线数据和决策参考。方法应用Excel、EpiInfo软件统计分析国家突发公共卫生事件管理信息系统报告的四川省2006～2010年突发公共卫生事件(不包括未分级事件)数据。结果四川省2006～2010年突发公共卫生事件呈整体逐年减少趋势,2008年汶川大地震当年处于相对的波谷。全省2006～2010年每个年度突发公共卫生事件都呈现4～6月和9～11月2个高峰。与2008年前后两年相比,2008年全省18个地震极重灾县所属6个市州中有5个市州的突发公共卫生事件在全省的排序均出现明显下降。2006～2010年四川省学校突发公共卫生事件占事件总数的75.00%,其中乡小学居事件发生地点、事件原因、发病数和死亡数等各项指标之首,在此期间,全省无特别重大突发公共卫生事件发生,9类突发公共卫生事件中,以传染病事件(79.30%)和食物中毒事件(14.33%)为主;传染病事件以水痘、流行性腮腺炎、风疹等呼吸道传染病和甲肝等疫苗可预防性疾病为主,占82.93%。结论四川省现有的卫生应急体系建设为突发公共卫生事件应急处置奠定了良好的基础,2006～2010年全省突发公共卫生事件呈现整体逐年下降的趋势,所有突发公共卫生事件均得到及时有效地处置。汶川大地震后全国军民强有力的灾后救援工作,使2008年四川省突发公共卫生事件降到历史最低水平,实现了大灾之后无大疫的目标;卫生系统对口援建,连续取得了四川省灾后3年无大疫的成就。加强传染病和中毒事件防控,重点针对疫苗可预防性疾病,可极大地降低突发公共卫生事件的发生,减少发病数和死亡数。多部门联合、全社会参与,共同预防和控制学校突发公共卫生事件,尤其是做好农村和乡小学的传染病防控工作,才能及时防控各类突发公共卫生事件,减少其危害性。

Objective To study and analyze the related data to emergent public health events in 2008 Wenchuan Earthquake and two years before and after the earthquake,to examine the emergent health control system of Sichuan in terms of organization,implement,current status and problems,so as to offer first-hand data and decision-making references to the perfection of the monitoring system and raising the effect of control and prevention of the emergent public health envents effect.Methods The report data were statistically analyzed by Excel,EpiInfo software.Results Between 2006 and 2010,the emergent public health events in Sichuan had reduced gradually year by year,and a wave trough was formed in 2008 when Wenchuan Earthquake attacked;the emergent public health events in each year mainly took place in two peaks,one was from April to June and the other was from September to November.Compared with the period between 2006 and 2010,five among six heavily afflicted cities and prefectures with 18 heavily damaged counties in 2008 had dropped in the listing of emergent public health events.Between 2006 and 2010,the emergent public health events happening in schools of Sichuan accounted for 75.00%,especially the township primary schools were on the top of each index as place,cause,morbidity and mortality,but there were no serious emergent public health events.Among nine types of emergent public health events,the contagious disease events accounted for 79.30% while the food poisoning events accounted for 14.33%;and the contagious disease events mainly were respiratory tract infection diseases such as chicken pox,mumps and measles,and hepatitis A which were all preventable with vaccine,and accounted for 82.93%.Conclusion？The construction of Sichuan＇s health emergency system is a good foundation for the handling of emergent public health events.The emergent public health events in the whole province get gradually reduced year by year between 2006 and 2010,and all kinds of emergent public health events have been handled properly.With the national support for the disaster relief of Wenchuan Earthquake,the provincial emergent public health events after the quake in 2008 have scored the lowest level in the history without severe epidemics after the earthquake;and the plan of no severe epidemics within three years after the earthquake has come true with partner assistance in health system.By improving the control of contagious disease,food poison and preventable diseases,the incidence of emergent public health events can be dramatically reduced with lower morbidity and mortality.Only by means of multi-departmental cooperation and social participation for jointly preventing and controlling school emergent public health events,especially for preventing and controlling the contagious diseases in countryside and township primary schools,can all kinds of emergent public health events be timely prevented and controlled with decreased hazard.