“东方之星客船倾覆事件”搜救人员血吸虫感染风险评估

Risk assessment of schistosomiasis transmission on rescue workers involved in“Oriental Star shipwreck event”

目的评估"东方之星客船倾覆事件"发生流域灾后救援人员血吸虫感染风险,为科学制定防控措施提供依据。方法通过现场观察及回顾性调查等方式,获取监利县"东方之星客船倾覆事件"现场救援情况和当地血吸虫病历史疫情资料,结合专题小组讨论和风险矩阵,对救援人员感染血吸虫的风险进行评估。结果此次参与搜救人员超过10 000人,主要包括武警、当地群众、预备役军人等,其中武警为主要搜救人员(占39%)。回顾性调查显示,监利县历史血吸虫病疫情较重,但经多年积极防治,疫情显著下降,2014年人群感染率为0.44%,事发流域上、下游两村有螺面积仅6.6 hm2,且已连续11年未查到感染性钉螺,钉螺密度不高。综合评估表明,灾后救援人员血吸虫感染风险评估等级为中度危险。结论事发水域存在血吸虫感染的可能,但发生概率不高。应对搜救人员加强防护和健康教育,开展高危环境灭螺,强化监测预警,防止出现灾后血吸虫病流行。

Objective To assess the impact of the＂Oriental Star shipwreck event＂on the risk of schistosomiasis transmission in Jianli County,Hubei Province,so as to provide the evidence for formulating appropriate measures of schistosomiasis prevention and control. Methods Based on the field observation and investigation,the data of the on-the-spot rescue and the historical endemic situation of schistosomiasis in Jianli County were collected and analyzed. Meanwhile,the focus group discussion and risk matrix were conducted to assess the risk of schistosome infection of the rescuers. Results Over 10 000 rescuers participated in the search operation,including the armed police forces,local people,reservists and so on. The armed police forces were the major components,which accounted for 39%. Jianli country was schistosomiasis endemic area with a high infection level in history,but the endemic situation had been mitigated significantly after years of positive prevention and treatment;the schistosome infection rate of population was 0.44% in 2014 and the Oncomelania hupensis snail area was only 6.6 hm2 around the rescue areas in the upstream and downstream. In addition,the snail density was not high,and no infected snails had been found for 11 years. The risk of schistosome infection was in the medium level. Conclusions Though there exists the schistosome infection risk in the water area where the accident happened,the probability of occurrence is not high. In order to prevent the outbreak and endemic of schistosomiasis,the protection measures and health education to the rescuers as well as snail control and monitoring,and early-warning should be strengthened.