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Article(id=1241676528879202891, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202406071, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1717689600000, receivedDateStr=2024-06-07, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773968353719, onlineDateStr=2026-03-20, pubDate=1731168000000, pubDateStr=2024-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773968353719, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773968353719, creator=13701087609, updateTime=1773968353719, updator=13701087609, issue=Issue{id=1241676522256388920, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='21', pageStart='3841', pageEnd='4032', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773968352140, creator=13701087609, updateTime=1773968629818, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241677686985249701, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241677686985249702, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=4002, endPage=4008, ext={EN=ArticleExt(id=1241676531009909403, articleId=1241676528879202891, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the epidemiological characteristics of public health emergencies in Yunnan Province’s border areas (2012—2022), columnId=1228016573156360233, journalTitle=Modern Preventive Medicine, columnName=Disease Control and Prevention, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the epidemiological characteristics of public health emergencies in Yunnan Province’s border areas in recent years, providing a scientific basis for effective prevention and control measures.

Methods

Data on public health emergencies reported in 25 border counties (cities) of Yunnan Province from 2012 to 2022 were collected through the “China Disease Prevention and Control Information System-Public Health Emergency Reporting Management System”. Descriptive epidemiological methods were employed to analyze the epidemiological characteristics.

Results

From 2012 to 2022, a total of 452 public health emergencies were reported in Yunnan Province’s border areas, with 31 020 cases and 110 deaths, resulting in an overall incidence rate of 0.94% and a case fatality rate of 0.35%. The primary types of events were infectious disease outbreaks (75.2%) and food poisoning (22.1%). The peak periods for infectious disease outbreaks were June and November, while food poisoning peaked from May to July. The leading causes of events were chickenpox (21.0%), COVID-19 (17.7%), and wild mushroom poisoning (9.5%), with wild mushroom poisoning accounting for the most deaths (53 cases, 48.2%). Schools (47.7%) and communities/villages (27.7%) were the main locations for infectious disease outbreaks. Dehong Prefecture reported 192 events, constituting 42.7% of the total, with 13 644 cases, representing 44.0% of the total cases. Twelve (48.0%) border counties (cities) reported 16 public health emergencies caused by imported infectious diseases, primarily from Myanmar (93.7%) and Laos (6.3%). Main diseases included dengue fever (31.3%), COVID-19 (31.3%), and chikungunya (18.8%), with a peak period for imported infectious disease-related events from July to September.

Conclusion

The reported public health emergencies in Yunnan Province’s border areas are mainly due to infectious disease outbreaks and food poisoning, with peak seasons in summer and winter. Major causes include chickenpox, COVID-19, and dengue fever, while the leading cause of death is wild mushroom poisoning. Schools and communities are critical locations for the prevention and control of infectious disease outbreaks. It is recommended that border areas strengthen monitoring, early warning, and risk assessment for key diseases and vectors, with particular attention to cross-border disease prevention and control in regions adjacent to Myanmar.

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目的

分析云南省边境地区近年来突发公共卫生事件的流行特征，为进一步有效开展防控工作提供科学依据。

方法

通过“中国疾病预防控制信息系统-突发公共卫生事件报告管理系统”收集云南省25个边境县（市）2012—2022年报告的突发公共卫生事件资料，运用描述流行病学方法分析其流行特征。

结果

2012—2022年云南省边境地区共报告突发公共卫生事件452起，累积报告病例31 020例、死亡110例，总体罹患率0.94%，总体病死率0.35%。事件类型以传染病暴发和食物中毒为主，分别占75.2%和22.1%。传染病暴发高发期为6月、11月，食物中毒高发期为5—7月。引发事件的原因主要为水痘、新冠病毒感染和野生菌中毒，分别占21.0%、17.7%、9.5%；引起死亡最多的为野生菌中毒，53例，占48.2%。学校（47.7%）和社区/村（27.7%）是传染病暴发的主要场所。德宏州报告的事件数为192起，占总事件数的42.7%，报告的病例数为13 644例，占总病例数的44.0%。12个（48.0%）边境县（市）报告境外输入传染病导致的突发公共卫生事件共16起，输入来源为缅甸和老挝，分别占93.7%和6.3%；输入病种主要为登革热、新冠病毒感染和基孔肯雅热，分别占31.3%、31.3%、18.8%，境外输入传染病相关事件高发期为7—9月。

