2019 年武汉市血吸虫病疫情监测与风险评估

目的 分析武汉市 2019 年血吸虫病疫情监测和风险评估资料,掌握疫情动态,为制定消除策略提供依据。方法 收集武汉市 2019 年血吸虫病常规监测、监测点监测、风险监测等疫情资料,对人群、家畜、钉螺、野粪以及环境的监测结果进行分析,对疫情传播风险进行评估。 结果 武汉市 2019 年血吸虫病疫情网络直报全年零报告。全市 28 个监测点共开展本地人群血清学检测 15 102 人,阳性 97 人,阳性率为 0. 64%;其中男性阳性率 0. 87%,高于女性 0. 41%( χ2 = 65. 67,P<0. 001);随着年龄增长,血检阳性率呈上升趋势( χ2 趋势 = 75. 58,P<0. 001);阳性率较高的职业依次为渔船民、农民、工人、离退人员。 粪检 479 人,未检出阳性。 监测点开展流动人口血检 2 655 人,未发现阳性。 牛存栏 197 头,粪检均未发现阳性。 钉螺调查面积 1 875. 33 hm2,查出有螺面积 731. 21 hm²,活螺平均 密度为 0. 018 只 / 0. 1 m²。 野粪采样 11 份,均未发现阳性。 90 个风险监测点投放哨鼠 240 只,采集野粪 14 份,均未发现阳性;区级血防机构共查螺 187 987 框,活螺平均密度 0. 006 5 只 / 0. 1 m2;市级复核查螺 13 877 框,活螺平均密度 0. 003 8 只 / 0. 1 m²,均未发现阳性;风险评估为Ⅲ级(低)风险。 结论 武汉市血吸虫病传播阻断后疫情持续下降,疫情处于历史最低水平。 但钉螺孳生环境依然复杂、高危人群血防意识薄弱、垸内钉螺压缩困难、有螺地带野粪污染等潜在风险不容忽视,应持续强化监测预警,及时消除潜在风险。

Surveillance and evaluation of schistosomiasis in Wuhan City in 2019

Objective To analyze the surveillance and risk assessment data of schistosomiasis in Wuhan City in 2019 for understanding the dynamic epidemic status data basis to develop elimination strategies. Methods The data,including regular monitoring,site surveillance and risk monitoring,were collected in Wuhan area in 2019,analyzed the momtoring results of population,livestock,snail,wild feces and environment,and evaluated the risk of epidemic transmission. Results No single case of schistosomiasis was reported by the direct reporting system in Wuhan in 2019. A total of 15 102 local residents from the 28 surveillance sites underwent serological test,which revealed positive in 97 people (0. 64%). The positive rate was higher in men than in women (0. 87% vs. 0. 41%, χ2 = 65. 67,P<0. 001),and tended to increase with advanced age group ( χ2 trend = 75. 58,P<0. 001). The occupation associated with relatively higher positive rate successively represented by boat fishermen,farmer,workers and retirees. Stool examination in 479 people showed no positive infection. No positive case was found in the 2 655 floating people in the surveillance sites undergone indirect hemagglutination (IHA) test. Stool test of the 197 heads of cattle in stock showed no positive infection. Snail survey was conducted in area of 1 875. 33 hm²,where 731. 21 hm2 were identified with snail prevalence. The density of living snail was 0. 018 / 0. 1 m². There was no positive results in the 11 aliquots of wild feces collected. 240 sentinel mice were placed in the risk monitoring sites,and were totally negative by examination. No infection was found in another 14 aliquots of wild feces. A total of 187 987 frames of snail were inspected by district level institution,with an average density of the snail were 0. 006 5 / 0. 1m2. A total of 13 877 frames of snail were inspected by municipal level institution,with an average density of the snail were 0. 003 8 / 0. 1 m²,and no positive snails were detected. Risk assessment was concluded as class Ⅲ (low risk). Conclusion The epidemic of schistosomiasis continues to decline in Wuhan area after transmission interruption,and reaches the lowest level in history. However, potential risks such as the complex snail breeding environment,weak awareness of schistosomiasis prevention among high  risk population,difficulty to reduce the snail areas within the embankment and fecal pollution in snail areas,should not be ignored. These findings suggest endless monitoring and early warning should be strengthened in order to timely eliminate potential risks at early stage.