1950-2018年云南省人间鼠疫流行病学特征分析

Epidemiological analysis of human plague in Yunnan Province from 1950 to 2018

目的了解1950-2018年云南省人间鼠疫的分布状况及流行趋势,为鼠疫的防控提供参考。方法1950-2018年云南省鼠疫疫情资料来源于云南省地方病防治所历年的疫情监测、疫情总结资料及《云南省地方病防治所所志》,收集整理数据,运用描述性流行病学方法,对鼠疫流行概况、时间分布、地区分布、人群分布等进行分析。结果1950-2018年,云南省先后在10个州(市)38个县(市、区)的鼠疫疫源地发生人间病例,共确诊病例3463例,死亡637例;可分两个流行周期,即近史流行末期(1950-1955年)和复燃流行期(1982-2005年);云南省家鼠疫源地人间鼠疫病死率为18.00%(615/3416),野鼠疫源地病死率为46.81%(22/47),二者比较差异有统计学意义(χ2=25.267,P<0.01);近史流行末期病死率为21.46%(633/2950),复燃流行期病死率为0.78%(4/512),二者比较差异有统计学意义(χ2=124.478,P<0.01);1986年以后确诊的513例病例,流行季节主要集中于7-11月份(441例),人群普遍易感,多发于15~45岁人群(217例)。结论云南省人间鼠疫流行范围较广,且呈现流行-静息-再流行-再静息的周期性,总体上呈下降趋势,但由于疫源地的持续存在,人间鼠疫防控仍需给予重视。

Objective To analyze the distribution and epidemic trend of human plague in Yunnan Province from 1950 to 2018,and to provide basis for prevention and control of the plague.Methods The epidemic data of plague in Yunnan Province from 1950 to 2018 were from the epidemic surveillance and summary data of Yunnan Institute for Control and Prevention of Endemic Disease over the years,and from"the Records of Yunnan Institute for Control and Prevention of Endemic Disease".The data were collected and collated,and the descriptive epidemiological methods were used to analyze the epidemic situation,time distribution,regional distribution and population distribution of the plague.Results From 1950 to 2018,human cases occurred successively in the plague foci of 38 counties(cities,districts)in 10 prefectures(cities)in Yunnan Province,with a total of 3463 confirmed cases and 637 deaths,which could be divided into two epidemic cycles:the end of recent history epidemic period(1950-1955)and the relapse epidemic period(1982-2005).The case fatality rate of human plague in the plague foci of domestic plague in Yunnan Province was 18.00%(615/3416),and that of wild rodents plague was 46.81%(22/47),the difference was statistically significant(χ2=25.267,P<0.01).At the end of recent history epidemic period,the case fatality rate was 21.46%(633/2950),and 0.78%(4/512)at the relapse epidemic period,the difference was statistically significant(χ2=124.478,P<0.01).Of the 513 cases diagnosed after 1986,the epidemic season was mainly from July to November(441 cases),and the population was generally susceptible,mostly in people aged 15-45 years old(217 cases).Conclusions The epidemic scope of human plague in Yunnan Province is relatively wide,and shows the periodicity of epidemic-rest-re-epidemic-re-rest,which generally shows a downward trend.However,due to the persistence of the epidemic focus,the prevention and control of human plague still needs to be paid attention.