新中国霍乱防控实践的半世纪回顾(1961-2011)

自1949年新中国成立后的将近12年内(1949-1960),在旧中国猖獗近130年(1820-1948)的古典霍乱在中国大地上完全绝迹。但自1961年世界第7次霍乱大流行开始后不久,埃尔托霍乱即在广东省西部沿海数县开始流行,至当年底,共发生患者4319例,死亡429例,病死率9.94%。在地区分布上,也由广东一省扩展至包括广东在内的沿海10个省市自治区。尽管病例时多时少,但一直没有停止,至2011年已经历了半个世纪,全国除青海和西藏外的其他各地几乎都有或多或少的病例发生,全国发病总数也达到344864例,死亡5555例,病死率1.61%。令人欣慰的是,2011年的发病数已由既往每年的3位、4位、甚至5位数下降为24例,且自2007年以后的连续5年中再从未发生过死亡病例。本文通过6个段落,详细记述了新中国霍乱发生发展的实际状况,流行规律及经多年实践证明确有实效的预防和控制对策,也认真反思了工作中的主要缺点和错误,提出必须以史为鉴,更好的开拓未来。

Cholera Prevention and Control-China,1961-2011

In about 12 years’ time(1949-1960) after the founding of the People’s Republic of China,the classic cholera that had kept raging over the past 130 years across China just disappeared from the face of the earth in this part of the world.However,it was not long after the breakout of the world’s 7th cholera pandemic in 1961 that Eltor cholera started to spread out across several coastal counties in west Guangdong province,taking its toll in the form of 4 319 patients,of whom 429 died,producing a fatality rate of 9.94%.As for the regional distribution,the disease expanded from the one province of Guangdong towards 10,Guangdong included.The number of infection cases rose and fell but never ceased.During half a century up to 2011,save for the province of Qinghai and the region of Tibet,cholera cases occurred practically everywhere all over the country,whether in higher or lower numbers,totally 344 864 patients,out of whom 5 555 died,with a fatality rate of 1.61%.What’s gratifying is that in 2011,the number of cases dropped down to 24 from such high levels as 3,4 or even 5 digits in previous years and that from 2007 on,in 5 years no fatalities ever happened.This article intends to chronicle in detail,through 6 parts,how in reality cholera came to happen and develop in new China,its patterns of spreading and the strategies,proved to be effective over years’ practice,to prevent and control the disease.The article intends as well to reflect over the defects and errors committed in our relevant work,with a view to opening up a better future,based on the historical lessons.