青海省三江源地区1958-2021年人间鼠疫流行特征分析  

Epidemiological characteristics of human plague in the Sanjiangyuan region,Qinghai province,China,1958-2021

作　　者：蒋可 熊浩明 田富彰[2] 何多龙[2] 张爱萍[2] 杨建国[2] 李翔[2] 郭文涛[2] 李伟[3] JIANG Ke;XIONG Hao-ming;TIAN Fu-zhang;HE Duo-long;ZHANG Ai-ping;YANG Jian-guo;LI Xiang;GUO Wen-tao;LI Wei(Department of Public Health,Medical School,Qinghai University,Xining,Qinghai 810001,China;Qinghai Institute for Endemic Disease Prevention and Control,Xining,Qinghai 810021,China;National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]青海大学医学部公共卫生系,青海西宁810001 [2]青海省地方病预防控制所鼠疫预防控制科,青海西宁810021 [3]中国疾病预防控制中心传染病预防控制所,北京102206

出　　处：《中国媒介生物学及控制杂志》2022年第6期838-842,共5页Chinese Journal of Vector Biology and Control

基　　金：国家卫生健康委鼠疫防治研究重点实验室(共建)(2019PT310004);青海省科技厅基础研究计划项目(2019-ZJ-7074);青海省鼠疫防控及研究重点实验室(2021-ZJ-Y15)。

摘　　要：目的 针对鼠疫防控中出现的新特点,分析青海省三江源地区1958-2021年人间鼠疫流行状况和特征,为制定切合实际的鼠疫防制对策提供科学依据。方法 收集青海省地方病预防控制所人间鼠疫病例数据库中三江源地区的病例资料,应用Excel 2010、SPSS 26.0与ArcMap 10.2软件及描述流行病学方法对三江源地区人间鼠疫疫情的年际变化与流行趋势、季节分布、地区分布、人群分布、传染源及传播途径和病例分型进行统计分析。结果 青海省三江源地区在1958-2021年共发生人间鼠疫90起,报告病例253例,死亡138例,病死率为54.55%(138/253)。所有病例中男性164例,女性89例;除去年龄不详的4例病例,在其余249例病例中,16~30岁的青壮年占比最多,为39.76%(99/249);民族以藏族居多,为205例;职业分布以牧民为主,占总病例数的80.20%。人间鼠疫在5-11月发生,其中8月为高发期;64年间三江源地区以玉树藏族自治州人间鼠疫最为严重,所辖曲麻莱县、玉树市和囊谦县分别发生人间鼠疫15起48例、15起41例、12起37例;首发病例主要由剥食等途径接触旱獭感染而引起,其次为蚤叮咬;首发病例的鼠疫病型仍以腺鼠疫为主(71例);所有病例中以肺鼠疫患者最多,为161例(原发性128例,继发性33例)。结论 青海省三江源地区的人间鼠疫疫情依然严峻,需要采取各项防控措施,从而有效控制人间鼠疫的发生和流行。Objective To analyze the situation and characteristics of human plague epidemics in the Sanjiangyuan region, Qinghai province, China from 1958 to 2021, and to provide a scientific basis for formulating practical preventive measures against plague. Methods The data on human plague cases in the Sanjiangyuan region were collected from the human plague database of Qinghai Institute for Endemic Disease Control and Prevention. With Excel 2010, SPSS26.0, and ArcMap 10.2 softwares, descriptive epidemiological methods were used to analyze the annual change, epidemic trend, seasonal distribution, regional distribution, population distribution, source of infection, route of transmission, and type of human plague in the Sanjiangyuan region. Results From 1958 to 2021, there were a total of 90 human plague epidemics in the Sanjiangyuan region, involving 253 cases and 138 deaths, with a mortality rate of 54.55%(138/253).There were 164 males and 89 females in all cases. Excluding four cases of unknown age, among the remaining 249 cases,young adults aged 16-30 years accounted for the highest proportion, which was 39.76%(99/249). The majority of the cases were Tibetan(205 cases). In occupational distribution, pastoralists accounted for 80.20% of the total cases. Human plague occurred during May to November, peaking in August. In the past 64 years of the Sanjiangyuan region, the situation of human plague was most serious in Yushu Tibetan Autonomous Prefecture, where Qumalai county had 15outbreaks(48 cases), Yushu city had 15 outbreaks(41 cases), and Nangqian county had 12 outbreaks(37 cases). First cases were mainly caused by exposure to marmot infection through butchering and eating, followed by flea bites. Most first cases were bubonic plague(71 cases). Among all cases, pneumonic plague was the most common type, involving161 cases(128 primary and 33 secondary cases). Conclusion The human plague situation in the Sanjiangyuan region remains unfavorable, which requires multiple preventive measures to effectively control human plague

关 键 词：人间鼠疫 流行特征 三江源 气候变化 

分 类 号：R516.8[医药卫生—内科学]