结论

云南省边境地区报告的突发公共卫生事件以传染病暴发和食物中毒为主，夏、冬季为高发季节，主要病因为水痘、新冠病毒感染、登革热，主要死因为野生菌中毒。学校和社区是传染病暴发防控的重点场所。建议边境地区加强重点疾病及传播媒介的监测预警和风险评估，重点关注与缅甸接壤地区传染病跨境输入防控。

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常利涛，E-mail:；
林燕，E-mail:；
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常利涛与林燕为共同通信作者

邬志薇（1986—），硕士，主管医师，研究方向：传染病疫情监测、突发公共卫生事件处置

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邬志薇（1986—），硕士，主管医师，研究方向：传染病疫情监测、突发公共卫生事件处置

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邬志薇（1986—），硕士，主管医师，研究方向：传染病疫情监测、突发公共卫生事件处置

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Investigation on the surveillance and prevention of infectious diseases cross-border spread in Yunnan[J].Chinese Journal of Frontier Health and Quarantine, 2019, 42(1): 25-28.(In Chinese), articleTitle=Investigation on the surveillance and prevention of infectious diseases cross-border spread in Yunnan, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1241821853648491002, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, xref=1., ext=[AuthorCompanyExt(id=1241821853656879614, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, companyId=1241821853648491002, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Yunnan Provincial Center for Disease Control and Prevention, Epidemic Monitoring/Public Health Emergency Response Center,Kunming, Yunnan 650500, China), AuthorCompanyExt(id=1241821853665268222, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, companyId=1241821853648491002, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.云南省疾病预防控制中心疫情监测/突发公共卫生事件处置中心，云南 昆明 650500)]), AuthorCompany(id=1241821853765931530, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, xref=2., ext=[AuthorCompanyExt(id=1241821853778514445, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, companyId=1241821853765931530, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.云南省云南省疾病预防控制中心学校卫生所，云南 昆明 650500)])], figs=[ArticleFig(id=1241821858761347869, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=EN, label=Figure 1, caption=Monthly distribution of public health emergencies in border areas of Yunnan, 2012—2022, figureFileSmall=fCnTNvVGKioKf20bdiUcZA==, figureFileBig=wzk8iXaxcoYGfYEvNkOjhQ==, tableContent=null), ArticleFig(id=1241821858870399776, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=CN, label=图1, caption=2012—2022年云南省边境地区突发公共卫生事件月度分布, figureFileSmall=fCnTNvVGKioKf20bdiUcZA==, figureFileBig=wzk8iXaxcoYGfYEvNkOjhQ==, tableContent=null), ArticleFig(id=1241821859059143470, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=EN, label=Table 1, caption=

Grading of public health emergencies in border areas of Yunnan, 2012—2022

, figureFileSmall=null, figureFileBig=null, tableContent=
事件级别起数（%）病例数罹患率（%）死亡数病死率（%）
较大（Ⅲ级）70（15.5）2 70011.4923.41
一般（Ⅳ级）280（61.9）24 7199.2130.05
未分级102（22.6）3 6019.950.14
合计452（100.0）31 0209.41100.35
), ArticleFig(id=1241821859184972595, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=CN, label=表1, caption=

2012—2022年云南省边境地区突发公共卫生事件分级情况

, figureFileSmall=null, figureFileBig=null, tableContent=
事件级别起数（%）病例数罹患率（%）死亡数病死率（%）
较大（Ⅲ级）70（15.5）2 70011.4923.41
一般（Ⅳ级）280（61.9）24 7199.2130.05
未分级102（22.6）3 6019.950.14
合计452（100.0）31 0209.41100.35
), ArticleFig(id=1241821859365327677, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=EN, label=Table 2, caption=

