11流病傳染病預(yù)防控制

Death

Rate

of

10

Main

Diseases

in

Certain

Regionin

2009(Total)RankCause

(in

city)Death

Rate(1/106)Cause

(in

county)Death

Rate(1/106)1MalignantNeoplasms167.57MalignantNeoplasms159.152CerebrovascularDisease126.27CerebrovascularDisease152.093Heart

Disease128.82Heart

Disease112.894Diseases

ofthe

RespiratorySystem65.40Diseases

of

the

Respiratory

System98.165Injury

&

Poisoning34.66Injury

&

Poisoning54.116Endocrine,Nutritional

&MetabolicDiseases20.33Diseasesofthe

Digestive

System14.557Diseases

of

the

DigestiveSystem16.58Endocrine,

Nutritional&

Metabolic

Diseases11.258Disease

of

t

itourinarySystem7.34Infectious

disease7.259Disease

of

theNervous

System6.89Disease

of

theGenitourinary

System7.2210Infectious

disease6.29Disease

of

theNervous

System5.08Data

from

Health

Digest

2009,

MOHPeking

University

Health

Science

CenterMorbidity

of

Infectious

Diseases

in

China

2009Data

from

Chinese

Health

Digest

2009RankDiseaseMorbidity

(1/105)1Viral

Hepatitis（

性肝炎）107.302TB（結(jié)核）81.093Syphilis（

）23.074Dysentery（細(xì)菌性痢疾）20.455Influenza

A(

)（甲型流感）9.176Gonorrhea（

）9.027Newborn

Tetanus（新生兒破傷風(fēng)）8.008Measles（麻疹）3.959Brucellosis（布病）2.7010Scarlet

Fever（猩紅熱）1.6612Malaria（瘧疾）1.0613AIDS（獲得性免疫缺陷綜合癥）1.00Peking

University

Health

Science

Center傳染病流行過程的三個環(huán)節(jié)易感者能夠引起宿主致病的各種生物體病原體傳染源途徑在自然條件下被病原體寄生的人或其他動物Peking

University

Health

Science

Center（一）傳染源source

of

infectionPeking

University

Health

Science

Center傳染源Peking

University

Health

Science

Center傳染源Peking

University

Health

Science

Center“傷寒

”Peking

University

Health

Science

Center病原攜帶者作為傳染源的意義取決于Peking

University

Health

Science

Center傳染源Peking

University

Health

Science

Center狂犬HIV

1型于非洲的黑猩

弓形蟲猩Peking

University

Health

Science

CenterPeking

University

Health

Science

Center（二）途徑Peking

University

Health

Science

Center常見的途徑Peking

University

Health

Science

Center1.

經(jīng)空氣

(air-borne

infection)Peking

University

Health

Science

CenterSARSPeking

University

Health

Science

Center經(jīng)空氣傳染病的流行特征Peking

University

Health

Science

Center2．經(jīng)水(water-borne

infection)Peking

University

Health

Science

Center經(jīng)飲水流行特征Peking

University

Health

Science

Center倫敦霍亂1849.9.7技術(shù)所限，不能檢測病原菌地形圖:三間分布Peking

University

Health

Science

Center經(jīng)疫水流行特征Peking

University

Health

Science

Center3．經(jīng)食物(food-borneinfection)：黃瓜？豆芽？德國下旬，性大腸桿菌中包含年月Peking

University

Health

Science

CenterJan,

1-4,

1988毛蚶（Ark

s

）HAV

隱 染率<50%HAV :

1,500,000:

310,000:

47率:12.5%經(jīng)濟損失:10

億1988甲肝大暴發(fā)車棚做臨時Peking

University

Health

Science

Center4．接觸(contact

infection)Peking

University

Health

Science

Center1985年1995年1998年HIV/AIDS2011年者和約78萬，其中15

萬Peking

University

Health

Science

Center他是一名血友病患者，在注射血制品的過程中了

。在與

的夫妻生活中，被

傳染了后來

生了弟弟。，不幸的是弟弟出生后發(fā)現(xiàn)也已經(jīng)

了姐姐Peking

University

Health

Science

Center5．經(jīng)媒介節(jié)肢動物(arthropod/vector-borne

infection)Peking

University

Health

Science

Center6．經(jīng)土壤(soil-borne

infection)Peking

University

Health

Science

Center7．醫(yī)源性(iatrogenic

infection)(Hospital

infection)染，指住院醫(yī)院即醫(yī)院獲得得的在醫(yī)院內(nèi)獲，包括在住院期間發(fā)生的和在醫(yī)院獲得出院后發(fā)生的；但不包括入院前已開始或入院時已處于潛伏期的。醫(yī)務(wù)在醫(yī)院獲得的也屬于醫(yī)院。Peking

