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目的了解云南省炭疽疫源地的流行状况,评估疫情发生的风险,为制定有效的预防控制措施提供科学依据。方法选择3个不同类型的疫区县,对疫区县内2001～2012年所有病例和高危人群开展调查,内容包括基本情况调查、病例回顾性调查、病例和高危人群感染状况调查、可疑污染环境调查等。结果共调查71例病例,含2例死亡病例。病例主要发生在6～9月,病例分布随年份呈现出逐年下降趋势。男性多于女性,平均年龄(38±3)岁,以中青年农民为主。疫点主要分布在生产生活和经济条件较差的偏远农村地区,疫区群众的炭疽健康知识知晓率仅为33.68%,剥食不明原因死亡动物的危险行为普遍存在。检测病例血清12份,抗体阳性率16.67%;高危人群血清53份,抗体阳性率1.89%。34份土样中未分离培养出炭疽芽孢杆菌。结论 3个疫区县代表了云南省不同的炭疽流行区域,疫源地较为活跃。全省炭疽疫情总体上稳中有降,但局部地区疫情依然较重,疫情点状暴发的风险较高。做好疫情监测和风险评估,提高实验室检测能力和加强健康教育等预防控制措施是今后防控工作的重点。
Objective To understand the prevalence of anthrax epidemic in Yunnan Province, assess the risk of outbreak and provide a scientific basis for effective prevention and control measures. Methods Three different types of endemic areas were selected to investigate all the cases and high-risk groups from 2001 to 2012 in the affected counties and counties, including the investigation of the basic conditions, the case retrospective investigation, the investigation of the cases and the infection among the high-risk groups, the suspicious contamination of the environment Investigation and so on. Results A total of 71 cases were investigated, including 2 deaths. The cases mainly occurred from June to September, and the distribution of cases showed a year-by-year downward trend year by year. More men than women, the average age (38 ± 3) years old, mainly young and middle-aged farmers. The epidemic spots were mainly distributed in remote rural areas where the production and living conditions were poor and the economic conditions were poor. The awareness rate of anthrax health knowledge among the epidemic areas was only 33.68%. Pest risk behaviors of unexplained dead animals were widespread. Detection of serum samples in 12 cases, antibody positive rate of 16.67%; high-risk serum 53, antibody positive rate of 1.89%. 34 soil samples were not isolated culture of Bacillus anthracis. Conclusion The three endemic areas and counties represent different epidemic areas of anthrax in Yunnan Province, and the epidemic areas are relatively active. The overall anthrax epidemic in the province has been steadily declining, but the epidemic in some areas is still heavy and the risk of spot-like outbreaks is high. Doing prevention and control of epidemic situation and risk assessment, improving laboratory testing ability and strengthening health education are the focuses of prevention and control in the future.