国际航行船舶媒介生物控制标准及监测方法的研究

对国际航行船舶进行媒介生物控制是防止传染病在国际间传播,保护人体健康的有效措施。而媒介生物控制的实施,应有统一的、规范的、易行的控制标准和监测方法,使船舶的卫生监督、传染病监测、卫生处理工作更具规范性,有效性。因此,根据多年实践经验,结合船舶结构和航行特点,参照其它方面的媒介生物考核标准及监测方法,提出国际航行船舶的媒介生物控制标准及监测方法。     

大榭港区国际航行船舶卫生监督状况分析

目的了解大榭港区各类型国际航行船舶卫生状况,对大榭港区国际航行船舶进行卫生监督。方法对国际航行船舶饮用水、餐具进行检测,检查船舶受医学媒介生物侵害情况。结果 2007—2010年大榭港区卫生监督船舶总数1553艘次,携带媒介生物船舶292艘次,医学媒介生物阳性率为18.80%。船舶饮用水、餐具抽检合格率为68.6%、85.9%。饮用水、餐具合格率、媒介生物阳性率存在年度和船型差异。结论国际航行船舶仍存在一定的公共卫生风险,做好日常卫生监督,采取有效措施进行预防与控制。     

大窑湾口岸船舶卫生状况分析

〔目的〕对大窑湾口岸2004~2006年停靠的国际航行和内贸运输船舶进行卫生检疫查验和卫生监督,并对船舶媒介生物进行卫生学调查,随时掌握船舶啮齿动物和医学媒介生物携带情况。〔方法〕检疫人员通过对船舶实施卫生监督,每次做好媒介生物数量调查表,汇总统计,并进行综合评价。〔结果〕大窑湾口岸2004~2006年停靠船舶总数5131艘次,卫生不合格船舶562艘次,不合格率达10.9%,携带媒介生物船舶452艘次,其医学媒介生物检出率达8.8%。〔结论〕来自国内内贸运输船舶和国际航行的油轮和货轮卫生状况不容忽视,它将直接影响口岸卫生状况的好坏和安全,因此检验检疫机构应采取有效的预防控制措施,提高船舶卫生质量,是防止疫情传入传出的重要手段。     

舟山口岸输入性医学媒介生物监测及防控对策

〔目的〕掌握舟山口岸输入性医学媒介生物特征,为制定有效防控措施提供依据。〔方法〕分析舟山口岸2009年入境国际航行船舶截获医学媒介生物种群构成、季节消长、地区来源和船舶携带媒介等情况特征,评估各风险因子危害性,进而提出防控措施和建议。〔结果〕2009年舟山口岸截获143批次8种媒介生物,德国小蠊为主要截获种类,媒介生物的截获没有明显季节消长规律,携带医学媒介生物的船舶以东南亚国家来源为主,修理船携带媒介生物风险高于其他船舶。〔结论〕不同种类与来源地的入境国际航行船舶携带医学媒介生物差别较大,应根据风险因子不同,采取有效措施做好输入性医学媒介生物及相关传染病的监测防治工作。     

舟山口岸外籍修理船舶的检疫风险研究

[目的]探索外籍修理船舶存在的卫生问题，制定相应的卫生处理措施。[方法]通过定性和定量研究的方法，获取外籍修理船舶在卫生状况、疫情传播、媒介生物入侵、船舶生活垃圾处理、压载水排放等方面存在的卫生问题。[结果）外籍修理船舶鼠患、虫患阳性率明显高于正常航行船舶．外籍修理船舶卫生状况与正常航行船舶相比较，存在显著性差异。外籍修理船舶修理期间会产生大量生活垃圾和动植物废弃物．外籍修理船舶需要排放大量压载水。[结论]外籍修理船舶比一般航行船舶存在更多的卫生问题，更容易导致疫情传播和医学媒介、外来生物的入侵，应加强卫生监督管理。     

