媒介与媒介生物性疾病

该文在收集分析文献材料的基础上，探讨了媒介与媒介生物性疾病等概念及其相互关系。（1）狭义的媒介生物即传染病流行三环节中的生物性传播因素，即有关的节肢动物；广义的媒介生物即世界卫生组织所定义的、包括人畜共患病的脊椎和非脊椎动物的终宿主和中间宿主以及动物贮存宿主。（2）当前世界范围内广泛接受的媒介生物性疾病概念为由节肢动物、鼠类和软体动物起主要传播作用的传染病。（3）自然疫源性疾病的概念当前仪见使用于中俄两国，分原始的和后来扩展的两种，且后者定义不甚严格，但当前我国对该概念的使用已远远超出其原始定义的范围，按照原始定义，自然疫源性疾病必然同时既是人畜共患病，又是一种狭义的媒介生物性疾病。（4）媒介生物性疾病与人畜共患病及按原始定义的自然疫源性疾病三者的关系可以概括为：媒介生物性疾病与自然疫源性疾病是整体与部分的关系，后者是前者的一部分；媒介生物性疾病与人畜共患病的关系是绝大部分重叠的关系。三个概念中目前在世界范围内应用最多的足人畜共患病，其次是媒介生物性疾病，应用最少的为自然疫源性疾病。     

新发媒传疾病及其防控

本文对新发媒传疾病的流行现状、流行特征和防控进行阐述,提出在“同一个世界,共同拥有健康”的理念下,建立立体化全方位的防控体系以应对新发媒传疾病的威胁。     

新发和再发虫媒传染病

近几十年来节肢动物传播的病原体在全球范围内扩散,成为新的公共卫生威胁。气候变化、城市化、土地开垦、人口增长、生活习俗的改变以及便捷的交通等自然和社会因素正在推动它们广泛传播。本文对近年来新发和再发虫媒传染病的病原学、流行病学、临床表现、诊断、治疗和预防作一综述。     

Insecticide resistance in lice collected from homeless people in Moscow

Permethrin and malathion resistance in body and head lice collected from homeless people in Moscow was investigated in March 2009 to March 2010. Most micropopulations were found to have permethrin-resistant individuals. Their proportion varied from 8.7 to 100%. Cross resistance of body lice to 5 insecticides (the pyrethroids permethrin, d-phenothrin, cypermethrin, deltamethrin, and the organic chlorine compound DDT) was revealed in one case. The lice remained susceptible to organic phosphorus insecticides (fenthion, malathion). The data on permethrin resistance in the lice, obtained by the standard method (immersion of the insects into an insecticide solution), correlated with those yielded by the modified WHO method.     

Review of vector-borne diseases in Hong Kong

The epidemiology of vector-borne diseases in Hong Kong has changed over the past decade but still poses a significant public health risk. We provided a comprehensive review of the epidemiological information and analysed the trends of major vector-borne diseases, including the vector situation in Hong Kong. The incidence of malaria has dropped dramatically in the past few decades and is now mainly an imported disease acquired from malaria endemic countries. Locally acquired dengue fever occurred in 2002 and 2003, and thereafter all cases were imported, mainly from Southeast Asia areas. Only a few local cases of Japanese encephalitis were reported in the past decade. In contrast, there is a notable increase in scrub typhus and spotted fever cases. The emergence of chikungunya fever in Asia and Indian Ocean countries also resulted in importation of human cases. Given the heavy traffic between this international city and other parts of the world, as well as the presence of vectors in this densely populated area, vigilance should be maintained against these infections. Comprehensive public health measures encompassing disease surveillance, vector surveillance and control measures with support from all sectors of the community are required to combat the old and newly emerging vector-borne diseases in Hong Kong.     

El Nino-Southern Oscillation and vector-borne diseases in Anhui, China

This paper examines the relationship between monthly Southern Oscillation Index (SOI) and monthly incidences of hemorrhagic fever with renal syndrome (HFRS) and malaria in Anhui Province, China, over the periods 1971-1992 and 1966-1987, respectively. On the basis of monthly data over a 22-year period, results indicated that there were positive and negative relationships, respectively, between the SOI and monthly incidences of malaria and HFRS. The results suggest that the SOI could be used as an index in the study of the association of climate variability with the transmission of such diseases, particularly over larger areas, such as at a provincial or even state level, where averaging rainfall or temperature data across regions is inappropriate.     

