四川芦山地震灾区血吸虫病传播风险初步分析与评估

目的 评估 “4 ⋅ 20” 四川芦山地震灾区灾后血吸虫病传播风险， 为科学制定灾后血吸虫病防控措施提供依据。方法 通过回顾性调查雅安市血吸虫病历史疫情资料和芦山县血吸虫病监测点疫情数据， 并选择芦山县芦阳镇火炬村和天全县新华乡落改村为现场， 进行血吸虫病传播风险快速评估， 综合分析、 评估灾后血吸虫病传播风险。结果 芦山县和天全县历史血吸虫病疫情较重。火炬村和落改村2个评估点的活螺平均密度分别为0.02只/0.1 m2 和和0.03只/0.1 m2 ， 未发现感染性钉螺。落改村评估点发现犬粪密度为0.009份/100 m2 。地震灾后灾区沟渠等环境受损严重， 易造成钉螺扩散。居民安置点厕所等卫生设施遭到严重破坏， 容易出现粪便污染环境； 外来救援人员的进入和人群流动性增加， 容易导致外来传染源输入。结论 地震灾后芦山县和天全县已具备血吸虫病传播的高风险条件， 极易出现血吸虫病暴发流行。应合理设置灾民安置点， 加强粪便管理， 开展高危环境灭螺， 加强健康教育宣传， 强化监测， 防止出现灾后血吸虫病暴发流行。

Risk assessment of schistosomiasis transmission in earthquake-stricken areas after the Lushan Earthquake in Sichuan Province on April 20, 2013

Objective To assess the impact of the“4 ⋅ 20”Lushan Earthquake on the risk of schistosomiasis transmission in Lushan and Tianquan counties，so as to provide the evidence for formulating appropriate measures for schistosomiasis prevention and control. Methods Based on a comprehensive literature review，an analysis of schistosomiasis monitoring data in the earth? quake affected counties，and a field investigation，a rapid assessment on the impact of the earthquake on schistosomiasis was con? ducted. Results Lushan and Tianquan counties were two endemic areas of schistosomiasis with high transmission level in histo? ry，especially Lushan County where Oncomelania snail distribution/density was the highest in Sichuan Province. After the earth? quake，the streams and damaged ditches were blocked up，potentially leading to the spread of Oncomelania snails，and the dam? aged sanitary facilities may also lead to the release of excrement，contaminating the environment where snails resided. Meanwhile， the people who were relocated due to the earthquake may have higher exposures to contaminated environment. In addition，increas? ing population mobility（e.g. relief workers）also had the potential to bring infection sources in the earthquake affected areas. Fur? ther，animals，which may serve as reservoirs for the parasite such as homeless dogs，may also add the complexity of local schisto? somiasis transmission. Conclusions The epidemic risk of schistosomiasis in Lushan and Tianquan counties is high. To prevent the outbreak and epidemic of schistosomiasis，the victim settlements should be established appropriately and the excrement should be managed carefully. Meanwhile，the snail control should be carried out in the high? risk environments. The health education， monitoring， patient treatments and expanded chemotherapy should be carried out and strengthened.