新传染病:发现·确认·流行·防治

〔目的〕　控制新出现传染病的发生与流行。〔方法〕　根据传染病的流行特点 ,进行研究分析 ,提出相应的预防和控制措施。〔结果〕　对新传染病及时发现并遵循确认原则予以确认 ,充分认识其危害性 ,加强卫生检疫和传染病监测 ,预防和控制新传染病的发生和流行。〔结论〕　面对新传染病的不断发生 ,必须充分认识对人类造成的危害 ,认真落实各项预防措施 ,才能控制新传染病的发生与流行     

回顾SARS教训 控制新出现传染病

21世纪人类出现的第一个严重流行的新疾病——严重急性呼吸道综合征（SAILS），表明一种新出现的传染病可以造成全球的巨大破坏。经过各国科学家的努力，目前对SARS的认识有了比较清晰的轮廓。现就SARS流行特点、发病机制及传播控制研究等进行简述，以避免因其他因素（例如人感染高致病性禽流感）产生严重呼吸道症状疾病，而被误认为是SARS的再次来临，造成不必要的恐慌，并为将来应对SARS再次来临或新出现类似传染病提供借鉴。     

回顾SARS教训控制新出现传染病

21世纪人类出现的第一个严重流行的新疾病——严重急性呼吸道综合征（SAILS），表明一种新出现的传染病可以造成全球的巨大破坏。经过各国科学家的努力，目前对SARS的认识有了比较清晰的轮廓。现就SARS流行特点、发病机制及传播控制研究等进行简述，以避免因其他因素（例如人感染高致病性禽流感）产生严重呼吸道症状疾病，而被误认为是SARS的再次来临，造成不必要的恐慌，并为将来应对SARS再次来临或新出现类似传染病提供借鉴。[第一段]     

2006年南宁市传染病流行情况分析

目的通过对南宁市传染病流行情况分析,掌握流行趋势,做好南宁市疾病预防控制工作。方法收集2006年南宁市传染病疫情资料,进行描述性流行病学分析。结果2006年南宁市无重大传染病暴发流行,甲、乙类传染病发病率372.56/10万。结论加强疾控机构能力建设,完善县、乡、村三级疾病预防控制网络建设,强化疫情预测预警能力。以SARS、禽流感、流感等传染病防控为重点,加强重大传染病的预防控制和监测工作。     

东莞市2003年法定报告传染病疫情分析

为掌握东莞市法定传染病的流行情况，进一步加强传染病管理，控制和降低该市法定传染病发病率，现将该市2003年的疫情资料分析如下。     

新出现传染病与传染病控制国际法规

自20世纪70年代以来,相继发现了40余种新的传染病,新出现传染病的控制已成为发展中国家和发达国家共同面对的又一个公共卫生问题.各国为了在传染病的控制上进行国际合作,先后制订了传统的和现代的国际法规.随着新疾病的不断出现和老疾病的死灰复燃,现行的国际传染病控制法规--<国际卫生条例>存在的缺陷越发显现出来,为此,世界卫生组织对该条例进行了修订,以确保提供一个明确的框架,国际社会可在该框架内协调一致地工作.另外,对美国、加拿大、俄罗斯、日本、韩国有关控制传染病的法规进行了简要介绍,以供参考.     

1990～2001年珠海市传染病流行趋势分析

目的 掌握珠海市近十年主要传染病的流行特点，为制定相应的防制策略和措施提供科学的依据。方法 通过比较不同时期、地区、人群主要传染病发病的分布情况，分析1990～2001年珠海市传染病的流行特点和趋势。结果 自1990年以来珠海市传染病疾病谱发生了变化，甲乙类传染病总发病率为323．34／10万，本地居民的传染病发病率呈下降趋势，暂住人员的传染病发病率波动在9．82～749．44／10万。肠道传染病得到有效控制，性接触传播传染病有播散的趋势。结论 今后珠海市传染病防治工作应完善常规疾病监测，继续加强霍乱、疟疾、登革热、艾滋病和流感等重点传染病的防制，重视暂住人员传染病防治和新发传染病的监测工作。     

预防传染病，要学会自我保护

过去人们曾普遍认为．传染病不再对人类健康构成大的威胁。然而．不时新出现的和重新出现的传染病流行，一次次为人类敲响警钟。肺结核、性病等过去已控制的传染病、狂犬病等人畜共患传染病，以及虫媒传染病（如由蚊子叮咬导致的疟疾），呈高发态势。其实早在1997年，世界卫生组织就将”全球警惕，采取行动，防范新出现的传染病”作为世界卫生日的主题，表明了国际社会对传染病的普遍关注。     

1950～2003年平江县法定传染病流行趋势分析

目的系统分析平江县1950～2003年法定传染病流行趋势,为制定传染病防治对策提供依据. 方法按照国家统一规定的法定传染病进行分类整理,运用时间序列和自身对照方法,分析发病率、死亡率的变动趋势. 结果平均发病率、死亡率大幅度下降,传染病构成发生了明显的变化,计划免疫相关传染病已显著下降. 结论平江县传染病得到了有效控制,但传染病疫情出现了新的特点,防制形势仍然严峻,应及时制定科学防病对策,加强预防和监测.     