新发和重现虫媒病:流行现状及应对策略

气候变暖、全球化和城市化推进、媒介昆虫抗药性等因素导致疟疾、登革热、莱姆病、西尼罗热、基孔肯雅热、巴尔通体感染等新出现和再次肆虐的虫媒病流行,全球媒介生物和虫媒病的威胁持续上升.由于环保的要求,可以选择的卫生杀虫剂品种逐渐减少,媒介生物和虫媒病的控制面临严重的挑战.该文综述了近年来全球新发和重现的重要虫媒病的研究进展和流行现状,并阐述了媒介生物综合治理全球策略框架、政府干预措施及媒介生物可持续控制技术等应对策略.

Abstract：

Following the warming of climate, globalization, urbanization, insect drug-resistant as well as other social and environmental changing factors, malaria, dengue fever, West Nile fever and other vectorborne diseases emerge and re-emerge continuously. The threats of vectors and vector-borne diseases are increasing. However, owing to the environmental protection policies, more and more pesticides are forbidden, control of vectors and vector-borne diseases are facing with severe challenges. The research development and epidemic status of several important vector-borne diseases were reviewed in this paper. The framework of vector management stratogy,intervention of governments and sustainable vector control technologies were also introduced in the paper.     

Alcoholism and somatic comorbidity among homeless people in Mannheim,Germany

Aims  To assess the prevalence of alcoholism and somatic codisorders of homeless people.
Design  Epidemiological cross-sectional field study in a sample of the homeless in the area.
Setting  The study was conducted from 1997 to 1999 in the inner-city area of Mannheim, Germany (approximately 320 000 inhabitants).
Participants  One hundred and two single homeless people (15–16% of the estimated total population of single homeless people in the city).
Measurement  Alcoholism, substance abuse and mental disorders were diagnosed with the SCID. Medical examinations were performed by an experienced physician. Blood samples were taken and urine samples collected. Further assessments were conducted for factors potentially correlating with mental or physical state.
Findings  Of the study probands, 63.7% presented with the alcohol dependence syndrome or harmful use, 61.7% had current somatic problems or disorders. Probands with alcohol dependence had significantly more frequent somatic disorders in total, more cerebral degeneration, liver disease or alcoholic polyneuropathies. Multiple stepwise regression identified alcoholism, life-satisfaction, duration of homelessness and lacking social support as significant explanatory factors for having a somatic disorder. Alcoholism increased the risk of physical ill-health more than fourfold.
Conclusion  Alcoholism is a major contributor to the physical ill-health of homeless people. Treatment or rehabilitation of addictive behaviour among the homeless should be of major concern for adequate service planning or provision.     

Viral hepatitis and other infectious diseases in a homeless population

GOALS: To determine the prevalence of four common infectious diseases-hepatitis B, hepatitis C, human immunodeficiency virus (HIV), and tuberculosis-as well as co-infection rates and risk factors in a homeless population. BACKGROUND: The prevalence of infectious diseases, especially viral hepatitis, among the homeless population is largely unknown. STUDY: This study consists of a retrospective analysis of the history and laboratory data collected from all homeless veterans admitted to a Veterans Administration (VA) domiciliary from May 1995 to March 2000. RESULTS: Of the homeless veterans admitted to a VA domiciliary program, 597 of 829 were screened for markers of all four infectious diseases. The overall prevalence of anti-hepatitis C virus (HCV) antibody, and positive result for purified protein derivative (PPD), anti-HIV antibody, and hepatitis B surface antigen (HbsAg) were 41.7%, 20.6%, 1.84% and 1.17%, respectively. At least one of the four markers was positive in 52.6% and more than one in 12%. Co-infection with HCV occurred commonly in veterans who were positive for anti-HIV (72.7%) and HBsAg (57.1%). Four self-reported major risk factors (intravenous drug use, alcohol abuse, previous imprisonment, and prior stay in a shelter) were evaluated. Multivariate analysis indicates that intravenous drug use and anti-HBs reactivity are independent risk factors for HCV infection, HCV infection for anti-hepatitis B surface antibody reactivity, and older age for PPD positivity. CONCLUSIONS: Chronic hepatitis C and co-infections are common among the homeless population. Patients infected with HIV and hepatitis B virus frequently are co-infected with HCV. Infections frequently are associated with certain identifiable risk factors.     