Classification of public health emergencies in border areas of Yunnan, 2012—2022

, figureFileSmall=null, figureFileBig=null, tableContent=
事件类型起数（%）发病数罹患率（%）死亡数病死率（%）
传染病暴发340（75.2）28 7310.88110.04
甲类传染病3（0.6）30.0300.00
丙类传染病106（23.5）7 4963.9240.05
乙类传染病126（27.9）17 6620.5960.03
其他105（23.2）3 5704.8510.03
突发中毒109（24.1）2 11515.25994.68
食物中毒100（22.1）2 03615.49803.93
其他中毒9（2.0）7910.931924.05
其他事件3（0.7）1744.2100
合计452（100.0）31 0200.941100.35
), ArticleFig(id=1241821859520516936, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=CN, label=表2, caption=

2012—2022年云南省边境地区突发公共卫生事件分类情况

, figureFileSmall=null, figureFileBig=null, tableContent=
事件类型起数（%）发病数罹患率（%）死亡数病死率（%）
传染病暴发340（75.2）28 7310.88110.04
甲类传染病3（0.6）30.0300.00
丙类传染病106（23.5）7 4963.9240.05
乙类传染病126（27.9）17 6620.5960.03
其他105（23.2）3 5704.8510.03
突发中毒109（24.1）2 11515.25994.68
食物中毒100（22.1）2 03615.49803.93
其他中毒9（2.0）7910.931924.05
其他事件3（0.7）1744.2100
合计452（100.0）31 0200.941100.35
), ArticleFig(id=1241821859684094804, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=EN, label=Table 3, caption=

Distribution of the top 5 regions with the highest number of public health emergencies in border areas of Yunnan,2012—2022

, figureFileSmall=null, figureFileBig=null, tableContent=
事件数位次地区事件数（起）发病数死亡数
1芒市531 9354
2陇川县501 5005
3景洪市489 1376
3盈江县482 0378
4瑞丽市428 1724
5富宁县332 3444
), ArticleFig(id=1241821859860255577, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=CN, label=表3, caption=

2012—2022年云南省边境地区突发公共卫生事件报告数前五位地区分布

, figureFileSmall=null, figureFileBig=null, tableContent=
事件数位次地区事件数（起）发病数死亡数
1芒市531 9354
2陇川县501 5005
3景洪市489 1376
3盈江县482 0378
4瑞丽市428 1724
5富宁县332 3444
), ArticleFig(id=1241821859973501800, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=EN, label=Table 4, caption=

Site distribution of public health emergencies in border areas of Yunnan, 2012—2022

, figureFileSmall=null, figureFileBig=null, tableContent=
场所类型事件数（%）发病数死亡数病死率（%）
学校216（47.8）11 19410.01
小学137（30.3）7 40510.01
幼儿园44（9.7）1 36400
中学34（7.5）2 41100
特殊教育学校1（0.2）1400
社区/村125（27.7）15 764160.10
家庭84（18.6）2 889812.80
厂矿企业*13（2.9）28282.84
餐饮服务单位**7（1.5）29941.34
其他场所7（1.5）59200
合计452（100.0）31 0201100.35
), ArticleFig(id=1241821863446385519, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=CN, label=表4, caption=

2012—2022年云南省边境地区突发公共卫生事件发生场所分布

, figureFileSmall=null, figureFileBig=null, tableContent=
场所类型事件数（%）发病数死亡数病死率（%）
学校216（47.8）11 19410.01
小学137（30.3）7 40510.01
幼儿园44（9.7）1 36400
中学34（7.5）2 41100
特殊教育学校1（0.2）1400
社区/村125（27.7）15 764160.10
家庭84（18.6）2 889812.80
厂矿企业*13（2.9）28282.84
餐饮服务单位**7（1.5）29941.34
其他场所7（1.5）59200
合计452（100.0）31 0201100.35
), ArticleFig(id=1241821863588991863, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=EN, label=Table 5, caption=

The main causes of public health emergencies in border areas of Yunnan, 2012—2019

, figureFileSmall=null, figureFileBig=null, tableContent=
位次事件数构成比(%)事件原因(发病数)死亡原因(死亡数)
1水痘(26.0)登革热(13 209)野生菌中毒(45)
2野生菌中毒(12.5)水痘(2 845)有毒植物中毒(11)
3流感(10.1)流感(2 233)甲醇中毒(5)
4登革热(9.8)急性出血性结膜炎(1 616)职业性硫化氢中毒(4)
5流腮(7.1)流腮(1 451)狂犬病(4)
), ArticleFig(id=1241821863748375424, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=CN, label=表5, caption=