国际航行船舶外来医学媒介生物输入风险因素的Meta分析

目的综合分析外来医学媒介生物通过国际航行船舶输入的风险因素。方法运用Meta分析方法对国内有关外来医学媒介生物输入风险因素的4项研究结果进行了定量综合分析并绘制森林图,累计分析媒介阳性船舶、对照船舶分别为1 206和14 555艘,统计处理主要采用Dersimonian和Laird的随机效应模型。结果对4项研究的Meta分析表明:船龄、到达季节、来源地属传染病疫区、曾检出媒介生物、货物种类为动植物产品或矿石煤炭等5项因素与船舶携带外来媒介生物的可能性呈正关联(综合OR均大于1),其中,曾检出媒介生物、货物种类为动植物产品与船舶携带外来媒介生物有较高的关联度(综合OR均大于4)。结论经过Meta分析筛选出的5项因素是外来医学媒介生物通过国际航行船舶输入的重要风险因素,检验检疫机关应重点针对这些因素加大对国际航行船舶的检疫监管,防止外来媒介生物及其携带的病原体传入我国。     

中美两国对国际航行船舶卫生监督的比较

通过对中美两国国际航行船舶卫生监督的比较，认为中美两国对国际航行船舶卫生监督都是以其本国的法律作为依据，但在法规上中国对国际航行船舶实施卫生监督更明确。从船舶卫生监督内容制定来看，都是以《国际卫生条例》、世界卫生组织编写的《船舶卫生指南》为基础，结合本国法律法规来制定的；从船舶卫生监督内容来看，中美两国对国际航行船舶卫生监督的主要内容是一致的，但美国监督项目更细、更明确、更具公正性；从船舶卫生监督的重点来看，美国对水的卫生、食品卫生及个人卫生非常重视，而我国对媒介控制、环境卫生、传染病控制比较重视，从评价标准来看，都是以打分来评估，但又有区别，且有效期不一样；从船舶卫生监督方法来看，都是以询问、检查证书、现场检查及抽样、采样检查等方法来检查的；从卫生监督没有达到及格船舶处理来看，一般都允许整改后，再进行检查，但对有严重卫生问题的船舶进行不同处罚。     

张家港入境船舶媒介生物状况分析

目的了解入境国际航行船舶医学媒介生物状况及其风险因素。方法对2010年张家港194艘入境船舶,按照季节、国籍和船舶种类的不同,分析船舶携带医学媒介生物状况。结果蝇类、蜚蠊为船舶携带的主要媒介生物,检出率分别为37.10%和10.31%,蝇类具有季节消长规律。中国和东南亚国籍船舶、装载废钢的船舶携带医学媒介风险较高。结论进行风险分析,加强对中国、东南亚及装载废物原料船舶的卫生监督,做好高温季节的灭蝇工作,能有效防治媒介入侵。     

一起船舶携带输入性褐带皮蠊的案例分析

目的对一艘国际航行船舶携带输入性褐带皮蠊的情况和原因进行分析,制定相应的检疫对策。方法对来自美西航线的国际航行船舶"XX"轮上携带输入性蜚蠊的检查、鉴定及处理。结果鉴定为褐带皮蠊。对策应加大对国际航行船舶蜚蠊等病媒生物的监督检查力度,有效防止输入性病媒生物通过国际航行船舶携带传入传出国境,维护口岸卫生安全。     

2000～2006年秦皇岛港入境船舶携带输入性医学媒介生物情况的监测分析

目的了解掌握入境国际航行船舶携带输入性医学媒介生物的情况。方法在秦皇岛港检疫锚地对入境国际航行船舶携带的输入性医学媒介生物包括鼠类、蚊类、蝇类、蠓类、蚋类和蜚蠊等进行采集并进行计数和分类鉴定。结果2000￣2006年共调查2000余艘次入境国际航行船舶,已鉴定确认的输入性医学媒介生物95种,其中鼠类2种,蚊类22种,蝇类51种,吸血蠓类12种,蚋类5种,蜚蠊3种,发现新种5个,中国新记录7个。结论调查证明了入境国际航行船舶携带输入性医学媒介生物的情况相当严重,应采取有效措施加以控制。     