1952～2009年合浦县甲乙类传染病流行趋势分析

目的描述合浦县58年来甲乙类传染病的流行情况,分析传染病的发病特点和流行趋势,为今后制定防治措施提供科学依据。方法对合浦县1952~2009年法定传染病疫情资料进行分析。结果合浦县1952~2009年共报告甲乙类传染病22种,累计发病387 965例,年平均发病率866.92/10万;累计死亡3 386例,年平均死亡率7.57/10万。发病和死亡总体呈现明显下降趋势,传染病发病居前5位的病种发生明显变化,血源及性传播疾病、呼吸道传染病发病有上升趋势,肠道传染病发病明显下降。结论合浦县甲乙类传染病得到了有效的控制,传染病构成发生了显著变化,旧病种死灰复燃,新病种不断出现,传染病防控工作面临着新老传染病的双重威胁。     

Emerging trends in international law concerning global infectious disease control

International cooperation has become critical in controlling infectious diseases. In this article, I examine emerging trends in international law concerning global infectious disease control. The role of international law in horizontal and vertical governance responses to infectious disease control is conceptualized; the historical development of international law regarding infectious diseases is described; and important shifts in how states, international institutions, and nonstate organizations use international law in the context of infectious disease control today are analyzed. The growing importance of international trade law and the development of global governance mechanisms, most prominently in connection with increasing access to drugs and other medicines in unindustrialized countries, are emphasized. Traditional international legal approaches to infectious disease control--embodied in the International Health Regulations--may be moribund.     

Conflict and emerging infectious diseases

Detection and control of emerging infectious diseases in conflict situations are major challenges due to multiple risk factors known to enhance emergence and transmission of infectious diseases. These include inadequate surveillance and response systems, destroyed infrastructure, collapsed health systems and disruption of disease control programs, and infection control practices even more inadequate than those in resource-poor settings, as well as ongoing insecurity and poor coordination among humanitarian agencies. This article outlines factors that potentiate emergence and transmission of infectious diseases in conflict situations and highlights several priority actions for their containment and control.     

Securitization of infectious diseases in Vietnam: the cases of HIV and avian influenza

The frequent and swift emergence of new and devastating infectious diseases has brought renewed attention to health as an issue of international importance. Some states and regional organizations, including in Asia, have begun to regard infectious disease as a national and international security issue. This article seeks to examine the Vietnamese government's response to the epidemics of avian influenza and Human immunodeficiency virus. Both diseases have been recognized at different times as threats to international security and both are serious infectious disease problems in Vietnam. Yet, the character of the central government's response to these two epidemics has been starkly different. How and why this disparity in policy approaches occurs depends largely on the epidemiological, economic and political context in which they occur. Although epidemiological factors are frequently explored when discussing disease as a security issue, seldom are the political, social and economic characteristics of the state invoked. These dimensions, and their interaction with the epidemiology of the disease, are central to understanding which diseases are ultimately treated by states as security issues. In particular, the role of economic security as a powerful motivator for resistance to control measures and the role that local implementation of policies can have in disrupting the effect of central government policy are explored. In exploring both the outcomes of securitization, and its facilitating conditions, I suggest some preliminary observations on the potential costs and benefits of securitizing infectious disease and its utility as a mechanism for protecting health in Asia.     

International health and emerging infectious diseases

This article explored the role of international health in reducing the impact of infectious diseases by espousing the monumental application of global electronic communication and socioeconomic development initiatives. The interaction between the society and environmental changes have dramatic effects on the frequency of infectious diseases worldwide. Development of dams, human population expansion, migration patterns, urbanization and the invasion of hitherto virgin forests, and global warming enhance the proliferation of vectors of infectious diseases. Sustainable development and emphasis on primary prevention initiatives, coupled with the application of technology to improve farming, provision of safe water and electrification of rural communities, are significant steps in infectious disease control.     