云南省边境地区2012—2019年引起突发公共卫生事件的主要原因

, figureFileSmall=null, figureFileBig=null, tableContent=
位次事件数构成比(%)事件原因(发病数)死亡原因(死亡数)
1水痘(26.0)登革热(13 209)野生菌中毒(45)
2野生菌中毒(12.5)水痘(2 845)有毒植物中毒(11)
3流感(10.1)流感(2 233)甲醇中毒(5)
4登革热(9.8)急性出血性结膜炎(1 616)职业性硫化氢中毒(4)
5流腮(7.1)流腮(1 451)狂犬病(4)
), ArticleFig(id=1241821863874204552, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=EN, label=Table 6, caption=

The main causes of public health emergencies in border areas of Yunnan, 2020—2022

, figureFileSmall=null, figureFileBig=null, tableContent=
位次事件数构成比(%)事件原因(发病数)死亡原因(死亡数)
1新冠(51.3)新冠(3 207)野生菌中毒(8)
2手足口病(12.2)登革热(786)非职业性一氧化碳中毒(7)
3水痘(11.5)流感(735)甲醇中毒(3)
4流感(6.4)手足口病(634)有毒植物中毒(3)
5野生菌中毒(3.9)水痘(520)其他感染性腹泻(2)、新冠(2)
), ArticleFig(id=1241821864016810897, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=CN, label=表6, caption=

云南省边境地区2020—2022年引起突发公共卫生事件的主要原因

, figureFileSmall=null, figureFileBig=null, tableContent=
位次事件数构成比(%)事件原因(发病数)死亡原因(死亡数)
1新冠(51.3)新冠(3 207)野生菌中毒(8)
2手足口病(12.2)登革热(786)非职业性一氧化碳中毒(7)
3水痘(11.5)流感(735)甲醇中毒(3)
4流感(6.4)手足口病(634)有毒植物中毒(3)
5野生菌中毒(3.9)水痘(520)其他感染性腹泻(2)、新冠(2)
), ArticleFig(id=1241821864155222939, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=EN, label=Tabel 7, caption=

Regional distribution of public health emergencies caused by imported outbreaks in border areas of Yunnan, 2012—2022

, figureFileSmall=null, figureFileBig=null, tableContent=
地区事件数（起）病例数事件原因
瑞丽市34霍乱、基孔肯雅热、新冠
耿马县2197登革热、新冠
镇康县24登革热、新冠
沧源县11登革热
江城县11新冠
龙陵县11登革热
陇川县125麻疹
泸水市11登革热
芒市11基孔肯雅热
孟连县11新冠
腾冲市11黑热病
盈江县11基孔肯雅热
总计16238—
), ArticleFig(id=1241821864293634977, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676528879202891, language=CN, label=表7, caption=

2012—2022年云南省边境地区境外输入疫情引发的突发公共卫生事件地区分布

, figureFileSmall=null, figureFileBig=null, tableContent=
地区事件数（起）病例数事件原因
瑞丽市34霍乱、基孔肯雅热、新冠
耿马县2197登革热、新冠
镇康县24登革热、新冠
沧源县11登革热
江城县11新冠
龙陵县11登革热
陇川县125麻疹
泸水市11登革热
芒市11基孔肯雅热
孟连县11新冠
腾冲市11黑热病
盈江县11基孔肯雅热
总计16238—
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2012—2022年云南省边境地区突发公共卫生事件流行特征分析
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邬志薇 1 , 林燕 1 , 郑尔达 1 , 何继波 1 , 常利涛 2
现代预防医学 | 疾病预防控制 2024,51(21): 4002-4008
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现代预防医学 | 疾病预防控制 2024, 51(21): 4002-4008
2012—2022年云南省边境地区突发公共卫生事件流行特征分析
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邬志薇1, 林燕1 , 郑尔达1, 何继波1, 常利涛2
作者信息
  • 1.云南省疾病预防控制中心疫情监测/突发公共卫生事件处置中心，云南 昆明 650500
  • 2.云南省云南省疾病预防控制中心学校卫生所，云南 昆明 650500

