目的在易感季节针对已达到血吸虫病传播控制的长江下游镇江市丹徒段沿江重点水域,实施血吸虫感染性监测预警和应急处置技术应用及集成示范,为构建敏感有效的疫情监测预警和处置体系提供参考依据。方法基于流行病学基础数据库和传播危险因素识别,在长江镇江丹徒段68.9km长的滩涂上筛选确定7个高风险区域为监测预警点。于2009-2016年每年的3-5月调查环境螺情与人畜病情;5-9份采用哨鼠法测定水体感染性,并采用现场观察法调查人畜接触江水状况;2009-2011年采用哨螺法测定血吸虫毛蚴对水体的污染性。一旦查见感染性钉螺,或出现急性感染病人,或查见粪检阳性病人,或出现感染性哨鼠,或发现感染性哨螺等疫情,即刻发布预警警示并启动处置程序,针对疫情采取相应应急处置措施。结果 2009-2016年7个监测预警点所在区域均未查见感染性钉螺;在7个监测预警点检查哨鼠3643只,查出阳性哨鼠30只,哨鼠阳性率为0.82%,共发现3个预警点6次哨鼠法测定水体具有感染性。2009-2011年共投放哨螺9 000只,钉螺逸蚴共32 490只次,解剖钉螺5 191只,均未检出毛蚴。针对出现感染性哨鼠的3个监测预警点发布水体感染性预警警示6次;对监测预警阳性点区域重点人群查病2262人,查出DDIA阳性128人,阳性率5.66%;粪检阳性10人,感染率为0.44%;监测男性和女性血清学阳性率分别为6.80%和3.71%,感染率分别为0.56%和0.24%,性别血清学阳性率(χ2=9.42,P<0.01)及感染率(χ2=6.21,P<0.01)差异均有统计学意义。未查出急性血吸虫病病人。检查放养羊228只次,查出阳性12只次,感染率为5.26%。对查出的128例DDIA阳性、10例粪检阳性者及12只次阳性羊均采用吡喹酮进行同步化疗;开展药物灭螺50hm2,应急灭蚴19hm2;并及时采取了健康教育及个人防护、安全用水及粪便管理等集成处置措施,有效控制了疫情发生。结论江滩型血吸虫病传播控制地区实施重点水域感染性监测预警并及时采取有效应急处置措施对扼制疫情的发生发展效果显著。哨鼠法是测定水体感染性客观、敏感和有效方法之一。 Objective To monitor and early warning and treatment of schistosomiasis in the sensitive areas of Zhenjiang Dantu section of the lower reaches of the Yangtze River in the susceptible season for the purpose of controlling the spread of schistosomiasis. In order to build a sensitive and effective epidemic prevention and early warning system and disposal system Provide a reference basis. Methods Based on the database of epidemiology and the identification of risk factors for transmission, 7 high risk areas were screened and identified as early warning points on 68.9km long beach in Dantu section of the Yangtze River in Zhenjiang. Surveys of environmental snail and human and animal disease from March to May in 2009-2016; 5-9 samples of water infectivity by using the sentinel mouse method; investigation of the contact of people and livestock with the on-the-spot observation method; 2009-2011 Determination of Schistosoma japonicum miracidia on water pollution. Once an infectious snail is found or an acute infection occurs or if a stool positive patient or an infected stinger is found or an outbreak of infectious whistleblower is detected, an early warning alert is issued and a treatment procedure is initiated to respond to the outbreak Emergency measures. Results Infected snails were not found in the 7 monitoring and early warning spots in 2009-2016. Of the 36 mosquitoes detected in 7 monitoring and early warning points, 30 were positive and 0.82% were positive, and the total positive rate was 0.82% 3 prewarning point 6 times sentinel method to determine water infectivity. A total of 9,000 sentinel snails were sent in 2009-2011, 32 490 snail-lacunar larvae and 5 191 snail snails were dissected. No miracidia was detected. A total of 2262 people were investigated in key populations in the positive point of surveillance and early warning system, and 128 were positive for DDIA, the positive rate was 5.66%. The positive stool test was 10 The infection rate was 0.44%. The seroprevalence of males and females were 6.80% and 3.71% respectively. The infection rates were 0.56% and 0.24% respectively. The positive rate of serology (χ2 = 9.42, P <0.01) Rate (χ2 = 6.21, P <0.01), the differences were statistically significant. Did not detect acute schistosomiasis patients. Check the stocking 228 times, found positive 12 times, the infection rate was 5.26%. 128 cases of DDIA-positive, 10 cases of stool-positive and 12 cases of positive sheep were treated with praziquantel for simultaneous chemotherapy; to carry out the drug snail 50hm2, emergency killing larvae 19hm2; and promptly taken health education and personal protection , Safe water and manure management and other integrated measures to effectively control the outbreak. Conclusion The implementation of monitoring and early warning of infectious status of key waters in the endemic areas of schistosomiasis and the timely and effective measures for emergency treatment of schistosomiasis endemic areas have a significant effect on controlling the occurrence and development of the epidemic. The sentinel method is one of the objective, sensitive and effective methods for determining water infectivity.