浙江省血吸虫病疫情回顾性调查

Retrospective investigation for endemic situation of schistosomiasis in Zhejiang Province

目的分析浙江省血吸虫病流行区达到传播控制(传控)、传播阻断(传阻)前、后螺情与病情的动态变化规律,为血吸虫病防治工作提供科学依据。方法选择浙江省秀洲区(水网型)、诸暨市(山丘型)为调查县。采取回顾性调查方法,搜集整理达到传控前10年至2008年的疫情资料,分析各县螺情、病情变化趋势及规律。结果秀洲区和诸暨市在达到传控标准之前,人畜病情和螺情总体呈明显下降趋势,且血吸虫人群感染率、家畜感染率与钉螺面积均呈正相关关系(r人=0.764,P<0.01,r畜=0.709,P<0.01;r人=0.775,P<0.01,r畜=0.676,P<0.01)。达到传阻标准后有残存钉螺复现,未查到本地病人、畜和感染性钉螺,但查到7例输入性传染源。结论浙江省达到血吸虫病传阻标准以来疫情稳定;但有残存钉螺和外来传染源输入。血防监测巩固工作的重点是查灭残存钉螺和防控外来传染源。

Objective To analyze the changing rules of schistosomiasis endemic situation before and after reaching the criteria of schistosomiasis transmission controlled or transmission interrupted in Zhejiang Province,so as to provide scientific evidence for schistosomiasis control. Methods Xiuzhou District and Zhuji City were selected and investigated retrospectively to collect schistosomiasis epidemiological information 10 years before they reached the criteria of transmission controlled and the subsequent years until 2008. The database of retrospective investigation was established for analyzing the trends and rules of changes of Oncomelania hupensis snail status and schistosome infection status of cattle and human. Results The snail status and schistosome infection kept a steady declining before reaching the criteria of transmission controlled,and there were positive correlations between the area of living snails and the infection rates of human and animal in two places（rhuman=0.764,P〈0.01,rcatlle=0.709,P〈0.01;rhuma=0.775,P〈0.01,rcatlle=0.676,P〈0.01）;No local infection person and animal except residual snails,and found 7 cases of imported infection source were found after reaching the transmission interruption. Conclusion The epidemic status of schistosomiasis in zhejiang is stable after reaching the criteria of transmission interruption,and residual snail are easy to refound and spread under some certain conditions,and some imported cases were found sometimes,which may increase the risks for reemergence of schistosomiasis. The integrated solidification strategy with emphasis on control of residual snails and imported cases should be taken in the areas of transmission interruption in the future.