黄热病的防控研究进展

摘要

黄热病是一种经蚊媒传播的自然疫源性疾病,在历史上曾引起欧洲港口城市及美洲一些地区疫情的暴发,给人类社会造成巨大的灾难.上世纪40年代,投入可终身免疫的17D系列疫苗对暴发地区的人群进行大面积接种以来,该病一度出现沉寂状态.但自上世纪90年代初,该病又陆续在非洲、南美热带地区和国家暴发流行,病死人数甚至超过2014年在西非3国暴发流行的埃博拉热;特别是2016-2017年在安哥拉、刚果和巴西流行以来,已经夺走了数千人的生命;此外,2016年我国从安哥拉输入了11例病例,这是有史以来亚洲首见疫情,引起我国政府的高度重视.世界卫生组织(WHO)制定了2017-2026年消除黄热病流行的策略,其主要依据在于17D疫苗能够安全有效的控制本病的流行.蚊媒控制及疫苗预防接种,特别是对后者抱有很大期望,WHO的消除策略可能实现,但这需要有关国家强有力的执行保证,同时还需要各国共同遵守全球检疫条例的规定.为此,本文从历史及近期黄热病暴发流行的特点,结合预防接种简述了有关本病的的防控措施,期望WHO消除黄热病流行的策略能在2026年成功实现.%Yellow fever(YF) is a natural focal disease transmitted by infected mosquitoes,which had caused epidemic in some areas of Europe and America port city in the history,bringing great disaster to human society.Since 40s of last century,a series of derivative strain of 17D vaccines,providing lifelong protection,had been vaccinated a large population who are trave ling to or living in areas at risk for YF,which avoid the outbreak of the disease,appearing quiet state.Since the beginning of 1990s,the disease had outbreak successively in Africa,tropical American areas and its nations.The mortality was even more higher than Ebola happened in 3 countries in West Africa between 2014 and 2015.In 2016-2017the large outbreak in Angola,Congo and Brazil,has claimed thousands of lives.Yellow fever has never occurred in Asia until the introduction of 11 cases by jet travel from Angola to China,which attracted the attention of Chinese government.Yellow fever elimination initiative strategic plan for 2017 2026 was launched by WHO,mainly based on that 17D vaccine which is safe and effective to control the spread of this disease.The measures of controlling mosquitoes and vaccination programs,in particular putting great expectations for the latter,are the main measures for prevention the disease and achievement the goal of WHO elimination strategic plan.But strong guarantees of related countries and abiding by the provisions of the global quarantine regulations are also important.Therefore,this article reviews the historical and the recent epidemic outbreaks of yellow fever,vaccination and other prevention measures,hoping that the WHO elimination of the yellow fever epidemic strategy will achieve successfully in 2026.