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气象灾害后韩国的水源性和食源性疾病发病情况。

Incidences of Waterborne and Foodborne Diseases After Meteorologic Disasters in South Korea.

机构信息

Department of Preventive Medicine and Public Health, School of Medicine, Ajou University, Suwon, Korea.

Department of Ecology Research, ChungNam Institute, Gongju, Korea.

出版信息

Ann Glob Health. 2016 Sep-Oct;82(5):848-857. doi: 10.1016/j.aogh.2016.10.007.

Abstract

BACKGROUND

Climate change could increase the number of regions affected by meteorologic disasters. Meteorologic disasters can increase the risk of infectious disease outbreaks, including waterborne and foodborne diseases. Although many outbreaks of waterborne diseases after single disasters have been analyzed, there have not been sufficient studies reporting comprehensive analyses of cases occurring during long-term surveillance after multiple disasters, which could provide evidence of whether meteorologic disasters cause infectious disease outbreaks.

OBJECTIVES

This study aimed to assess the nationwide short-term changes in waterborne and foodborne disease incidences after a meteorologic disaster.

METHODS

We analyzed cases after all 65 floods and typhoons between 2001 and 2009 using the Korean National Emergency Management Agency's reports. Based on these data, we compared the weekly incidences of Vibrio vulnificus septicemia (VVS), shigellosis, typhoid fever, and paratyphoid fever before, during, and after the disasters, using multivariate Poisson regression models. We also analyzed the interactions between disaster characteristics and the relative risk of each disease.

FINDINGS

Compared with predisaster incidences, the incidences of VVS and shigellosis were 2.49-fold (95% confidence interval, 1.47-4.22) and 3.10-fold (95% confidence interval, 1.21-7.92) higher, respectively, the second week after the disaster. The incidences of VVS and shigellosis peaked the second week postdisaster and subsequently decreased. The risks of typhoid and paratyphoid fever did not significantly increase throughout the 4 weeks postdisaster. The daily average precipitation interacted with VVS and shigellosis incidences, whereas disaster type only interacted with VVS incidence patterns.

CONCLUSIONS

The incidences of VVS and shigellosis were associated with meteorologic disasters, and disaster characteristics were associated with the disease incidence patterns postdisaster. These findings provide important comprehensive evidence to develop and support policies for managing and protecting public health after meteorologic disasters.

摘要

背景

气候变化可能会增加受气象灾害影响的地区数量。气象灾害会增加传染病爆发的风险,包括水传播和食物传播疾病。尽管已经分析了许多单一灾害后水传播疾病的爆发,但还没有足够的研究报告综合分析多次灾害后长期监测期间发生的病例,这些研究可能为气象灾害是否会引发传染病爆发提供证据。

目的

本研究旨在评估气象灾害后水传播和食物传播疾病的全国短期变化。

方法

我们使用韩国国家灾害管理局的报告分析了 2001 年至 2009 年间发生的 65 次洪水和台风事件后的病例。基于这些数据,我们使用多变量泊松回归模型比较了灾害前、灾害中和灾害后每周的创伤弧菌败血症(VVS)、志贺氏菌病、伤寒和副伤寒发病率。我们还分析了灾害特征与每种疾病的相对风险之间的相互作用。

结果

与灾害前的发病率相比,VVS 和志贺氏菌病的发病率分别在灾害后第二周上升了 2.49 倍(95%置信区间,1.47-4.22)和 3.10 倍(95%置信区间,1.21-7.92)。VVS 和志贺氏菌病的发病率在灾害后第二周达到峰值,随后逐渐下降。伤寒和副伤寒的风险在灾害后 4 周内没有显著增加。日平均降水量与 VVS 和志贺氏菌病的发病率相互作用,而灾害类型仅与 VVS 的发病率模式相互作用。

结论

VVS 和志贺氏菌病的发病率与气象灾害有关,灾害特征与灾害后疾病发病率模式有关。这些发现为制定和支持气象灾害后管理和保护公共卫生的政策提供了重要的综合证据。

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