1978-2014年青海省果洛州鼠疫流行病学分析

An epidemiological analysis of plague outbreaks from 1978 to 2014 in Guoluo Prefecture,Qinghai Province

目的分析1978-2014年果洛藏族自治州鼠疫流行态势,为制定预防控制对策提供科学依据。方法采用描述性流行病学方法对1978-2014年青海省果洛州的鼠疫监测报告、鼠疫自然疫源地调查资料和人间鼠疫病例数据库的数据进行分析。结果 1978-2014年青海省果洛州共分离鼠疫菌14株。动物鼠疫的流行季节为7~10月,流行地区主要在玛多县、玛沁县;果洛州人间鼠疫共发生8起,发病22例,死亡12例,病死率为54.6%,病例中以肺型居多,占59.1%(13/22)。人间鼠疫疫情发生在旱獭鼠疫流行高峰期和藏系绵羊鼠疫滞后期。结论果洛州鼠疫流行形势严峻,应采取综合性防治对策,做好疫情预报预测,严防人间鼠疫流行。

Objectives To analyze the epidemiological characteristics of plague outbreaks in Guoluo Prefecture, Qinghai Province from 1978 to 2014 in order to provide a scientific basis of formulating proper control measures. Methods Reports on plague surveillance, data from studies of natural plague loci, and data from a database of human cases of the plague in Guoluo Prefecture between 1978 and 2014 were analyzed using descriptive epidemiology. Results Fourteen strains of Yersinia pestis were isolated from infected animals, insects, and patients in Guoluo Prefecture, Qinghai Prov- ince from 1978 to 2014. Of those strains, 7 （50%） were isolated from patients, 6 （42.9%） were isolated from animals, and 1 （7.1%） was isolated from Ixodes crenulatus. Plague was prevalent among animals from July to October. Areas where the plague was prevalent were mainly distributed in the 2 counties of Madu and Maqen. Eight cases of plague invol- ving humans occurred in Guoluo Prefecture, resulted in 22 cases, 12 deaths, and a fatality rate of 54. 55%. The most prevalent form of plague was pneumonic plague, which accounted for 59.1% （13/22） of plague cases. Plague was con- tracted through contact with infected patients, Marmota himalayana, or Tibetan sheep. Plague affected humans during a peak in outbreaks among Marmota himalayana and delayed outbreaks among Tibetan sheep. Conclusion The plague is still highly prevalent in Guoluo Prefecture, Qinghai Province, and the plague remains a danger. Control measures should be implemented to reduce the incidence of plague among humans.