中国血吸虫病潜在流行区的风险评估

中国寄生虫学与寄生虫病杂志 ›› 2012, Vol. 30 ›› Issue (6): 3-428-433.

中国血吸虫病潜在流行区的风险评估

许静1，李石柱1，黄轶昕2，操志国3，涂祖武4，吴成果5，缪峰6，党辉1，张利娟1，陈朝7，王立英7，郭家钢1，周晓农1*

1 　中国疾病预防控制中心寄生虫病预防控制所，卫生部寄生虫病原与媒介生物学重点实验室，世界卫生组织疟疾、血吸虫病和丝虫病合作中心，上海 200025；2 　江苏省血吸虫病防治研究所，无锡 214064；3　安徽省血吸虫病防治研究所，合肥 230061；4 　湖北省血吸虫病防治研究所，武汉 430070；5 　重庆市疾病预防控制中心，重庆 400042；6 　山东省寄生虫病防治研究所，济宁 272100；7 　卫生部疾病预防控制局，北京 100040

出版日期:2012-12-31 发布日期:2013-02-05

Risk Evaluation of Schistosomiasis japonica in Potential Endemic Areas in China

XU Jing1，LI Shi-zhu1，HUANG Yi-xin2，CAO Zhi-guo3，TU Zu-wu4，WU Cheng-guo5，MIU Feng6，DANG Hui1，ZHANG Li-Juan1，CHEN Zhao7，WANG Li-ying7，GUO Jia-gang1，ZHOU Xiao-nong1*

1 National Insitute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vecotr Biology，MOH；WHO Collaborating Centre for Malaria, Schistosomiasis and Filariasis，Shanghai 200025，China；2 Jiangsu Institute of Schistosomiasis，Wuxi 214064，China；3 Anhui Institute of Schistosomiasis，Hefei 230061，China; 4 Hubei Institute of Schistosomiasis，Wuhan 430070，China；5 Chongqing Center of Disease Control and Prevention，Chongqing 400042，China；6 Shandong Institute of Parasitic Diseases，Jining 272100，China；7 Bureau of Disease Control and Prevention，MOH，Beijing 100040，China

Online:2012-12-31 Published:2013-02-05

摘要/Abstract

摘要： 目的分析大型水利工程对血吸虫病传播的影响，评估血吸虫病潜在流行区的疾病传播风险。方法 2008-2010年，在三峡库区和南水北调等大型水利工程途经的江苏省盱眙县、洪泽县、金湖县和高邮县，山东省微山县，湖北省潜江市和宜昌市夷陵区，安徽省巢湖市居巢区，重庆市万州区和开县，以及长江下游河口段的张家港市等5省（市）11个县（市、区），选择血吸虫病潜在流行区开展传播风险相关因素监测并进行风险评估分析。每个县（市、区）至少设立1个固定监测点和3个流动监测点。2008年随机抽取当地6~65岁常住居民，2008-2010年每年对监测县（市、区）内的当地暂住流动人口，采用间接红细胞凝集试验或酶联免疫吸附试验进行筛查，血检阳性者用改良加藤法或尼龙绢集卵孵化法进行病原学检查。2008-2010年每年对居巢、潜江、高邮和万州等4个县（市、区）的家畜开展血吸虫感染情况调查。此外，对危险地带和可疑环境开展钉螺孳生分布调查和水体漂浮物的监测，并在江苏省盱眙县、洪泽县、金湖县和高邮县的通江河道采用稻草帘诱螺法开展钉螺扩散调查。结果监测点共8 256名当地居民接受了血清学检查，抗体阳性率为0.7%（60/8 256），60例抗体阳性者中55例接受了病原学检查，均为阴性。2008-2010年流动人口的抗体阳性率分别为2.0%（53/2 611）、1.4%（56/3 944）和1.7%（74/4 581），3年间差异无统计学意义（χ2=3.57，P>0.05）；在抗体阳性者中，居巢区连续3年均查获了粪检阳性者，共22例，另于2010年在金湖县检获1例粪检阳性。除在金湖和高邮的可疑环境检获钉螺外，其他监测点均未查获钉螺，检获的钉螺中未发现感染性钉螺。水体漂浮物和稻草帘诱螺监测，检获大量水生贝类和螺，但未检获钉螺。结论尚未发现三峡库区和南水北调相关工程引起钉螺扩散和血吸虫病传播的情况，但存在相关风险，有必要建立长期血吸虫病监测预警体系，不同类型地区血吸虫病传播因素监测的重点可不同。