Toward a transdisciplinary understanding and a global control of emerging infectious diseases

The Franceville International Centre for Medical Research (CIRMF) organized a first international symposium on infectious diseases, environments, and biodiversity. Over 200 international experts gathered in Gabon to forecast and work to prevent the emergence of infectious diseases. This symposium aimed to strengthen the regional and international fight against the emergence of infectious diseases with high-level scientific debates. Toward this goal, it brought together experts in human and animal health, the environment, and ecology, including biologists, climatologists, microbiologists, epidemiologists, public health professionals, and human and social sciences specialists. National, regional and international participants were present to debate on the challenges related to the emergence of infectious diseases and on the responses to be implemented. The symposium was very successful, and plans for a second symposium of this kind to be held in the near future in another high-biodiversity area are already underway.     

Social ecosystem health: confronting the complexity and emergence of infectious diseases

The emergence and re-emergence of infectious diseases and their rapid dissemination worldwide are challenging national health systems, particularly in developing countries affected by extreme poverty and environmental degradation. The expectations that new vaccines and drugs and global surveillance would help reverse these trends have been frustrated thus far by the complexity of the epidemiological transition, despite promising prospects for the near future in biomolecular research and genetic engineering. This impasse raises crucial issues concerning conceptual frameworks supporting priority-setting, risk anticipation, and the transfer of science and technology's results to society. This article discusses these issues and the limitations of social and economic sciences on the one hand and ecology on the other as the main theoretical references of the health sciences in confronting the complexity of these issues on their own. The tension between these historically dissociated paradigms is discussed and a transdisciplinary approach is proposed, that of social ecosystem health, incorporating these distinct perspectives into a comprehensive framework.     

International Circumpolar Surveillance, an Arctic network for the surveillance of infectious diseases

Peoples of the Arctic and sub-Arctic regions live in social and physical environments that differ substantially from those of their more southern-dwelling counterparts. The cold northern climate keeps people indoors, amplifying the effects of household crowding, smoking, and inadequate ventilation on person-to-person spread of infectious disease. The emergence of antimicrobial drug resistance among bacterial pathogens, the reemergence of tuberculosis, the entrance of HIV into Arctic communities, and the spectre of pandemic influenza or the sudden emergence and introduction of new viral pathogens such as severe acute respiratory syndrome are of increasing concern to residents, governments, and public health authorities. The International Circumpolar Surveillance system is a network of hospital, public health agencies, and reference laboratories throughout the Arctic linked together to collect, compare, and share uniform laboratory and epidemiologic data on infectious diseases and assist in the formulation of prevention and control strategies.     

传染病智慧化症状监测的进展与挑战

智慧化症状监测是我国传染病智慧化预警多点触发和多渠道预警体系的重要组成部分,是传统症状监测在新技术发展下的必然路径。智慧化症状监测不仅包括医院就诊患者的大量医疗数据,还囊括未在医院就诊、海量的非医疗数据。然而,发展的同时也迎来了挑战,如信息爆炸、成本-效益问题以及数据共享、数据安全和隐私问题。本文通过对智慧化症状监测相关概念发展的思考和总结,为传染病智慧化预警方法与技术的发展提供参考,为我国和全球传染病防控提供新思路。     

传染病新特点与口岸卫生检疫应对

目的提高国境口岸应对传染病的新特点的能力。方法分析传染病新近出现新的特点和趋势,提出国境口岸卫生检疫的应对措施。结果应对传染病出现全球化、卷土重来的新特点,口岸卫生检疫工作任重道远,加强国际、国内、区域间及人医与兽医的合作,调整卫生检疫模式及内容,建立有效的防控体系。结论在传染病全球化和增多的情况下,建立有效的卫生检疫模式。     

Social inequalities and emerging infectious diseases.

Although many who study emerging infections subscribe to social-production-of-disease theories, few have examined the contribution of social inequalities to disease emergence. Yet such inequalities have powerfully sculpted not only the distribution of infectious diseases, but also the course of disease in those affected. Outbreaks of Ebola, AIDS, and tuberculosis suggest that models of disease emergence need to be dynamic, systemic, and critical. Such models--which strive to incorporate change and complexity, and are global yet alive to local variation--are critical of facile claims of causality, particularly those that scant the pathogenic roles of social inequalities. Critical perspectives on emerging infections ask how large-scale social forces influence unequally positioned individuals in increasingly interconnected populations; a critical epistemology of emerging infectious diseases asks what features of disease emergence are obscured by dominant analytic frameworks. Research questions stemming from such a reexamination of disease emergence would demand close collaboration between basic scientists, clinicians, and the social scientists and epidemiologists who adopt such perspectives.