国际邮轮相关传染性疾病的研究与分析

Research and analysis of international cruiser-related infectious diseases

目的对已报道的1973年至今国际邮轮相关传染性疾病进行流行病学分析，以期为相关传染病的诊断和防控提供指导依据。方法检索1973年至今发表于Pubmed、Medlineovid和中国知网关于邮轮传染性疾病流行病学的文献，同时整理美国CDC发布的邮轮胃肠道传染性疾病报告数据，对疾病种类、病原体类型及航行区域等因素进行统计分析。结果邮轮上的传染性疾病以消化道传染病和呼吸道传染病为主，其中消化道传染病更为多见。消化道传染病病原体中，诺如病毒、志贺氏菌和肠产毒性大肠杆菌为最主要病原体。呼吸道传染病中发病率最高的病原体为流感病毒，其次为水痘和军团菌。发生传染性疾病的邮轮中，航行于热带海域的邮轮比例显著多于温带海域或寒带海域（72．72％VS13．64％）。结论消化道传染病和呼吸道传染病是邮轮相关传染性疾病的主要类型，其病原体分布具有一定特征，且发生情况可能与航行海域存在联系。了解邮轮相关性传染性疾病流行病学情况对相关疾病的快速诊断与防控管理有一定指导意义。

Objective To analyze the epidemiological problems concerning cruiser-related infectious diseases reported since 1973, so as to provide evidences for the diagnosis, prevention and control of diseases. Methods Information retrieval was made by using Pubmed, Medline and China Knowledge Resource Integrated Database （CNKI） to find out papers concerning cruiser-related infectious diseases reported from 1973 to the present, and at the same time, data concerning cruiser-related gastrointestinal infectious diseases published by the Center for Disease Control （CDC） were also sorted out, and finally statistical analyses were made on such related factors as the category of diseases, types of pathogens and the areas of navigation. Results Research results indicated that gastrointestinal infectious diseases and respiratory infectious diseases, the gastrointestinal infectious diseases in particular, were the two main types of cruiser-related infectious diseases. Norovirus, shigella and Escherichia coli were the most commonly detected pathogens in the gastrointestinal infectious disease pathogens, whereas the most pathogenic factor for respiratory diseases were influenza virus, followed by varicella and legionella. In all the cruisers that were affected by infectious diseases, those sailing in tropical waters had the higher incidence rate, which was significantly higher than those sailing in temperate and frigid zones, which accounted for 72.72%, 13.64% and 13.64% respectively. Conclusions Gastrointestinal infectious diseases and respiratory infectious diseases were the main types of cruiser-related infectious diseases, and the distribution of pathogens had their special patterns, which were closely related with the geographic regions of sailing. Knowledge about cruiser-related infectious diseases was of important significance for rapid diagnosis, prevention and control of related diseases.