    • 邬志薇（1986—），硕士，主管医师，研究方向：传染病疫情监测、突发公共卫生事件处置

通讯作者:

常利涛，E-mail:；
林燕，E-mail:；
Analysis of the epidemiological characteristics of public health emergencies in Yunnan Province’s border areas (2012—2022)
Zhi-wei WU1, Yan LIN1 , Er-da ZHENG1, Ji-bo HE1, Li-tao CHANG2
Affiliations
  • Yunnan Provincial Center for Disease Control and Prevention, Epidemic Monitoring/Public Health Emergency Response Center,Kunming, Yunnan 650500, China
出版时间: 2024-11-10 doi: 10.20043/j.cnki.MPM.202406071
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摘要
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目的

分析云南省边境地区近年来突发公共卫生事件的流行特征，为进一步有效开展防控工作提供科学依据。

方法

通过“中国疾病预防控制信息系统-突发公共卫生事件报告管理系统”收集云南省25个边境县（市）2012—2022年报告的突发公共卫生事件资料，运用描述流行病学方法分析其流行特征。

结果

2012—2022年云南省边境地区共报告突发公共卫生事件452起，累积报告病例31 020例、死亡110例，总体罹患率0.94%，总体病死率0.35%。事件类型以传染病暴发和食物中毒为主，分别占75.2%和22.1%。传染病暴发高发期为6月、11月，食物中毒高发期为5—7月。引发事件的原因主要为水痘、新冠病毒感染和野生菌中毒，分别占21.0%、17.7%、9.5%；引起死亡最多的为野生菌中毒，53例，占48.2%。学校（47.7%）和社区/村（27.7%）是传染病暴发的主要场所。德宏州报告的事件数为192起，占总事件数的42.7%，报告的病例数为13 644例，占总病例数的44.0%。12个（48.0%）边境县（市）报告境外输入传染病导致的突发公共卫生事件共16起，输入来源为缅甸和老挝，分别占93.7%和6.3%；输入病种主要为登革热、新冠病毒感染和基孔肯雅热，分别占31.3%、31.3%、18.8%，境外输入传染病相关事件高发期为7—9月。

结论

云南省边境地区报告的突发公共卫生事件以传染病暴发和食物中毒为主，夏、冬季为高发季节，主要病因为水痘、新冠病毒感染、登革热，主要死因为野生菌中毒。学校和社区是传染病暴发防控的重点场所。建议边境地区加强重点疾病及传播媒介的监测预警和风险评估，重点关注与缅甸接壤地区传染病跨境输入防控。

突发公共卫生事件  /  传染病  /  流行特征  /  边境地区
Objective

To analyze the epidemiological characteristics of public health emergencies in Yunnan Province’s border areas in recent years, providing a scientific basis for effective prevention and control measures.

Methods

Data on public health emergencies reported in 25 border counties (cities) of Yunnan Province from 2012 to 2022 were collected through the “China Disease Prevention and Control Information System-Public Health Emergency Reporting Management System”. Descriptive epidemiological methods were employed to analyze the epidemiological characteristics.

Results

From 2012 to 2022, a total of 452 public health emergencies were reported in Yunnan Province’s border areas, with 31 020 cases and 110 deaths, resulting in an overall incidence rate of 0.94% and a case fatality rate of 0.35%. The primary types of events were infectious disease outbreaks (75.2%) and food poisoning (22.1%). The peak periods for infectious disease outbreaks were June and November, while food poisoning peaked from May to July. The leading causes of events were chickenpox (21.0%), COVID-19 (17.7%), and wild mushroom poisoning (9.5%), with wild mushroom poisoning accounting for the most deaths (53 cases, 48.2%). Schools (47.7%) and communities/villages (27.7%) were the main locations for infectious disease outbreaks. Dehong Prefecture reported 192 events, constituting 42.7% of the total, with 13 644 cases, representing 44.0% of the total cases. Twelve (48.0%) border counties (cities) reported 16 public health emergencies caused by imported infectious diseases, primarily from Myanmar (93.7%) and Laos (6.3%). Main diseases included dengue fever (31.3%), COVID-19 (31.3%), and chikungunya (18.8%), with a peak period for imported infectious disease-related events from July to September.

