芦山地震灾区疫苗可预防传染病的初步风险评估  

Preliminary Assessment on Risk of Vaccine Preventable Diseases in Earthquake Area in Lushan,Sichuan Province

作　　者：解瑞峰[1,2] 张栋梁[3,4] 王鸿[5] 殷大鹏[1] 郑景山[1] 刘青恋[6] 郝利新[1] 余文周[1] 温宁[1] 张国民[1] 李艺星[1] 刘大卫[1] 夏伟[1] 刘燕敏[1] 刘宇[6] 漆琪[6] 朱锦蓉 杨慎宗 张琴[5] 王华庆[1] 崔富强[1] 罗会明[1] 方刚[6] 李黎[1] 

机构地区：[1]中国疾病预防控制中心免疫规划中心,北京100050 [2]邹城市疾病预防控制中心,山东邹城273500 [3]宁波市疾病预防控制中心,浙江宁波315010 [4]中国疾病预防控制中心现场流行病学培训项目,北京100050 [5]芦山县疾病预防控制中心,四川芦山625600 [6]四川省疾病预防控制中心,成都610041

出　　处：《中国疫苗和免疫》2014年第2期160-164,共5页Chinese Journal of Vaccines and Immunization

摘　　要：目的评估四川省芦山地震灾区疫苗可预防传染病的发生、传播风险，为灾后预防控制（防控）传染病提供有针对性的建议。方法采集2008—2013年4月20日灾区的传染病报告数据，进行回顾性疫情分析；收集疫苗接种率数据和免疫规划服务体系受损情况，分析地震灾害对灾区疫苗可预防传染病发生、传播可能产生的影响；对甲型肝炎（甲肝）等12种疫苗可预防传染病的发生和传播进行风险评估，并提出防控建议。结果芦山地震灾区2012年国家免疫规划疫苗实际接种率可能被高估。震后免疫规划服务体系遭受严重破坏，对疫苗可预防传染病发生、传播造成影响的因素主要有：安置点卫生条件差、疫源动物和媒介昆虫活动变化、人群流动性加大以及免疫规划服务可及性下降等。综合评估甲肝、流行性腮腺炎（流腮）在灾区传播的风险较高，其次麻疹、风疹和水痘易发生局部爆发疫情。结论震后灾区疫苗可预防传染病的防控，应开展甲肝疫苗和麻疹一流腮-风疹联合疫苗的群体性预防接种，做好水痘和流行性乙型脑炎等疫苗储备，加强疫苗可预防传染病的监测和报告，并尽快恢复常规免疫服务。Objective To assess the risk factors to the incidence and spread of vaccine preventable diseases after the earthquake in Lushan country, Sichuan province and provide guidance for taking more effective prevention and control measures of vaccine preventable diseases in earthquake areas. Method The data of communicable diseases reported from January 1, 2008 to April 20, 2013 in earthquake area were analyzed. Based on the data of immunization coverage, the degree of the immunization program service system damage by the earthquake and the consuhion of experts, the risk factors which might increase vaccine preventable diseases iransmission and the list of main epidemic-prone diseases were described. Result The true immunization coverage level may be overestimated in 2012. The immunization program service system was destroyed seriously. The factors which might increase vaccine preventable diseases transmission included temporary resettlement with poor sanitary condition, increased exposure to host animals and vectors, increased population movement, increased susceptibility to disease, and limited access to health services, especially the limitation of immunization program service. Hepatitis A and mumps was with high transmission potential. The transmission potential of measles, rubella and varicella easy outbreak after earthquake. Conclusion The post disaster measures to prevent and control vaccine preventable diseases in Lushan should focus on carrying out mass vaaaination with hepatitis A vaccine and MMR vaccine, increasing the storge of vaccines of varicella and Japanese encephalitis, strengthening the surveillance and report of vaccine preventable diseases, recoverying the routine immunization program service as soon as possible.

关 键 词：地震灾区 疫苗可预防传染病 风险评估 

分 类 号：R186[医药卫生—流行病学]