输入性疟疾对巩固消除疟疾成果防止再传播的挑战和对策

Challenge and response of imported malaria for preventing malaria re-establishment

疟疾曾是我国流行历史最久远,影响范围最广泛,危害最严重的传染病之一,经过几代疟防工作者几十年不懈的努力,我国成功实现了从年发病例3000万到0的突破,并已连续4年无本地原发疟疾病例,达到了世界卫生组织消除疟疾的标准。但我国每年仍有数千例境外输入性疟疾,原疟疾流行区的传疟媒介依然存在,因境外输入病例导致的死亡病例和输入继发病例时有发生,境外输入性疟疾对我国巩固消除疟疾成果,防止输入再传播造成新的威胁。本文就境外输入疟原虫虫株的病原生物学特征、境外输入性疟疾病例的临床特点和诊治需求、境外输入病例在本地传播可能性等进行了分析,并提出及时发现输入传染源、规范诊治输入性病例和精准阻断输入再传播三个防止输入再传播的对策建议。

Malaria was one of the most serious infectious diseases with the longest epidemic history in China.After decades of unremitting efforts by several generations of malaria workers,the malaria cases from 30 million per year to zero in China,and there have been no indigenes malaria cases for four consecutive years,which has reached the goal of WHO malaria elimination.However,there are thousands of imported malaria cases in China every year,and the malaria vector still exists in the original malaria-endemic areas.Deaths caused by imported malaria cases and secondary imported malaria cases occur somewhile.Imported malaria give rise to new challenge to prevent re-establishment of malaria in China.In this paper,the pathogenic biology of inputted parasite strains,the clinical characteristics and treatment needs of imported malaria cases and the possibility of local transmission through imported case are analyzed.Three countermeasures and suggestions are proposed for early finding and standardized treatment of imported cases as well as accurate blocking of potential local transmission by imported case.