云南省人间鼠疫流行病学特征及其控制措施

Epidemiological Character and Control Measure for Human Plague in Yunnan

从 198 6～ 1998年 ,云南省有 46县、市发生动物鼠疫流行 ,其中 2 2县、市发生 49起人间鼠疫流行 ,确诊鼠疫患者2 73例 ,死亡 2例。主要传染源为黄胸鼠 ,传播媒介为印鼠客蚤 ,传播途径为鼠→蚤→人。人间病例全年均可发生 ,流行季节为 7～ 11月 ,高峰期为 9月。流行多发生在人口密集的县城及农村集镇 ,病例多呈散发 ,偶有小范围爆发 ,具有连续性、间断性和突发性特点。确诊的全部患者均为腺型 ,其中 3例继发败血型鼠疫。腺肿部位多见于下肢 (6 3.4% )。在 2 73例病人中 ,30例 (11.0 % )患者分离到鼠疫菌 ,2 41例 (88.3% )为血清学诊断 ,2例为临床诊断。分析认为加强鼠疫监测 ,早期发现和及时有效处理动物疫情 。

The rodents plague epidemic occurred in 46 counties and 49 episodes of human plague were epidemic, total of 273 cases were confirmed and 2 cases died in 22 counties of Yunnan Province from 1986 to 1998. Analysis showed that the main infectious source was of R.flavipectus, the infectious vector of X.cheopis, the infectious route of rodent→flea→human. The cases distributed in the whole year. There was an epidemic season from July to November and a peak in September. The human plague epidemic happened more times in county, city and town where the population was concentrated usually the patient was sporadic, occasionally occurred outbreak in small range. There was the characteristic of continuity, discontinuity and all of a sudden. All patients confirmed were of bubonic plague and 3 cases of all developed to septicemia plague. The swelled lymph nodes of most patients were located lower limbs (63.4%). Of 273 cases, 30 cases were confirmed by bacteriology (11.0%),241 cases with serology (88.3%) and 2 cases according to clinical symptoms. Analysis suggesed that strengthening plague surveillance, finding patients early, timely and efficaciously controlling rodent plague be an important measures for prevention of the human plague occurrence.