关键词: 日本血吸虫病, 潜在流行区, 风险评估, 水利工程

Abstract: Objective To analyze the impact of large hydraulic projects on schistosomiasis transmission and evaluate the transmission risk in potential endemic areas. Methods During 2008-2010, surveillance on risk factors related to schistosomiasis transmission and risk assessment were carried out in potential endemic sites in counties of Xuyu, Hongze, Jinhu, and Gaoyou in Jiangsu Province, Weishan County in Shangdong, Qianjiang City and Yiling District of Yichang City in Hubei, Juchao District of Chaohu City in Anhui Province, Wanzhou and Kaixian in Chongqing in Three Gorges Dam region or passed by South-to-North Water Diversion Project and Zhangjiagang City in Jiangsu Province located in lower reach of Yangtze River. At least one fixed and three temporary monitoring sites were set in each county（city or district）. Local inhabitants aged 6-65 years old were screened by indirect haemagglutination assay （IHA） or ELISA, and the sero-positives were tested by Kato-Katz or miracidium hatching techniques to investigate possible infection in 2008. The endemic status of schistosomiasis in mobile population was surveyed every year during 2008-2010. Infection status in livestocks was surveyed in Juchao, Qianjiang, Gaoyou and Wanzhou Counties in 2008-2010. Oncomelania hupensis distribution was investigated in risky and suspicious areas. Snail spreading investigation was conducted through salvaging floater and snails-inducing by straw curtains in rivers connected with Yangtze River. Results 8 256 local inhabitants were investigated by serological tests with a positive rate of 0.7% （60/8 256）. Among the 60 serologically positive subjects, 55 individuals were examined by stool examination but none of them was egg positive. The antibody prevalence rate of migrating population in 2008-2010 was 2.0%, 1.4%, and 1.7%, respectively, with no significant difference（χ2=3.57，P>0.05）. Among the serologically positive subjects, egg-positive cases were found in migrating population in Juchao District each year and one case was found in Jinhu County in 2010. Oncomelania snails were only found in in Jinhu and Gaoyou without infected ones. A lot of aquatic shell-fish and snails were collected in the water floater and straw curtain without Oncomelania snails. Conclusion　 Schistosomiasis is not endemic in the original non-endemic areas in Three Gorges Dam region and areas passed by South-to-North Water Diversion Project until now, but potential risk of transmission exists. Long term surveillance scheme on schistosomiasis should be established with varied monitoring factors in different category areas.

Key words: Schistosomiasis japonica, Potential endemic area, Risk assessment, Hydraulic project

许静, 李石柱, 黄轶昕, 操志国, 涂祖武, 吴成果, 缪峰, 党辉, 张利娟, 陈朝, 王立英, 郭家钢, 周晓农. 中国血吸虫病潜在流行区的风险评估[J]. 中国寄生虫学与寄生虫病杂志, 2012, 30(6): 3-428-433.

XU Jing, LI Shi-Zhu, HUANG Yi-Xin, CAO Zhi-Guo, CHU Zu-Wu, TUN Cheng-GuO, MIU Feng, DANG Hui, ZHANG Li-Juan, CHEN Zhao, WANG Li-Ying, GUO Jia-Gang, ZHOU Xiao-Nong. Risk Evaluation of Schistosomiasis japonica in Potential Endemic Areas in China[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2012, 30(6): 3-428-433.

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