国际航行船舶代理业务管理现状及检验检疫对策

目的建立科学高效的国际航行船舶代理业务监管模式,提高船舶代理业务工作质量、提高检验检疫监管效能、提高船舶通关速度,营造安全、和谐、便捷、高效的口岸环境。方法对国际航行船舶代理企业现状和检验检疫监管模式进行调查研究,分析存在的问题。船舶代理企业存在着管理方式落后,管理理念不佳、内部管理体系不完善、业务素质不高等问题,船舶代理业务的检验检疫监管存在着一定难度。结果一方面加强对船舶代理企业实行资格准入、诚信管理、日常考核、培训考试、持证上岗等制度约束。另一方面,引进AIS船舶自动识别系统,提高检验检疫监管效能。结论船舶代理业务直接关系到检验检疫工作质量,建议国家质量监督检验检疫总局相关管理部门尽快制定国际航行船舶代理业务相关规定与标准,完善卫生检疫监管模式。     

非洲感染性疾病监测现状

感染性疾病的流行与暴发是危害非洲人民健康和全球卫生安全的主要问题之一。感染性疾病监测体系的建立以及持续、规范、系统地开展监测工作,对于感染性疾病防控至关重要。随着我国“一带一路”战略逐步实施,中非之间交流合作不断深入,积极了解和参与非洲感染性疾病监测与防控工作,有助于保障全球卫生安全和促进中非经贸合作。本文主要从整个非洲、非洲不同区域以及部分非洲国家等3个层面介绍与分析非洲感染性疾病的监测现状,为我国开展输入性感染性疾病防控和卫生援外工作提供参考。     

Implementation and evaluation of the Victorian Suicide Register

Objective : The Victorian Suicide Register (VSR) is a state‐based suicide surveillance system that contains detailed information on people who die by suicide and the circumstances surrounding their death. In this paper, we provide an overview of the VSR and then describe the evaluation, which used the Centres for Disease Control and Prevention guidelines for surveillance system evaluation as a framework. Methods : The evaluation drew on three data sources to assess whether the VSR: i) embodies the attributes of a good public health surveillance system; and ii) can be used to inform community‐based suicide prevention efforts. Results : There was a high level of acceptability and enthusiasm for having an accessible data collection that can stimulate local action on suicide prevention planning. One of the key challenges identified was data quality, particularly around those data collected in the course of death investigations that are not designed for surveillance purposes. Conclusion : The VSR fills an important gap in the sustained and systematic collection of comprehensive information on suicide, with some key challenges identified. Implications for public health : Findings from the evaluation provide important strategic information for national and international jurisdictions seeking to establish their own suicide registers.     

Operation Safe Haven: an evaluation of health surveillance and monitoring in an acute setting

From May to June 1999, 3,920 ethnic Albanians from Kosovo arrived in Australia as part of Operation Safe Haven. These people were evacuated from refugee camps in the former Yugoslav Republic of Macedonia. Initial processing in Australia occurred at East Hills Reception Centre, and accommodation for the duration of stay was provided in eight Haven Centres in five States. The arrival of a large number of refugees in a short time frame is unprecedented in Australia. A health surveillance system was developed and critical health data were collected to assess health status and needs, plan care, monitor for potential outbreaks of communicable diseases, track service use, to meet international reporting requirements and document our response to this crisis. In this article the health surveillance system is evaluated and suggestions are offered for the formulation of specific guidelines necessary for health surveillance in acute settings.     

盐田港口岸2002～2006年国际航行船舶食品供应卫生监管模式探讨

目的分析国际航行船舶食品供应特点,为完善船舶食品供应卫生监管模式提供科学依据。方法对2002～2006年盐田港船供食品进行现场查验,对结果进行统计分析。结果船舶食品供应业务增长迅速,船舶食品供应各环节存在卫生风险。结论出入境检验检疫机构应抓好国际航行船舶食品供应各个环节的卫生监管工作,完善船舶食品供应卫生监管模式,保证食品安全卫生。     

出入境人员梅毒监测体系的建立与防控措施

目的建立完善出入境人员梅毒监测体系,为制定、实施、评价、调整国境口岸梅毒防控策略和措施提供基础性资料。方法研究建立出入境人员梅毒监测体系的基本要素,结合国境口岸传染病监测现状,提出国境口岸梅毒的防控措施。结果出入境人员梅毒监测体系包括相关法律法规、监测对象、监测点、实验室检测、疫情上报与反馈、体系运行评价标准等基本要素,实施过程中存在的问题亟待解决。结论通过出入境人员梅毒监测体系的建立,及时收集、整理、分析、反馈各项监测指标,采取相关卫生检疫措施,保障国民健康。出入境人员梅毒监测体系的建立是一项系统工程,应坚持在口岸出入境人员传染病监测工作实践中不断改进和完善。     

