甘肃省10种自然疫源性疾病的媒介昆虫组成与分布

本文对甘肃省１０种自然疫源性疾病及某媒介昆虫的组成、分布及医学意义进行了研讨，为这些疾病的防治工作提供了基础资料。     

甘肃省自然疫源性疾病宿主媒介种类组成及地理区划

建国以来,甘肃省陆续发现几种自然疫源性疾病,其中危害较重者为鼠疫、布鲁氏杆菌病(简称布病)、黑热病、包虫病以及80年代初传入的流行性出血热(简称EHF)等。引起党和政府的重视,相继成立专业机构,对上述几种主要疾病开展系统的调查、防治和研究,并取得了显著成绩。然而,我省尚待开发或正在开发的地区,具备一些其它自然疫源性疾病形成疫源地的环境和条件,究竟存在程度如何或存在的可能性多大,诸如此类问题至今未明确,     

甘肃省鸟类与自然疫源性疾病

本文就鸟类与自然疫源性疾病关系作尝试性探讨。全省可作为有关自然疫源性疾病病原体宿主或携带者的脊推动物１３３种，其中鸟类３４种，占全省鸟类５６４种的５．３２％，占全省动物宿主总数的２５．５６％，仅次于啮齿动物宿主（３８．３５％）。鸟类可作为鼠疫等７种自然疫源性疾病宿主，是森林、森林草原和草原疾病的主要宿主，它染疫后通过飞行迁徙将病原体做远程转移，可能使疫区扩大或形成新的疫源地。因此鸟类具有重要的流行病学意义。然而甘肃对鸟类与自然疫源性疾病研究甚少。本文目的在于引起重视，加强研究。     

肾综合征出血热媒介传播研究进展

肾综合征出血热（Hemorrhagic Fever with Renal Syndrome，HFRS）是一种以高热、低血压、出血、少尿和多尿等肾功能损害为特征，严重危害人类健康的自然疫源性疾病，亚、欧、非、美、澳五大洲的34个国家和地区均有病例发生，主要分布于欧亚大陆的北部和东部，近年有不断扩大的趋势。HFRS在我国分布广，发病多，病死率高，发病数占全世界的90％左右，我国除青海、新疆未发现HFRS病例外，其余各省均曾有过报告。     

云南省自然疫源性疾病和发展趋势及防治对策

自然疫源性疾病是指病原体通过动物宿主之间或媒介昆虫与动物宿主之间的传播而长期保存在自然界之中 ,人类在生产、生活活动中直接或间接地接触它们 ,可感染发病的这类疾病。建国以来 ,经过大量的调查和研究 ,证实我省存在有鼠疫、布鲁氏菌病、钩端螺旋体病、炭疽、流行性乙型脑炎、登革热、流行性出血热、狂犬病和斑疹伤寒 9种属自然疫源性疾病的法定报告传染病。还证实存在基孔肯雅、辛德毕斯、森林脑炎、Colti病毒和环状病毒病以及恙虫病、Q热、斑点热、埃立克体病、鹦鹉热、莱姆病等非法定报告自然疫源性传染病。由于我省自然疫源性疾…     

自然疫源性疾病学说的发展

巴甫洛夫斯基的疾病自然疫源性理论总体上的概念分为三个部分,既结构（自然疫源地的各要素）、功能（病原体的保存机制）以及自然疫源地生态系（各生态系统间的关系）。６０年的历史该理论可分为三个阶段：第一阶段是以虫媒动物病为基础发展而来。认为病原体、媒介和宿主动物是自然疫源性疾病不可缺少的三要素,既三位一体学说。疾病的疫源性与病原体在地理生态系中的循环相关;第二个阶段认为并不是在任何自然疫源性疾病中媒介都作为必要要素之一,既非虫媒性传染病类型。但是其疫源性还是与病原体在动物间不间断的循环相关;第三阶段该理…     

甘肃省自然疫源性疾病宿主动物种类组成与分布

甘肃省地处青藏高原、蒙新高原和黄土高原的交汇处,东经92°13'～108°43',北纬32°31'～42°47',东西长约1 305km,南北宽约500km.全境分为6个自然景观区(类型),即:陇西黄土高原低山丘陵干草原、半荒漠区;陇东黄土高原沟壑干草原、半荒漠区;陇南山地中山森林、草原区;甘南高原、峡谷高寒草甸草原、草原、森林及森林草原区;祁连山地高山山地草原、森林草原区;河西走廊半荒漠、荒漠草原、戈壁荒漠区.相邻各区间相互移行,地形地貌多样,气候变化明显,动物种类繁多.甘肃境内已证实存在10种自然疫源性疾病,其病原体的宿主或携带者动物共计96种,其中家畜、家禽15种.由于目前对自然疫源性疾病与人兽共患病的概念尚难明确界定,一些习惯上称为人兽共患病的疾病如布鲁氏菌病、包虫病等都有野生动物宿主,因此本文将这类疾病统称为自然疫源性疾病.     

