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公共卫生的法律层面:巴西在控制病媒传播疾病和人畜共患病方面的困难。

Legal aspects of public health: difficulties in controlling vector-borne and zoonotic diseases in Brazil.

作者信息

Mendes Marcílio S, de Moraes Josué

机构信息

Legislative Department, R. João Gonçalves, 604, 07010-000 Guarulhos, SP, Brazil.

Legislative Department, R. João Gonçalves, 604, 07010-000 Guarulhos, SP, Brazil; Research Center for Neglected Diseases, Faculty of Science of Guarulhos (FACIG/UNIESP), Av. Guarulhos, 1844, 07025-000 Guarulhos, SP, Brazil.

出版信息

Acta Trop. 2014 Nov;139:84-7. doi: 10.1016/j.actatropica.2014.07.008. Epub 2014 Jul 19.

Abstract

In recent years, vector-borne and zoonotic diseases have become a major challenge for public health. Dengue fever and leptospirosis are the most important communicable diseases in Brazil based on their prevalence and the healthy life years lost from disability. The primary strategy for preventing human exposure to these diseases is effective insect and rodent control in and around the home. However, health authorities have difficulties in controlling vector-borne and zoonotic diseases because residents often refuse access to their homes. This study discusses aspects related to the activities performed by Brazilian health authorities to combat vector-borne and zoonotic diseases, particularly difficulties in relation to the legal aspect, which often impede the quick and effective actions of these professionals. How might it be possible to reconcile the need to preserve public health and the rule on the inviolability of the home, especially in the case of abandoned properties or illegal residents and the refusal of residents to allow the health authority access? Do residents have the right to hinder the performance of health workers even in the face of a significant and visible focus of disease transmission? This paper argues that a comprehensive legal plan aimed at the control of invasive vector-borne and zoonotic diseases including synanthropic animals of public health importance should be considered. In addition, this paper aims to bridge the gap between lawyers and public health professionals and to facilitate communication between them.

摘要

近年来,媒介传播疾病和人畜共患病已成为公共卫生领域的一项重大挑战。基于登革热和钩端螺旋体病的患病率以及因残疾而损失的健康生命年数,这两种疾病是巴西最重要的传染病。预防人类接触这些疾病的主要策略是在家庭及其周边有效控制昆虫和啮齿动物。然而,卫生当局在控制媒介传播疾病和人畜共患病方面存在困难,因为居民常常拒绝其进入家中。本研究讨论了巴西卫生当局为抗击媒介传播疾病和人畜共患病所开展活动的相关方面,特别是在法律方面遇到的困难,这些困难常常阻碍这些专业人员迅速有效地采取行动。如何在保护公众健康的需求与住宅不可侵犯规则之间取得平衡,尤其是在废弃房产或非法居住者以及居民拒绝卫生当局进入的情况下?即使面对明显的重大疾病传播源,居民是否有权阻碍卫生工作者开展工作?本文认为,应考虑制定一项全面的法律计划,以控制包括具有公共卫生重要性的共生动物在内的侵入性媒介传播疾病和人畜共患病。此外,本文旨在弥合律师与公共卫生专业人员之间的差距,并促进他们之间的沟通。

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