【摘要】： 目的:了解SARS的流行病學(xué)規(guī)律,發(fā)現(xiàn)在不同時間對SARS實施不同控制措施(主要是擴大疑似病例的處理范圍和限制人口自由流動)的作用和效果,確立SARS在人群中的擴散趨勢得到有效控制的判別標準、超級傳播者在SARS傳播中的作用及SARS的控制策略等問題。 方法:本文采用2002年10月至2003年5月間我國發(fā)生SARS的疫情數(shù)據(jù),在對中國SARS流行病學(xué)系統(tǒng)分析結(jié)論的基礎(chǔ)上,應(yīng)用系統(tǒng)動力學(xué)的思想、理論和方法,建立了中國SARS流行病學(xué)系統(tǒng)動態(tài)反饋仿真模型,并在此基礎(chǔ)上對不同控制措施的效果進行了比較,對北京市和廣東省兩個主要疫區(qū)各種控制措施進行了仿真分析,在回答上述問題的基礎(chǔ)上,最后給出了中國SARS的防控策略及防控效果評價標準。 結(jié)果與討論: 1.通過仿真分析得出在SARS發(fā)病早期必須同時采用“擴大疑似病例的處理范圍”和“限制人口自由流動”兩種措施,才能有效抑制SARS的擴散;當病人的平均自由散毒時間低于10天以下時,此時控制的重點應(yīng)放在加強擴大疑似病人的隔離范圍上,這樣才能有效降低SARS的擴散速度并減輕經(jīng)濟影響。另外,還給出了兩種控制措施對SARS控制效果的影響及SARS的擴散趨勢是否被抑制住的判斷標準等。 2.通過對廣東省SARS真實發(fā)病情況的仿真分析發(fā)現(xiàn):SARS病毒存在變異,主要反應(yīng)在SARS傳出廣東省之后,SARS病人的傳染概率在原有的7.33%基礎(chǔ)上平均增強了4.8%左右;限制人口流動和擴大疑似病人隔離范圍兩項控制有延遲效應(yīng),分別為15天和20天左右;超級傳播者并不能改變SARS的傳播趨勢,只是增加了發(fā)病數(shù)量,延長了SARS病的控制時間;廣東省在SARS控制方面主要是在后期采取了擴大疑似病人的隔離范圍控制住了疫情,媒體在限制人口流動方面起了主要作用。另外,本文還給出了SARS控制效果判別標準及防控方案優(yōu)化標準。 3.通過對北京市SARS真實發(fā)病情況的仿真分析發(fā)現(xiàn):在SARS病毒的毒力處于高峰期,北京SARS得到快速有效控制一個重要經(jīng)驗是北京在SARS出現(xiàn)早期同時加強了擴大疑似病人隔離范圍和限制人口流動兩種控制措施,但在SARS發(fā)生全過程中不斷加強限制人口流動這一做法并不是最優(yōu)控制策略;限制人口流動和擴大疑似病人隔離范圍兩項控制有延遲效應(yīng),分別為15天和21天左右;另外本文還給出了當SARS病人的傳染概率處于高峰期時,SARS控制效果判別標準及防控方案優(yōu)化標準。 這些結(jié)論不僅對SARS防控方案的優(yōu)化非常重要,而且所建立的模型及其仿真實現(xiàn)技術(shù)對其他疫病的流行病學(xué)及防控策略研究都具有廣泛的普適性意義。
[Abstract]:Objective: to understand the epidemiological law of SARS, and to find out the effect of different control measures on SARS at different times (mainly to expand the treatment range of suspected cases and limit the free movement of population). The criteria for the effective control of the diffusion trend of SARS in the population, the role of super communicators in the spread of SARS and the control strategy of SARS are established. Methods: the epidemic data of SARS in China from October 2002 to May 2003 were used. Based on the results of systematic analysis of SARS epidemiology in China, the ideas, theories and methods of system dynamics were applied. The dynamic feedback simulation model of SARS epidemiology system in China was established, and the effects of different control measures were compared, and various control measures in two major epidemic areas of Beijing and Guangdong were simulated and analyzed. On the basis of answering the above questions, the prevention and control strategy and the evaluation criteria for the control effect of SARS in China are given. Results and discussions: 1. Through simulation analysis, it is concluded that in the early stage of SARS, two measures must be adopted at the same time: "enlarging the scope of treatment of suspected cases" and "restricting the free flow of population" in order to effectively suppress the spread of SARS. When the average free spreading time of patients is less than 10 days, the focus of control should be on strengthening the isolation of suspected patients, so as to effectively reduce the diffusion rate of SARS and reduce the economic impact. In addition, the influence of two kinds of control measures on the control effect of SARS and the criterion of whether the diffusion trend of SARS is restrained or not are given. 2. Through the simulation analysis of the true incidence of SARS in Guangdong Province, it was found that there was a variation of the SARS virus, and the infection probability of the patients with SARS increased by about 4.8% on the basis of the original 7.33% after the SARS was transmitted to Guangdong Province. Limiting population flow and expanding the isolation range of suspected patients had delayed effects, which were about 15 days and 20 days respectively. Super communicators could not change the transmission trend of SARS, but only increased the number of cases and prolonged the control time of SARS disease. In Guangdong Province, the SARS control was mainly carried out in the later stage to expand the isolation of suspected patients to control the epidemic, and the media played a major role in restricting population mobility. In addition, the criterion of SARS control effect and the optimization standard of prevention and control scheme are also given in this paper. 3. Based on the simulation analysis of the true incidence of SARS in Beijing, it is found that the virulence of SARS virus is at its peak. An important lesson of Beijing SARS's rapid and effective control is that at the same time Beijing strengthened its control measures to expand the scope of suspected patient isolation and restrict population mobility in the early stages of SARS. However, it is not the optimal control strategy to strengthen the restriction of population mobility during the whole process of SARS, and the two controls, restricting population flow and expanding the scope of suspected patient isolation, have delayed effects, which are about 15 days and 21 days, respectively. In addition, the criteria for judging the effectiveness of SARS control and optimizing the control scheme are given when the transmission probability of SARS patients is in the peak period. These conclusions are not only very important for the optimization of SARS prevention and control scheme, but also have extensive universal significance for the epidemiology and control strategy research of other epidemic diseases.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2008
【分類號】：R181.3

【引證文獻】

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2 陳之強;突發(fā)公共衛(wèi)生事件擴散演化機理及協(xié)同應(yīng)急管理機制研究[D];西南交通大學(xué);2011年

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本文編號：2173991