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目的通过对2012年四川理塘县人间鼠疫疫情综合处置分析,为今后有效预防和控制鼠疫疫情积累经验。方法依据《国家鼠疫控制应急预案》、《人间鼠疫疫区处理标准及原则(GB15978-1995)》、《鼠疫诊断标准(WS279-2008)》和《四川省鼠疫应急预案》,对鼠疫患者与接触者进行隔离管理,并对隔离区和现场进行相关卫生学处置,鼠疫细菌培养、鼠疫间接血凝试验(IHA)、鼠疫反向血凝试验(RIHA)和鼠疫胶体金免疫层析法(GICA),按照卫生部行业标准-《鼠疫诊断标准(WS279-2008)》执行。结果细菌检测患者体材料15份、细菌阳性5份,确诊病例为腺型继发败血型鼠疫。自毙旱獭1份分离鼠疫菌1株;IHA检测接触者人体血清23份、结果阴性;RIHA检测病人体材料15份、阳性7份,滴度1∶80~40960不等;鼠疫胶体金免疫层析法(GICA)抗原检测病人体材料15份、阳性7份;旱獭检材1份RIHA和GICA抗原检测均阳性。结论鼠疫疫情发生后,根据鼠疫传播特点,因地制宜,控制传染源、切断传播途径、保护易感者等效防措施,防止了鼠疫疫情扩散;同时证实理塘县为喜马拉雅旱獭鼠疫自然疫源地。
OBJECTIVE: To analyze the comprehensive treatment of the Plague epidemic in Litang County of Sichuan Province in 2012 to gain effective experience in the prevention and control of plague outbreaks in the future. Methods According to the National Preventive Plan for the Control of Plague and Epidemic Diseases, the Criteria and Principles for Handling Human Plague Epidemic (GB15978-1995), the Diagnostic Criteria for Plague (WS279-2008) and the Plague Emergency Plan in Sichuan Province, (IHA), RIHA and GICA were used to carry out isolation management and related hygiene treatment in isolation area and on-site, bacterial plague culture, indirect hemagglutination test (IHA) , In accordance with the Ministry of Health industry standards - “Plague Diagnostic Standards (WS279-2008)” implementation. Results Bacteria were detected in 15 patients and 5 were positive for bacteria. The confirmed cases were plague of glandular secondary septicemia. 1 self-marmot was isolated from Yersinia pestis; 23 strains of human serum from IHA test were negative, the result was negative; 15 RIHA samples from 7 patients were positive, the titer ranged from 1:80 to 40960; Analysis of the method (GICA) antigen test body material 15 copies, positive 7; Marmot samples 1 RIHA and GICA antigen were positive. Conclusions After the outbreak of the plague occurred, according to the characteristics of the spread of the plague, according to local conditions, controlling the source of infection, cutting off the route of transmission and protecting the equivalent measures of susceptibility to prevent the spread of plague outbreaks. Meanwhile, Litang County was confirmed as a natural foci of plague in the Himalayan marmot.