Health risks in the global shipping industry: An overview

The shipping industry has always been one in which workers' relative risks of ill health, injury and death have been considerable. However, the industry has been utterly transformed since the mid 1970s by the shift to flags of convenience, the sub-contracting of operations by owners to international ship management companies and crewing companies, the explosive growth of mixed nationality crews, and technological and economic changes which have reduced crewing levels and extended working hours. The shipping industry has become arguably the first truly global industry, inadequately controlled by flag-state and port-state regulatory regimes. The evidence of the impact of globalisation on seafarers' health and safety is reviewed and found to be fragmentary but indicative of potentially serious deleterious effects. Closer monitoring of seafarers' health and safety is required as is an enhanced international regulatory regime to narrow the very wide gap between best and worst industry practice.     

常熟口岸外来医学媒介生物入侵态势分析

目的掌握常熟口岸外来医学媒介生物的入侵情况,为口岸和地方卫生部门对医学媒介生物及虫媒传染病的防治工作提供参考依据。方法对常熟口岸2007-2009年的入境集装箱和国际航行船舶检疫查验截获的医学媒介生物资料进行整理、分析。结果常熟口岸外来医学媒介生物的来源主要是入境的集装箱,占98.154%;截获的医学媒介生物包括蝇类、蜚蠊、蚊类和鼠类,以蝇类为主,占97.217%(集装箱中蝇类检出占97.410%,船舶中占86.960%);截获携带医学媒介生物的集装箱来源地分布在19个国家,其中美国携带批次最多,占38.391%,其次为西班牙(占15.212%)和荷兰(占12.417%)。综合来看,入境集装箱中截获医学媒介生物数量在8月份最高。结论建议进一步加强内部培训,提高检验检疫人员的疫情意识和疫情截获技术,结合国际国内疫情流行态势,把握查验重点,提高疫情截获成效。和地方卫生部门密切配合,采取对策加强系统监测和控制,防止医学媒介生物及其传播的传染病传入,保护人民健康,为中国对外经济贸易服务。     

WHO Influenza Global Agenda

Influenza is a serious health problem worldwide. It is important to reduce morbidity and mortality from annual influenza epidemics and to prepare for the next influenza pandemic. During the influenza epidemics every year, an estimated half a million people worldwide die. In 2001, only 250 million vaccine doses were used globally, whereas the people at greatest risk of dying from influenza, those aged over 65, already number more than 380 million. The majority of people, particularly those in developing countries, has no access to the vaccine or are unaware of its benefits. The Global Agenda, which was discussed during a WHO meeting on May 6-7, 2002, contains 17 priority actions focusing on: strengthen clinical/virological surveillance nationally and internationally; increase knowledge on social/economic burden of influenza; increase vaccine usage; and accelerate national and international pandemic plans. The Global Agenda is aimed to give impartial guidance to achieve the above objectives at national/global level, supporting fund raising for influenza control. The WHO Global Influenza Programme intends to maintain the current momentum of international strategy development and will continue to provide leadership in influenza prevention and control.     

Sowing the seeds of neo-imperialism: the Rockefeller Foundation's yellow fever campaign in Mexico.

The Rockefeller Foundation's campaign against yellow fever in Mexico sought to advance the economic and political interests of U.S. capitalism. The campaign was implemented at a time of strong anti-American sentiments on the part of the Mexican people. With no diplomatic relationships between Mexico and the United States, the Rockefeller Foundation presented its campaign as an international commitment. Thus, Foundation doctors became the most salient U.S. diplomats. At the same time they made sure that the Mexican yellow fever would not spread to the United States through the southern border. The by-products of the campaign went beyond the political arena. Special techniques to combat the vectors allowed the Rockefeller Foundation's brigades to change the anti-American sentiments of the people. When the campaign ended, the Foundation had already set in place the foundation for the modern Mexican health care system. Benefits from the campaign also accrued to President Obregón, who used the campaign to strengthen his position of power. Mexican doctors adopting a pro-American attitude also allied with the Rockefeller Foundation to gain reputation and power within the emerging Mexican State.