青海省三江源地区人间鼠疫流行病学分析

目的 分析青海省三江源地区人间鼠疫流行病学特征,为制订防治对策提供参考依据.方法 以青海省人间鼠疫病例数据库为基础资料,整理、归纳、核实三江源地区1960-2006年人间鼠疫发生资料和部分个案调查资料及监测资料,进行流行病学回顾性分析.结果 1960-2006年,青海省三江源地区除12个年份没有发生人间鼠疫外,其他年份均有人间鼠疫病例发生,发病地区主要分布在玉树、果洛、黄南、海南4州12个县和格尔木市唐古拉山乡,共发生人间鼠疫85起,发病238例,死亡134例,病死率56.30%.人间鼠疫传染源中喜马拉雅旱獭占27.31%(65/238),偶蹄类占14.71%(35/238),食肉类占2.10%(5/238),兔形目占0.42%(1/238),肺鼠疫病人占49.16%(117/238),疫蚤叮咬占6.30%(15/238).流行季节为5-11月,8、9月为高峰期,10月份以后藏系绵羊作为人类鼠疫传染源引发的鼠疫病例占23.53%.临床病型中以肺型居多占61.34%,腺型占17.23%,败血型占16.81%,其他型占4.62%,但首发病例仍以腺鼠疫居多.结论 近年来,在三江源地区人间鼠疫的发生呈上升趋势,应适时调整鼠疫防治措施.

Epidemiologic analysis on human plague of Sanjiangyun Area in Qinghai Province, China

Objective To study on epidemiologic characteristics of human plague cases in Sanjiangyuan Area,and provide theoretical basis to work out the preventive measures.Methods Based upon the epidemiology information from the human plague case data bank of Qinghai Province,human plague data were analyzed retrospectively in Sanjiangyun Area by sorting,verifying and summing up of these data,including some of case file and monitoring data.Results Except for 12 years in the period of 1960 to 2006,there were human plague cases happened every year.The morbidity occurred mainly in 12 counties of 4 states,including Yushu,Guolou,Huangnan and Hainan,and Tanggula Town of Geermu City,a total of 85 human plague episodes were occurred,resulting 238 onsets,134 deaths,and a matality rate of 56.30%.The sources of infection were respectively Himalayan mormot 27.31%(65/238),artiodactyls 14.71%(32/238),carnivora 2.10%(5/238),Lagomorpha 0.42%(1/238),the pneumonic plague patient 49.16%(117/238),and biting of flea 6.30%(15/238).The prevalent season was from May all the way to November,the peak-months were August and September.After October,the sheep as the source of infection initiating human being plague accounted for 23.53%.Among the clinical types,the most prevalent type was pneumonic type(61.34%),and the rest,glandular type(17.23%),septic type(16.81%)and other types(4.62%),but the first plague case in each epidemic was mainly the glandular plague.Conclusions In recent years,the tendency of human plague prevalence increases in Sanjiangyuan Area,it is urgent to improve and adjust the prevention and treatment measures in time.