2014-2016年全国其他感染性腹泻突发公共卫生事件流行特征分析
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摘要
目的了解我国除霍乱、痢疾、伤寒/副伤寒之外的其他感染性腹泻突发公共卫生事件的发生规律和特点,探讨其空间聚集性,为识别重点防控方向提供依据。方法采用描述性流行病学方法对2014-2016年全国其他感染性腹泻突发公共卫生事件数据进行分析,应用ArcGIS 10.5软件空间统计模块进行空间自相关分析并绘制地图。结果 2014-2016年全国共报告除霍乱、痢疾、伤寒/副伤寒之外其他感染性腹泻突发公共卫生事件332起,累计报告病例17 130例,无死亡病例。11月至次年3月是高发期。86.14%的事件由诺如病毒感染引起。事件发生原因包括生活接触传播、食品污染和饮用水污染。其他感染性腹泻事件空间上呈明显地域化分布,报告省份均集中在我国东部,并呈空间聚集性特点,热点地区集中在广东省、广西壮族自治区(广西)和福建省。结论我国目前除霍乱、痢疾、伤寒/副伤寒之外其他感染性腹泻突发公共卫生事件主要以诺如病毒感染事件为主,做好重点人群的健康教育和学校等重点场所的监督管理,加强饮水卫生、食品安全监测和管理工作,是有效控制事件发生的主要措施。建议相关部门将高发病的广东省、广西和福建省等热点区域作为重点防治地区,进一步探索导致区域聚集性的原因和机制,采取有效防控措施,减少其他感染性腹泻事件的发生。
Objective To understand the epidemiological characteristics of the public health emergencies caused by infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid(hereinafter referred to as other infectious diarrheal diseases) in China. Methods Descriptive epidemiologic analysis was conducted by using the incidence data of other infectious diarrheal diseases in China from 2014 to 2016, which were collected from National Public Health Emergency Report Management Information System. The spatial auto-correlation analysis(Moran's I and Getis G) were conducted for spatial statistical analyses on the incidences of other infectious diarrhea. Results A total of 332 other infectious diarrhea epidemics were reported in China from 2014 to 2016, involving 17 130 cases and without death. The annual incidence of other infectious diarrheal epidemic was high during November-March. Norovirus infection epidemic accounted for 86.14%. The causes of these incidents included exposure in daily life and food or drinking water contamination. All the provinces reporting the epidemics were in eastern China. Spatial autocorrelation analysis showed that the spatial clustering of other infectious diarrhea epidemics in China was obvious, and the "hot spots" were mainly in Guangdong, Guangxi and Fujian provinces. Conclusion Norovirus infection was the main cause of other infectious diarrhea epidemics in China. It is necessary to strengthen the health education in key population and surveillance in key places, such as schools, and improve food and drinking water safety supervision and management for the effective prevention and control of other infectious diarrheal diseases. In addition, it is suggested to strengthen the prevention and control in provinces where the "hot spots" clustered, such as Guangdong, Guangxi and Fujian,further explore the causes and mechanisms of obvious disease clustering and take effective prevention and control measures to reduce the incidence of other infectious diarrheal diseases.
Objective To understand the epidemiological characteristics of the public health emergencies caused by infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid(hereinafter referred to as other infectious diarrheal diseases) in China. Methods Descriptive epidemiologic analysis was conducted by using the incidence data of other infectious diarrheal diseases in China from 2014 to 2016, which were collected from National Public Health Emergency Report Management Information System. The spatial auto-correlation analysis(Moran's I and Getis G) were conducted for spatial statistical analyses on the incidences of other infectious diarrhea. Results A total of 332 other infectious diarrhea epidemics were reported in China from 2014 to 2016, involving 17 130 cases and without death. The annual incidence of other infectious diarrheal epidemic was high during November-March. Norovirus infection epidemic accounted for 86.14%. The causes of these incidents included exposure in daily life and food or drinking water contamination. All the provinces reporting the epidemics were in eastern China. Spatial autocorrelation analysis showed that the spatial clustering of other infectious diarrhea epidemics in China was obvious, and the "hot spots" were mainly in Guangdong, Guangxi and Fujian provinces. Conclusion Norovirus infection was the main cause of other infectious diarrhea epidemics in China. It is necessary to strengthen the health education in key population and surveillance in key places, such as schools, and improve food and drinking water safety supervision and management for the effective prevention and control of other infectious diarrheal diseases. In addition, it is suggested to strengthen the prevention and control in provinces where the "hot spots" clustered, such as Guangdong, Guangxi and Fujian,further explore the causes and mechanisms of obvious disease clustering and take effective prevention and control measures to reduce the incidence of other infectious diarrheal diseases.