University

Health

Science

Center

年某醫(yī)院產(chǎn)科Ⅰ部產(chǎn)婦產(chǎn)褥熱病死率月份 產(chǎn)婦數(shù)

數(shù) 病死率５：開始使用漂白粉洗手。Peking

University

Health

Science

Center患者

系指由于醫(yī)護(hù)

的 、治療或預(yù)防措施不當(dāng)而引起的不利于身心健康的疾醫(yī)

病，包括醫(yī)院獲得 染，藥物所致的藥源性疾病，長期或大量使用某些藥物源

所致的營養(yǎng)缺乏癥等。性疾

醫(yī)務(wù)

在醫(yī)療服務(wù)中本身受到各種職業(yè)因素影響，例如，在職業(yè)接觸中本身受到員

，常見的乙型肝炎、肺結(jié)核等；接觸有害的化學(xué)物質(zhì)；放射性照射等臺大醫(yī)院： 年月 移植術(shù)后名接受

移植者名醫(yī)護(hù)Peking

University

Health

Science

CenterSARS病例發(fā)病、 的職業(yè)分布摘自：流行病學(xué)研究實例，第四卷Peking

University

Health

Science

Center8．圍生期(perinatal

infection)Peking

University

Health

Science

Center（三）易感人群人群易感性Peking

University

Health

Science

Center1．影響人群易感性升高的主要因素Peking

University

Health

Science

Center2.影響人群易感性降低的主要因素Peking

University

Health

Science

Center計劃免疫Peking

University

Health

Science

Center（二）中國的計劃免疫程序Peking

University

Health

Science

Center1987-2003年全球脊灰發(fā)病數(shù)滅活

(Salk)

減毒活

(Sabin)Peking

University

Health

Science

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a一蕊－七千夏，貯妒、？．全曠^

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University

Health

Science

Center中國1993~1999年S2xS3型重組

的分布1993199419951996199719981999Peking

University

Health

Science

Center出現(xiàn)脊髓灰質(zhì)炎，中國

報告

例脊灰確診病例原因：實際接種率低于上報接種率；導(dǎo)致點多線長面廣，

冷鏈系統(tǒng)失靈，效價降低甚至失效；與脊灰高發(fā)國家接壤：尼泊爾、

斯坦、塔坦等新生兒HBV疫苗納入計劃免疫管理，但需自費HBV納入計劃免疫，免費，

但需支付手續(xù)費，約10元新生兒HBV接種完全免費是預(yù)防HBV的最有效方法中華肝臟病雜志,2005,13:881-891Comparison

of

HBsAg

Prevalence

in

1992

and

2006%9.757.189.670.96Peking

University

Health

Science

CenterSource:

NNDSSVaccinelicensedHBsAgscreening

ofpregnantwomenmendedOSHA

ruleenactedAdolescentImmunizationmendedInfantimmunizationmendedHepatitis

B

by

Year,

United

States,1966

-

2000Peking

University

Health

Science

Center三、影響傳染病流行過程的因素Peking

University

Health

Science

Center社會因素Peking

University

Health

Science

Center傳染病的預(yù)防控制（一）預(yù)防為主（二）加強傳染病監(jiān)測（三）傳染病的全球化控制Peking

University

Health

Science

Center二、傳染病預(yù)防控制措施（一）傳染病報告Peking

University

Health

Science

Center（二）控制傳染源Peking

University

Health

Science

Center（二）控制傳染源檢疫期：最后接觸日至該病的最長潛伏期留驗（ 觀察）：在指定地點進(jìn)行觀察、限制活動范圍，實施診察、檢驗和治療醫(yī)學(xué)觀察：可正常工作學(xué)習(xí)，需接受體檢、測體溫、病原學(xué)檢查、衛(wèi)生處理Peking

University

Health

Science

Center（二）控制傳染源Peking

University

Health

Science

Center（三）切斷途徑滅菌：可殺滅一切微生物包括細(xì)菌芽孢的方法注意

劑對

和環(huán)境的危害Peking

University

Health

Science

Center（四）保護(hù)易感者Peking

University

Health

Science

Center（五）傳染病暴發(fā)、流行的緊急措施Peking

University

Health

Science

Center新時期傳染病流行特點及其對策Peking

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Health

Science

Center一、病原體變化帶來的新問題（一）新發(fā)現(xiàn)或再燃的傳染?。ǘ┎≡w耐藥（三）病原體突變與抗原變異Peking

University

Health