武汉市汉南区血吸虫病传播阻断后检出感染性钉螺的应急处置  

Emergency response of infectious snails detected after interruption of schistosomiasis transmission in Hannan District,Wuhan

作　　者：左玉婷 徐明星[1] 罗华堂[1] 宋秀兰 陈秋琴 王浩[1] 周水茂[1] ZUO Yu-ting;XU Ming-xing;LUO Hua-tang;SONG Xiu-lan;CHEN Qiu-qin;WANG Hao;ZHOU Shui-mao(Wuhan Center for Disease Prevention and Control,Wuhan,Hubei 430015,China;The Office of China Epidemiology Training Program,Chinese Center for Disease Control and Prevention,Beijing,102206,China;Hannan Center for Disease Prevention and Control,Wuhan,Hubei 430015,China)

机构地区：[1]湖北省武汉市疾病预防控制中心,湖北武汉430015 [2]中国疾病预防控制中心中国现场流行病学培训项目办公室,北京102206 [3]湖北省武汉市汉南区疾病预防控制中心,湖北武汉430015

出　　处：《中国热带医学》2023年第2期131-135,共5页China Tropical Medicine

基　　金：湖北省卫健委联合项目(No.WJ2019H399);武汉市卫健委青年项目(No.WG19Q02)。

摘　　要：目的分析武汉市汉南区通过环介导恒温扩增技术(loop-mediated isothermal amplification,LAMP)检出感染性钉螺疫情后的应急处置及远期干预效果,探讨LAMP技术在血吸虫病传播阻断区早期监测预警中的应用。方法对汉南区风险监测捡获钉螺进行解剖镜检和LAMP技术双检,鉴定钉螺血吸虫感染情况,对出现阳性钉螺的环境启动应急响应及强化干预,评估远期效果。结果2018年5月武汉市汉南区LAMP技术检出1管感染性钉螺,定位阳性螺点东庄村朱家汊,对其进行机械除障、杂物深坑填埋等工程灭螺,药物灭螺1.27万m^(2),钉螺死亡率80%以上;阳性螺点500 m内应急性查病未发现新发血检阳性人员,年底再对东庄村查病506人,间接红细胞凝集试验血吸虫感染筛查显示阳性人员30例,血阳率5.93%,未发现粪检阳性人员,血检阳性人员全部预防性服药;哨鼠、野粪监测结果均为阴性;开展健康教育,部署、刷新警示牌7份,发放宣传折页500份。针对阳性环境所在村进行了近3年强化干预与监测,阳性螺点钉螺密度由0.094只/框降至0.027只/框,东庄村人群血检阳性率由5.93%稳步降至3.74%。结论武汉市汉南区通过LAMP技术快速侦测到了镜检漏检的感染性钉螺,为阳性螺点的快速应急处置和消除创造了条件,提高了传播阻断区监测预警系统的敏感性。Objective To analyze the emergency response and long-term intervention effects after the detection of infectious snails epidemic by loop-mediated isothermal amplification(LAMP)assays in Hannan District,Wuhan City,and to explore the application of LAMP in early surveillance and early-warning of schistosomiasis transmission.Methods Snails picked up by the risk monitoring system in Hannan District were examined by anatomical microscopy and LAMP technology to identify the schistosomiasis infection.Emergency response and intensive intervention were initiated in the environment where positive snails appeared,and the long-term effects were evaluated.ResultsIn May 2018,the infectious snails were detected by LAMP technology in Hannan District,and the positive snails were located in Zhujiacha,Dongzhuang Village,Obstacles and weeds were removed and buried by machine in Zhujiacha.12700 m^(2)of snails were killed by drugs,and the mortality rate of snails was more than 80%;no new seropositive persons were found in the emergency examination within 500 m of the positive snail sites.506 people were examined in Dong Zhuang Village at the end of the year,and 30 positive IHA cases were detected with a blood positive rate of 5.93%,no positive fecal test was found,and all positive blood test patients took preventive medication.The monitoring results of sentinel rats and wild feces were all negative.Health education was carried out,7 warning signs were deployed and refreshed,and 500 publicity brochures were distributed.After nearly three years of intensified intervention and monitoring in the villages where the positive environment is located,and the density of snails on the stubborn snail has dropped from 0.094/frame to 0.027/frame,and the positive rate of blood test in Dongzhuang Village has steadily dropped from 5.93%to 3.74%.Conclusions The infected snails missed by microscopy were detected by LAMP in Hannan District,which created conditions for the rapid emergency treatment of environment and elimination of positive snail and impr

关 键 词：血吸虫 环介导恒温扩增技术 监测预警 

分 类 号：R532.21[医药卫生—内科学]