引文
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[3]陈晨,高永军,丁凡,等.2005-2012年我国其他感染性腹泻事件监测分析[J].实用预防医学,2014,21(6):695-697.DOI:10.3969/j.issn.1006-3110.2014.06.019.Chen C,Gao YJ,Ding F,et al.Monitoring and analysis of other infectious diarrhea events in China from 2005 to 2012[J].Pract Prev Med,2014,21(6):695-697.DOI:10.3969/j.issn.1006-3110.2014.06.019.
[4]卫生应急办公室.国家突发公共卫生事件应急预案[EB/OL].(2006-02-28)[2018-01-10].http://www.gov.cn/gzdt/2006-02/28/content_213129.htm.National Health and Family Planning Commission.National emergency plan for public health emergencies[EB/OL].(2006-02-28)[2018-01-10].h ttp://www.gov.cn/gzdt/2006-02/28/content_213129.htm.
[5]中华人民共和国卫生部.国家突发公共卫生事件相关信息报告管理工作规范(试行)[S].北京:卫生部办公厅,2005.Ministry of Health of the People's Republic of China.National operation standard for public health emergencies information reported and management(pilot)[S].Beijing:The General Office of the Ministry of Health of China,2005.
[6]姜庆五,赵飞.空间自相关分析方法在流行病学中的应用[J].中华流行病学杂志,2011,32(6):539-546.DOI:10.3760/cma.j.issn.0254-6450.2011.06.002.Jiang QW,Zhao F.Application of spatial autocorrelation method in epidemiology[J].Chin J Epidemiol,2011,32(6):539-546.DOI:10.3760/cma.j.issn.0254-6450.2011.06.002.
[7]徐肖楠,马海燕.浙江省2005-2011年痢疾流行状况及空间自相关分析[J].健康研究,2016,36(4):361-364.DOI:10.3969/j.issn.1674-6449.2016.04.001.Xu XN,Ma HY.Dysentery in Zhejiang province during the period from year 2005 to year 2011:the epidemic extent and a spatial autocorrelation analysis of the disease[J].Health Res,2016,36(4):361-364.DOI:10.3969/j.issn.1674-6449.2016.04.001.
[8]余建兴,赖圣杰,王鑫,等.中国27省(市、自治区)2009-2013年门诊腹泻病例诺如病毒流行特征分析[J].中华流行病学杂志,2015,36(3):199-204.DOI:10.3760/cma.j.issn.0254-6450.2015.03.003.Yu JX,Lai SJ,Wang X,et al.Analysis of epidemiology characteristics of norovirus among diarrheal outpatients in 27provinces in China,2009-2013[J].Chin J Epidemiol,2015,36(3):199-204.DOI:10.3760/cma.j.issn.0254-6450.2015.03.003.
[9]廖巧红,冉陆,靳淼,等.诺如病毒感染暴发调查和预防控制技术指南(2015版)[J].中华预防医学杂志,2016,50(1):7-16.DOI:10.3760/cma.j.issn.0253-9624.2016.01.003.Liao QH,Ran L,Jin M,et al.Guidelines on outbreak investigation,prevention and control of norovirus infection(2015)[J].Chin JPrev Med,2016,50(1):7-16.DOI:10.3760/cma.j.issn.0253-9624.2016.01.003.
[10]张静,常昭瑞,孙军玲,等.我国诺如病毒感染性腹泻流行现状及防制措施建议[J].疾病监测,2014,29(7):516-521.DOI:10.3784/j.issn.1003-9961.2014.07.004.Zhang J,Chang ZR,Sun JL,et al.Infectious diarrhea epidemics caused by norovirus and its control strategy in China[J].Dis Surveill,2014,29(7):516-521.DOI:10.3784/j.issn.1003-9961.2014.07.004.
[11]中华人民共和国卫生部.卫生部关于加强饮用水卫生监督监测工作的指导意见[J].中国卫生监督杂志,2012,19(2):106-108.Ministry of Health of the People's Republic of China.Guidance of the ministry of health on strengthening the supervision and monitoring of drinking water sanitation[J].Chin J Health Inspect,2012,19(2):106-108.