长江丹徒段沿江重点水域血吸虫感染性监测预警及应急处置

发布时间：2018-05-18 12:43

本文选题：血吸虫病 + 监测预警　；参考：《中国病原生物学杂志》2017年10期

【摘要】：目的在易感季节针对已达到血吸虫病传播控制的长江下游镇江市丹徒段沿江重点水域,实施血吸虫感染性监测预警和应急处置技术应用及集成示范,为构建敏感有效的疫情监测预警和处置体系提供参考依据。方法基于流行病学基础数据库和传播危险因素识别,在长江镇江丹徒段68.9km长的滩涂上筛选确定7个高风险区域为监测预警点。于2009-2016年每年的3-5月调查环境螺情与人畜病情;5-9份采用哨鼠法测定水体感染性,并采用现场观察法调查人畜接触江水状况;2009-2011年采用哨螺法测定血吸虫毛蚴对水体的污染性。一旦查见感染性钉螺,或出现急性感染病人,或查见粪检阳性病人,或出现感染性哨鼠,或发现感染性哨螺等疫情,即刻发布预警警示并启动处置程序,针对疫情采取相应应急处置措施。结果 2009-2016年7个监测预警点所在区域均未查见感染性钉螺;在7个监测预警点检查哨鼠3643只,查出阳性哨鼠30只,哨鼠阳性率为0.82%,共发现3个预警点6次哨鼠法测定水体具有感染性。2009-2011年共投放哨螺9 000只,钉螺逸蚴共32 490只次,解剖钉螺5 191只,均未检出毛蚴。针对出现感染性哨鼠的3个监测预警点发布水体感染性预警警示6次;对监测预警阳性点区域重点人群查病2262人,查出DDIA阳性128人,阳性率5.66%;粪检阳性10人,感染率为0.44%;监测男性和女性血清学阳性率分别为6.80%和3.71%,感染率分别为0.56%和0.24%,性别血清学阳性率(χ2=9.42,P0.01)及感染率(χ2=6.21,P0.01)差异均有统计学意义。未查出急性血吸虫病病人。检查放养羊228只次,查出阳性12只次,感染率为5.26%。对查出的128例DDIA阳性、10例粪检阳性者及12只次阳性羊均采用吡喹酮进行同步化疗;开展药物灭螺50hm2,应急灭蚴19hm2;并及时采取了健康教育及个人防护、安全用水及粪便管理等集成处置措施,有效控制了疫情发生。结论江滩型血吸虫病传播控制地区实施重点水域感染性监测预警并及时采取有效应急处置措施对扼制疫情的发生发展效果显著。哨鼠法是测定水体感染性客观、敏感和有效方法之一。
[Abstract]:Objective to implement the application and demonstration of schistosomiasis infection monitoring, early warning and emergency disposal technology in the key water areas along the Dantui section of Zhenjiang City, Zhenjiang City, where schistosomiasis transmission control has been achieved in susceptible seasons. To provide a reference for the establishment of sensitive and effective surveillance, early warning and management system of epidemic situation. Methods based on the basic epidemiological database and the identification of transmission risk factors, seven high-risk areas were selected as monitoring and early warning points on the beach of 68.9km in Dantuo section of Zhenjiang River, Yangtze River. From 2009 to 2016, 5 to 9 samples of environmental snails and human and animal diseases were investigated by sentinel rat method, and field observation method was used to investigate the water contact between human and animal. In 2009-2011, the contamination of Schistosoma japonicum cercariae to water was measured by sentinel snail method. As soon as an infectious snail is detected, or an acute infected patient is found, or a faecal positive patient is found, or an infectious sentinel rat is found, or an infectious sentinel snail is found, an early warning is issued and a disposal procedure is initiated. Corresponding emergency measures should be taken to deal with the epidemic situation. Results Infectious Oncomelania hupensis was not found in the 7 surveillance and warning sites in 2009-2016, and 30 positive sentinel rats were detected in 3643 sentinel rodents from 7 surveillance and early warning sites. The positive rate of sentinel rat was 0.82.The results showed that there were 9 000 sentinel snails, 32 490 Oncomelania snails and 5 191 snails dissected from 3 warning points. No cercariae were detected in all of the 9 000 sentinel snails, 32 490 Oncomelania snails, and 5 191 snails dissected in 2009-2011. For 3 surveillance and early warning points of infected sentinel rats, 6 times were issued for warning of water body infectivity. 2262 cases were detected among the key population in the area of positive spot of surveillance and early warning, with a positive rate of 5.66 for DDIA and 10 positive for faecal examination. The positive rate of serological examination was 6.80% in male and 3.71% in female, the infection rate was 0.56% and 0.24, and the positive rate of sex serology (蠂 ~ 2 ~ (9.42) P _ (0.01) and infection rate (蠂 ~ 2 ~ (6.21) P _ (0.01) were significantly different. No cases of acute schistosomiasis were detected. 228 sheep were examined, 12 were positive, and the infection rate was 5.26. All of the 128 DDIA positive individuals and 12 positive sheep were treated with praziquantel chemotherapy, 50hm2drug, 19hm2.Health education and personal protection were carried out in time. Integrated disposal measures such as safe water and excrement management can effectively control the outbreak. Conclusion Infectious surveillance and early warning in key water areas and effective emergency measures in Jiangtan schistosomiasis transmission and control area are effective in controlling the occurrence and development of schistosomiasis. Sentinel method is one of the objective, sensitive and effective methods for the determination of water infectivity.
【作者单位】：江苏省镇江市丹徒区疾病预防控制中心;镇江市丹徒区人民政府血吸虫病地方病防治工作领导小组办公室;江苏省血吸虫病防治研究所国家卫生和计划生育委员会寄生虫病预防与控制技术重点实验室江苏省寄生虫与媒介控制技术重点实验室;镇江市疾病预防控制中心;
【分类号】：R532.21

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