Legal aspects of public health: Difficulties in controlling vector-borne and zoonotic diseases in Brazil

In recent years, vector-borne and zoonotic diseases have become a major challenge for public health. Dengue fever and leptospirosis are the most important communicable diseases in Brazil based on their prevalence and the healthy life years lost from disability. The primary strategy for preventing human exposure to these diseases is effective insect and rodent control in and around the home. However, health authorities have difficulties in controlling vector-borne and zoonotic diseases because residents often refuse access to their homes. This study discusses aspects related to the activities performed by Brazilian health authorities to combat vector-borne and zoonotic diseases, particularly difficulties in relation to the legal aspect, which often impede the quick and effective actions of these professionals. How might it be possible to reconcile the need to preserve public health and the rule on the inviolability of the home, especially in the case of abandoned properties or illegal residents and the refusal of residents to allow the health authority access? Do residents have the right to hinder the performance of health workers even in the face of a significant and visible focus of disease transmission? This paper argues that a comprehensive legal plan aimed at the control of invasive vector-borne and zoonotic diseases including synanthropic animals of public health importance should be considered. In addition, this paper aims to bridge the gap between lawyers and public health professionals and to facilitate communication between them.     

Physical and psychological risk factors of ischemic heart diseases. Apropos of a prospective survey in Marseilles

The results of a survey carried out in Marseilles between 1972 and 1979 are reported. A common protocol was used to compare results with two other surveys performed conjointly in Paris and Brussels. The protocol was designed with special emphasis on the psychological factors with respect to the risk factors for ischaemic heart disease (IHD). Seven hundred and eighty six men in a Marseilles administrative department, aged 40 to 60 years (mean age 48.5 +/- 4.5 years) were followed-up for 74 months. Apart from cardiovascular clinical examination with measurement of height, weight, blood pressure and ECG recording, the initial check-up included serum cholesterol, triglycerides and glucose determination and a study of psychological risk factors based on the Bortner's scale for the evaluation of type A profile, and on a questionnaire : the SHEPI for evaluation of the N score (neuroticism). The annual IHD incidence was 9.5% with 4.2% of major events (death or infarction), and 5.3% of minor events (angina pectoris, suggestive ECG changes). Age, tobacco consumption, average systolic blood pressure, serum cholesterol and obesity index were higher in patients who became ill than in those who remained healthy, but overall and separate analysis of major and minor events showed no significant difference apart from age. On the other hand, the study of increased risk according to the level of each of these major factors gave significantly positive results except for the serum glucose level. The correlations between incidence of IDH and the value of each risk factor were not always the same according to the clinical expression (major or minor events). Psychological factors also differed according to the clinical expression of IHD : the Bortner scale was higher in patients developing IHD than in healthy subjects, and higher in those who suffered major events than in those who suffered minor events. On the other hand, the N score was higher in patients with minor events than in those suffering major events. These differences which were not statistically significant in the Marseilles study alone, became significant in the Franco-Belgian cooperative study. The increased risk with the number of associated factors (including psychological) is significant from the association of 2 factors, but only in the fifth decade.(ABSTRACT TRUNCATED AT 400 WORDS)     

Discriminant analysis: a method of identifying foci of vector-borne diseases.

Identification of foci of vector-borne diseases does not require knowledge of exact abundances of vectors and pathogens; rather, a focus is defined by the presence, or some minimal level of abundance, of a vector and pathogen. Stepwise discriminant analysis (DA) was applied to data on free-ranging adult wood ticks (the vector) and to data on isolations of Colorado tick fever virus from small mammals. Trap stations were grouped on the basis of relative abundance of wood ticks for one set of analyses and on the presence or absence of virus for another set of analyses. Additional data consisted of easily measured environmental variables. It is concluded that DA provides a useful tool for analysis of ecosystem structure and an effective means of identifying foci of infection.     

Landscape and geographical distribution of natural reservoirs of human vector-borne diseases in Southern Kazakhstan and Kirghizia

The paper presents data available in the literature on the natural foci of plague, tularemia, tick-borne spirochetosis, Crimean hemorrhagic fever, tick typhus, Q fever, zoonotic cutaneous leishmaniasis. The largest number of transmissible infections is shown to be in the natural areas of deserts and piedmont semiarid lands.