汶川地震阿坝州极重灾区如何开展卫生防疫工作

目的通过总结汶川地震震中阿坝州卫生防疫的经验，为地震活跃带地区的灾后重建和卫生防疫工作提供一手资料和参考。方法亲历和见证汶川地震后100天阿坝州卫生防疫全过程，收集、整理、分析受灾情况和卫生防疫工作的数据、工作模式、绩效和问题。结果阿坝州13个县中12县受灾，包括2个极重灾县和5个重灾区。死亡20233人，失踪7873人。卫生系统自身受损严重。震后2h阿坝州疾病预防控制中心启动应急预案，共向灾区派出4支防疫队，结合当地资源和外援力量，迅速建成县、乡、村三级防疫网络：①开展环境清理与消杀灭工作：截至8月27日，派出工作队2591支次，88298人次，动用车辆5294台次；消毒面积达18181．3万平方米，消毒处理垃圾场14132处，消毒处理粪坑33271个，处理蚊蝇、鼠孳生处154391处。②严格监管饮水及食品安全：截至6月20日，恢复集中供水点21个，分散式供水点1032个，灾后共采样监测生活饮用水829份，合格594份，合格率66．59％。③震后汶川威绵地区设17个临时安置点，共住86396人。④在黑热病疫区杀灭野犬。每周一次蚊、蝇、鼠密度监测，严密监控各种疫情。⑤积极开展健康教育与促进工作，截至8月27日，共发放宣传资料1597711册／张，培训26558人次。⑥疾病监测：震后90天，发现甲乙丙类法定传染病15种762例，无死亡。无传染病暴发疫情和其他突发公共卫生事件的报告。6月1～14日开展甲肝疫苗应急接种工作，包括6县18月龄至12岁儿童57157人份，13～16岁儿童、医务工作者、部队官兵、一线工作人员16268人份；小金县接种乙脑疫苗4435人份。从6月15日起，恢复常规免疫接种门诊；7月1日6县如期启动了扩大免疫工作。结论结合外援力量，阿坝州卫生防疫取得阶段性胜利，但这毕竟只是一种事后补救模式，事倍功半。希望通过

Anti-epidemic Measures in the Worst-Hit Aba Prefecture in Wenchuan Earthquake

Objective To summarize the experience of epidemic prevention in order to offer the first-hand data for reconstruction after the earthquake and epidemic control and prevention in the active seismic zone. Method We collected and analyzed the data of epidemic control and prevention and summarized their strengths and weaknesses. Results Of the 13 counties in Aba Prefecture, 12 were afflicted with 2 worst-hit counties and 5 worse-hit disaster areas. A total of 20 233 people were dead and 7 873 people were missing. Health system was severely damaged. Aba Center of Disease Control and Prevention started the contingency plan and sent 4 epidemic prevention teams to the disaster areas. With the combination of local materials and external aids, the epidemic prevention network of county, township and village was established. (1) Environment cleaning and elimination: up to August 27, 2008, 2 591 group times of teams involving 88 298 person times and 5 294 set times of vehicles were allocated. Disinfection area covered 18 181.3 m2 including 14 132 dumps, 33 271 cesspits and 154 391 breeding grounds of mosquitoes, flies and mice. (2) Critical supervision for the safety of drinking water and food: up to June 20, 21 centralized and 1 032 dispersed water supply sources were restored. We monitored 829 drinking water samples, among which 594 were qualified with the qualified rate of 66.59%. (3) A total of 86 396 people were resettled in 17 temporary sites. (4) Wild dogs were killed in Kala-azarepidemic areas. Mosquitoes, flies and mice were supervised once a week. (5) Disease supervision: A total of 762 cases in 15 legal infectious diseases were found within 90 days after the earthquake, and no death was found. No outbreak of infectious epidemic situations and burst public health events was reported. A total of 57 157 Hepatitis A vaccinations were inoculated in the children aged from 18 months to 12 years old and 16 268 in children aged from 13 to 16 years old, medical staff, military personnel and first-line workers. A total of 4 435 Japanese encephalitis vaccinations were inoculated in people in Xiaojin county. On June 15, routine inoculation clinic recovered and on July 1, expansive inoculation was started on schedule. Conclusion Phased victory is gained in epidemic control and prevention in Aba Prefecture, although it is only a latter-wit. It is suggested that a long-term system of the earthquake disaster as well as human and environmental protection should be reconsidered through the first-hand data of anti-epidemic measures of the Wenchuan earthquake.