Conclusion

The reported public health emergencies in Yunnan Province’s border areas are mainly due to infectious disease outbreaks and food poisoning, with peak seasons in summer and winter. Major causes include chickenpox, COVID-19, and dengue fever, while the leading cause of death is wild mushroom poisoning. Schools and communities are critical locations for the prevention and control of infectious disease outbreaks. It is recommended that border areas strengthen monitoring, early warning, and risk assessment for key diseases and vectors, with particular attention to cross-border disease prevention and control in regions adjacent to Myanmar.

Public health emergencies  /  Infectious diseases  /  Epidemiological characteristics  /  Border areas
邬志薇, 林燕, 郑尔达, 何继波, 常利涛. 2012—2022年云南省边境地区突发公共卫生事件流行特征分析. 现代预防医学, 2024 , 51 (21) : 4002 -4008 . DOI: 10.20043/j.cnki.MPM.202406071
Zhi-wei WU, Yan LIN, Er-da ZHENG, Ji-bo HE, Li-tao CHANG. Analysis of the epidemiological characteristics of public health emergencies in Yunnan Province’s border areas (2012—2022)[J]. Modern Preventive Medicine, 2024 , 51 (21) : 4002 -4008 . DOI: 10.20043/j.cnki.MPM.202406071
正文
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云南省地处我国西南边陲，全省有8个州（市）的25个县（市）分别与缅甸、越南、老挝接壤，边境线全长4 060 km，边境大部分地区属热带、亚热带气候，人口跨境流动活跃。特殊的地理、气候条件，复杂的社会文化背景，以及相对欠发达的经济发展水平，给云南省边境地区的传染病和突发公共卫生事件防控工作带来巨大的压力和挑战。本文通过分析云南省边境地区突发公共卫生事件的发生、流行特征，以期为科学有效开展防控工作提供依据。
1　资料与方法
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1.1　资料
数据源于云南省25个边境县（市）于2012年1月1日—2022年12月31日期间通过“中国疾病预防控制信息系统-突发公共卫生事件报告管理系统”报告的突发公共卫生事件信息。本研究涉及的云南省边境县（市）定义为：云南省辖区内与邻国接壤的县级行政区域，共25个。
1.2　方法
对事件发生的时间、地区、场所、病种等分布特征进行描述分析。使用Excel 365对数据进行统计分析。检验水准α=0.05。
2　结果
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2.1　突发公共卫生事件基本情况
2012—2022年云南省边境地区共报告突发公共卫生事件452起，累积报告病例31 020例，波及人口3 291 762人，总体罹患率0.94%；死亡110例，病死率0.35%。较大（Ⅲ级）事件70起（15.5%），一般（Ⅳ级）事件280起（61.9%），未分级事件102起（22.6%）。无特别重大事件（Ⅰ级）及重大事件（Ⅱ级）报告。见表1。
2.2　分布特征
2.2.1　类型分布
事件类型以传染病暴发疫情和突发中毒为主。其中，传染病暴发疫情340起（75.2%）、突发中毒109起（24.1%）、其他公共卫生事件3起（0.7%）。
