江苏高邮湖区2009~2013年血吸虫病疫情态势分析

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目的了解高邮湖区4县(市)达到血吸虫病传播阻断后疫情现状,探讨今后防治策略和措施。方法每年3~5月份,采取系统抽样结合环境抽查法进行钉螺调查;每年6~9月份,采用网捞法和稻草帘诱螺法开展钉螺扩散监测。每年对高邮湖区的居民、渔船民、养殖户等采用胶体染料试纸条法或酶联免疫吸附试验进行血吸虫病筛查,阳性者采用Kato-katz法(1粪3检)进行检查。结果 2009~2013年累计查螺34 448.52hm2,发现有螺面积544.85hm2,其中新发现有螺面积19.51hm2;解剖钉螺16 400只,未发现感染性钉螺。累计灭螺1 499.78hm2,有螺面积下降了97.83%。累计打捞漂浮物6 231㎏,投放稻草帘1 800块,结果未发现钉螺。血清学查病79 669人次,阳性661人,阳性率为0.83%,各年度间血检阳性率差异有统计学意义(χ2=27.01,P<0.01)。粪检查病7 030人,查出病人7例,血吸虫感染率为0.10%。慢性血吸虫病人3例,急性血吸虫病人4例,均为输入性病例。治疗病人7例,扩大化疗739例。结论高邮湖区血吸虫病疫情稳定,但发现了新的螺情、输入性粪检阳性病人和急性血吸虫病患者,需实施以压缩钉螺面积、防止输入性传染源为主要目的防控措施。 Objective To understand the epidemic situation of schistosomiasis in four counties (cities) in Gaoyou Lake and to find out the strategies and measures for future prevention and treatment. Methods From March to May every year, snail surveys were conducted by systematic sampling combined with environmental sampling method. From June to September every year, snail snail method was used to carry out snail diffusion monitoring. Every year, residents of Gaoyou Lake, fishing boat people, farmers and other colloidal dye test strips or ELISA test for schistosomiasis screening, positive by Kato-katz method (1 manure 3) for examination. Results A total of 34 448.52hm2 of snails were found from 2009 to 2013. There were 544.85hm2 snail areas, of which 19.51hm2 were newly discovered and 16 400 snails were dissected. No infectious snails were found. Accumulated off snail 1 499.78hm2, there is a screw down 97.83%. A total of 6,231 tons of floating debris were flooded and 1,800 straw curtains were put on. As a result, no snails were found. There were 79 669 seropositive patients with 661 positives, the positive rate was 0.83%. There was a significant difference in the positive rates of blood tests between years (χ2 = 27.01, P <0.01). 7 030 people were examined for faecal disease, 7 were detected, and the rate of schistosomiasis was 0.10%. 3 cases of chronic schistosomiasis, 4 cases of acute schistosomiasis, are imported cases. Treatment of patients in 7 cases, 739 cases of extended chemotherapy. Conclusions The epidemic situation of schistosomiasis in Gaoyou Lake is stable. However, new snail cases, positive cases of enteric fecal tests and acute schistosomiasis cases are found. The prevention and control of imported sources should be implemented.
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