云南省鲁甸地震灾区重点传染病风险评估

Preliminary assessment on risk of priority communicable disease in earthquake hit area in Ludian, Yunnan province

目的分析云南省鲁甸地震灾区重点传染病的发生和传播风险,为震区灾后的传染病防控工作提供有针对性的建议。方法采集灾区的甲乙丙类传染病报告数据,查阅文献资料并咨询专家意见,分析地震对灾区传染病发生、传播可能产生的影响;对灾区重点传染病的发生和传播划分风险等级。结果 2004年以来,云南鲁甸地震灾区主要报告病种为肺结核、乙型病毒性肝炎和细菌性痢疾。灾后可能对传染病发生、传播造成影响的因素包括安全饮水及食品缺乏,群众居住条件简陋、生活条件差,人群与病媒生物的接触机会增多,卫生服务可及性降低及人口流动加大等。综合评估结果显示细菌性痢疾、其他感染性腹泻等6种传染病事件风险为高;麻疹等10种传染病事件风险为中等;鼠疫、霍乱的风险为低。结论震区灾后传染病防控工作应该保证饮用水安全;加强食品卫生;做好安置点设置及卫生管理;加强健康教育;加强疾病监测和暴发控制;恢复公共卫生基本服务;持续做好灾区风险评估。

Objective To analyze the risk factors to the incidence and spread of communicable diseases and find out the epidemic-prone diseases after the earthquake in Ludian county, Yunnan province, and provide guidance for taking more effective prevention and control measures of communicable diseases in quake hit area. Methods The data of communicable diseases reported from January 1, 2004 to July 31, 2014 in quake hit area were analyzed. Based on the literature review and consultation of experts, the risk factors which might increase communicable disease transmission and the list of main epidemic-prone diseases were described. Results The major diseases reported in Ludian country and Qiaojia country since2004 were pulmonary tuberculosis, hepatitis B and bacillary dysentery. The factors which might increase communicable disease transmission included lacked safe drinking water and safe food, settlement with poor sanitary condition, increased exposure to host animals and vectors, limited access to health services and increased population movement. The result of the risk assessment shows that the risk of six communicable diseases which include bacillary dysentery and other infectious diarrheas was high, the risk of ten communicable diseases which include measles was medium, the risk of plague and cholera was low. Conclusion The post disaster measures to prevent and control communicable diseases in Ludian should focus on water and food safety, the management of settlement points and environment sanitation, health education, strengthening the prevention and control of communicable diseases, resuming basic public health service and developing risk assessment at different times.