340起传染病暴发疫情共报告病例28 731例、死亡11例。其中，甲类传染病事件3起，分别为鼠疫2起、霍乱1起（为缅甸输入）；乙类传染病事件126起，以新冠病毒感染（简称“新冠”）暴发为主，80起，占63.5%，其次为登革热暴发疫情31起，占24.6%；丙类传染病事件106起，以流行性感冒（简称“流感”）暴发为主，40起，占37.7%；非法定报告传染病暴发疫情105起，以水痘暴发为主，95起，占90.5%。引发病例数最多的为登革热，共报告病例13 995例。见表2。
109起突发中毒事件共报告病例2 115例，其中死亡99例（占总死亡数的90.0%），病死率4.68%。以食物中毒为主，100起，中毒原因主要为误食有毒野生菌、误食草乌等有毒植物及食物污染或变质。野生菌中毒共造成死亡53人，占总死亡数的48.2%。
2.2.2　时间分布
2012—2022年每年均有突发公共卫生事件报告，年均报告约41起。2022年报告的事件数最多，为86起，其中新冠暴发疫情51起；其次为2019年76起，其中流感暴发13起。
每个月均有事件报告，见图1。传染病暴发疫情高发期为6月（40起，其中手足口病暴发12起）和11月（55起，其中水痘暴发疫情19起、新冠暴发疫情18起）。食物中毒事件高发期为5—7月（47起，其中野生菌中毒37起）。其他类型事件呈散发。
2.2.3　地区分布
2012—2022年间，除西盟县外，其余24个边境县（市）均有突发公共卫生事件报告。报告事件数前五位分别为：芒市53起、陇川县50起、景洪市48起、盈江县48起、瑞丽市42起、富宁县33起；主要集中在德宏州（芒市、陇川县、盈江县、瑞丽市），共报告事件193起，占总事件数的42.7%，共报告病例13 644例，占总病例数的44.0%。报告病例数最多为景洪市的9 137例，其次为瑞丽市的8 172例。见表3。
2.2.4　场所分布
2012—2022年报告的突发公共卫生事件中，47.8%（216起）发生在学校，27.7%（125起）发生在社区/村庄，18.6%（84起）发生在家庭，其余散发在厂矿企业、餐饮服务单位等场所。见表4。
216起学校事件中，发生在小学137起（63.4%）、幼儿园44起、中学34起、特殊教育学校1起。主要原因为水痘（95起）、流感（34起）、手足口病（23起）、流行性腮腺炎（简称“流腮”，22起）等传染病暴发，以上4个病种报告的事件数占学校总事件数的80.6%，报告病例数占学校事件总病例数的72.6%。学校事件中，有8起因学生好奇食用蓖麻籽引起的中毒，发病269例，无死亡。
发生在社区/村庄的事件主要以新冠、登革热等传染病暴发疫情为主，占85.6%。发生在家庭的事件主要以有毒野生菌中毒和草乌中毒为主，家庭食物中毒事件的病死率达19.8%（66/334）。
2.2.5　事件原因分布
2012—2019年，报告事件数前三位的原因为水痘、野生菌中毒和流感，分别占26.0%、12.5%、10.1%，见表5。2020年新冠疫情暴发后，报告事件数前三位的原因为新冠、手足口病和水痘，分别占51.3%、12.2%、11.5%，见表6。2012—2022年，报告病例数最多的为登革热，共13 995例，占总病例数的45.1%。有毒野生菌中毒、草乌等有毒植物中毒及甲醇中毒是引起死亡的主要原因，其中野生菌中毒引起的死亡人数达53人，占总死亡数的48.2%。
2.2.6　境外输入疫情
2012—2022年，25个边境县（市）中有12个报告境外输入传染病导致的突发公共卫生事件，共报告16起，报告事件数前三位的地区为瑞丽市（3起）、耿马县（2起）、镇康县（2起），均为与缅甸接壤的地区，见表7。境外输入来源为缅甸（15起，占93.7%）和老挝（1起）。输入传染病病种为登革热（5起）、新冠（5起）、基孔肯雅热（3起）、麻疹（1起）、黑热病（1起）、霍乱（1起），其中输入后引发病例数最多的为登革热，202例，占84.9%。境外输入传染病暴发疫情报告时间集中在7—9月。
3　讨论
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2012—2022年间，云南省边境地区年均报告突发公共卫生事件41起，事件级别以一般（Ⅳ级）为主，死亡主要发生在较大（Ⅲ级）事件。一方面提示云南省边境地区突发公共卫生事件持续高发，需要持续关注、采取有效措施积极预防；另一方面说明云南省边境地区突发公共卫生事件监测系统具有一定的敏感性，能够及时发现并报告事件。
2012—2022年云南省边境地区报告的传染病类突发公共卫生事件主要以新冠、流感、水痘等呼吸道传染病暴发疫情及登革热等蚊媒传播疾病暴发疫情为主，发病高峰期为6月和11月，与云南省总体突发公共卫生事件发生规律及以往研究一致[1-3]。提示以上病种具有季节高发、传播范围广、传播途径易于实现等特点，是边境地区疾病预防控制的工作重点。有研究发现，云南省边境地区法定传染病发病率在2009—2018年间呈明显的上升趋势[4]，建议持续加强重点疾病及传播媒介的监测预警和风险评估，做到苗头事件早发现早处置。