1999～2008年云南省重要自然疫源性疾病疫情分析

目的分析1999～2008年云南省重要自然疫源性疾病疫情,为制定预防控制策略提供依据。方法收集1999～2008年云南省重要自然疫源性疾病相关数据,采用描述流行病学进行分析。结果1999～2008年,云南省发生的重要自然疫源性疾病包括细菌、螺旋体病类的鼠疫、布鲁氏菌病、炭疽、钩端螺旋体病,病毒类的狂犬病、流行性出血热、登革热、流行性乙型脑炎,以及寄生虫病类的疟疾、血吸虫病共10种疾病,病人109445例,死亡795例,病死率为0.73%。疟疾发病人数最多,其次为流行性乙型脑炎和钩端螺旋体病,狂犬病病死率为100%。鼠疫、血吸虫病流行得到有效控制;狂犬病、登革热、钩端螺旋体病和布鲁氏菌病疫情呈现上升趋势。全省16个州（市）中,除迪庆、怒江、曲靖、玉溪外均为重病区。发病群体男性显著高于女性,特别是炭疽、狂犬病、疟疾最为明显。不同疾病发病年龄组不同,高发群体主要为农民、学生、散居儿童和民工,以疟疾发病群体最广泛。结论云南省自然疫源性疾病疫情形势严峻。加强监测与预警、提升应急处置能力和严防大疫发生是防控的主要策略。     

必须重视来源于动物的感染病

来源于动物的感染病，是指传染源和（或）生物学传播媒介为野生或豢养动物（包括兽类、畜类、禽类、鳞介类及吸血节肢动物等）的动物相关性感染病，此前多以“人兽共患传染病”命名。其实，家畜和狗猫等宠物并非野兽，而禽、虫、鱼类更不属于兽类，故命名不确切。“动物源性传染病”一词原指人兽共患传染病的1个分类——以动物为主的（兽传或动物源性）人兽共患病（anthropozoonoses），如鼠疫、森林脑炎和布鲁菌病，用来代称，也不全面。“自然疫源性疾病”是以自然疫源地学说为依据的术语。     

华北地区自然疫源性疾病的分布及其与气象条件的关系

目的在华北地区8种自然疫源性疾病高发区进行热点区域探测,分析影响不同自然疫源性疾病发病率的气象因素。方法应用空间聚类分析方法对华北地区1994~2000年8种自然疫源性疾病高发区进行空间聚类分析,应用面板数据分析定量评价气象条件对肾综合征出血热等4种疾病发病率的影响。结果华北地区自然疫源性疾病以肾综合征出血热、斑疹伤寒和乙脑为主,年均发病率分别为4.17/10万、2.13/10万和0.23/10万。各省市8种传染病发病率存在差异,以河北、内蒙古发病率较高。不同类型自然疫源性疾病的高发聚集区空间分布为非随机分布。气象因素分析显示,肾综合征出血热、斑疹伤寒发病率与平均气温呈正相关,布病的发病率与平均最高气温呈负相关,斑疹伤寒、乙脑发病率与平均相对湿度呈正相关;肾综合征出血热发病率与日照呈负相关。结论华北地区8种自然疫源性疾病的分布具有显著的空间聚集性,其流行与气象条件关系密切。气温(包括气温的极值)、湿度和日照对自然疫源性疾病发病率的影响较大。建议在自然疫源性疾病的防控中纳入对气象条件和自然疫源地气候的监测。     

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.     

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。     

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.     

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.     

气候变暖对中国几种重要媒介传播疾病的影响

全球气候变暖对人类健康的影响越来越受到人们的重视。该文从气候变暖对国内血吸虫病、疟疾、登革热、流行性乙型脑炎、广州管圆线虫病、钩端螺旋体病以及其他虫媒疾病的影响、预测方法研究及今后的研究重点等几个方面,综述了气候变暖对中国几种重要媒介传播疾病影响的研究进展。     

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.     

Ectoparasitism and vector-borne diseases in 930 homeless people from Marseilles

Homeless people are particularly exposed to ectoparasites, but their exposure to arthropod-borne diseases has not been evaluated systematically. A medical team of 27 persons (7 nurses, 6 infectious disease residents or fellows, 2 dermatologists, and 12 infectious disease specialists) visited the 2 shelters in Marseilles, France, for 4 consecutive years. Homeless volunteers were interviewed, examined, and received care; and blood was sampled for cell counts and detection of bacteremia, antibodies to louse-borne (Rickettsia prowazekii, Bartonella quintana, and Borrelia recurrentis), flea-borne (R. typhi, R. felis), mite-borne (R. akari), and tick-borne (R. conorii) bacterial agents. We selected sex- and age-adjusted controls among healthy blood donors. Over 4 years, 930 homeless people were enrolled. Lice were found in 22% and were associated with hypereosinophilia (odds ratio, 5.7; 95% confidence intervals, 1.46-22.15). Twenty-seven patients (3%) with scabies were treated with ivermectin. Bartonella quintana was isolated from blood culture in 50 patients (5.3%), 36 of whom were treated effectively. The number of bacteremic patient increased from 3.4% to 8.4% (p = 0.02) over the 4 years of the study. We detected a higher seroprevalence to Borrelia recurrentis, R. conorii, and R. prowazekii antibodies in the homeless. Our study shows a high prevalence of louse-borne infections in the homeless and a high degree of exposure to tick-borne diseases and scabies. Despite effective treatment for Bartonella quintana bacteremia and the efforts made to delouse this population, Bartonella quintana remains endemic, and we found hallmarks of epidemic typhus and relapsing fever. The uncontrolled louse infestation of this population should alert the community to the possibility of severe re-emerging louse-borne infections.     

控制疟疾和登革热:澜沧江-湄公河合作应对虫媒传染病挑战

澜沧江-湄公河沿岸国家具有相似的热带病病原体和媒介,传播特征和模式相似,疾病防控也面临相同的挑战。本文基于澜沧江-湄公河合作疟疾和登革热联防联控项目,总结了中国云南和澜沧江-湄公河沿岸国家虫媒虫传染病面临的主要挑战,分析和评价了该区域的合作需求和所采取有针对性的努力措施,以促进澜湄合作参与国更好地应对虫媒传染病挑战。