食物中毒是造成云南省边境地区突发公共卫生事件死亡的主要原因，其中以发生在夏季的有毒野生菌中毒、冬季的草乌中毒为主要死因，家庭为食物中毒发生的主要场所。提示应在事件高发季节来临前，通过宣传栏、微信公众号、电视、广播、定向短信等方式，在社区广泛开展安全食用野生菌、不食用有毒中草药进补等主题食品安全健康宣传教育，提高百姓食物安全意识，把好“入口”关，避免类似事件发生。
学校和社区/村庄是云南省边境地区传染病类突发事件发生的主要场所，其中以小学为主，主要为水痘、流感、手足口病、流腮等传染病暴发，与其他文献报道一致[5-6]。学校人员长时间高度聚集，低年龄段学生个人卫生习惯及防护意识相对薄弱，一旦传染源带入，极易导致聚集性疫情[7-8]。同时，因中小学学生处于知识探索的年龄阶段，易发生因好奇误食有毒有害动植物的中毒事件。学校应在疾控机构的指导下，根据学校易发传染病及突发公共卫生事件的流行特征，针对不同年龄段的学生群体，有的放矢开展健康监测、健康教育、强化疫苗接种等防控工作。发生在社区/村的事件以传染病暴发疫情为主，加强疫情监测，及时发现、隔离、治疗传染源，是控制事件的重要手段。
西双版纳州分别在2016和2020年发生过2起甲类传染病鼠疫引发的突发公共卫生事件，应予以高度关注，认真开展鼠密度、鼠蚤密度监测，严格落实灭鼠、灭蚤工作，有效降低鼠疫发生风险[9]。德宏州的芒市、陇川县、盈江县、瑞丽市及西双版纳州的景洪市是突发公共卫生事件报告起数、报告病例数较高的地区。以上重点地区应进一步加强疾控机构、医疗机构、教育部门、检验检疫部门等多部门间的信息沟通共享，进一步提高监测预警网络体系的敏感性，加强卫生应急能力建设，充分做好突发事件应对准备，及时发现事件苗头并有效处置。
云南省境外输入传染病输入种类多、数量大，主要以登革热、疟疾等急性传染病为主，4—7月为疟疾输入的高峰时段，7—11月为登革热输入的高峰时段，输入来源主要为缅甸[10-12]。云南省多次与周边国家通过会议等形式探讨跨境传染病联防联控做法，更倾向于关注结核病、艾滋病等专病的防控，且对提高边境民众自我防护意识的引导亦较少[13]，传染病跨境联防联控工作存在尚未形成政府主导的信息共享和应急处置联动机制，跨境传染病疫情监测、信息共享和应急处置联动无长期可持续的经费支持和政策保障，局部地区的成绩和经验得不到推广等问题[14]。境外输入传染病导致的突发公共卫生事件主要发生在瑞丽市、耿马县、镇康县等与缅甸接壤，边民交流频繁的地区，输入起数最多、输入后引发病例数最多病种的均为登革热。建议针对较常见的跨境输入传染病，特别是登革热、基孔肯雅热等输入后易导致本土暴发的病种，各重点地区疾控机构在加强监测预警的基础上，应从经费支持、装备配置、人员能力提升、健康宣教等方面不断加强突发公共卫生事件应急能力建设，做好跨境输入传染病应对处置准备。同时结合当地实际，积极争取与邻国合作，建立健全传染病跨境联防联控机制，加强信息沟通、技术交流和参观学习，推广成功经验，有效防控传染病跨境传播。
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2024年第51卷第21期
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doi: 10.20043/j.cnki.MPM.202406071
  • 接收时间：2024-06-07
  • 首发时间：2026-03-20
  • 出版时间：2024-11-10
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  • 收稿日期：2024-06-07
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    1.云南省疾病预防控制中心疫情监测/突发公共卫生事件处置中心，云南 昆明 650500
    2.云南省云南省疾病预防控制中心学校卫生所，云南 昆明 650500

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2种不同金属材料的力学参数
科
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Number of
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Number of
species		 占总种数比例
Percentage of
total species (%)		 属
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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