地震后遇難者的尸體處置與傳染病預防的系統評價_《中國循證醫學雜志》

作者：

康德英 , 洪旗 , 李幼平 , 胡丹 , 衛茂玲

四川大學華西臨床醫學院循證醫學與臨床流行病學教研室（成都?610041）;

關鍵詞：

地震尸體處置傳染病系統評價

DOI：

10.7507/1672-2531.20080131

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背景與目的 　全球近20年因地震死亡數十萬人，震后大量遇難者尸體是否會造成大面積傳染病爆發一直是全球關注的熱點問題。本研究旨在通過全面檢索、收集相關文獻，系統評價全球近20年重大地震災害后有關遇難者尸體處理及傳染病控制的方法及效果，以期為遇難者尸體的科學處置提供當前最佳證據。
方法　制定檢索策略，在MEDLINE、Cochrane圖書館、CNKI與WHO網站上檢索并納入1988～2007年期間地震后尸體處置與傳染病控制的中英文全文文獻。采用臨床流行病學方法嚴格評價納入文獻。
結果　有關地震后遇難者尸體處理與傳染病爆發的研究文獻數量少，且多為描述性研究。本次評價共納入10篇文獻，包括2篇述評、4篇綜述和4個技術報告。文獻分析結果表明，災后傳染病爆發主要與災民異地安置的衛生條件、人口密度、飲水與食品安全及基本衛生設施有關，尚無證據表明傳染病爆發與尸體有關。現場尸體處置人員應做好自身防護措施。
結論　“地震后遇難者尸體會成為疾病的傳染源”是一誤區，建議政府部門應將尸體處置原則、模式納入應急機制與現場救助手冊。同時應強化對媒體、公眾的健康教育，消除誤區。

引用本文： 康德英,洪旗,李幼平,胡丹,衛茂玲. 地震后遇難者的尸體處置與傳染病預防的系統評價. 中國循證醫學雜志, 2008, 08(8): 575-580. doi: 10.7507/1672-2531.20080131 復制

1.	Watson JT, Gayer M, Connolly MA. Epidemics after natural disasters. Emerg Infect Dis, 2007, 13(1): 1-5.
2.	Communicable disease risk assessment and interventions Sichuan earthquake: the People’s Republic of China May 2008. http://www.who.int/diseasecontrol_emergencies/RA_China_Publication.pdf.Accessed June 28, 2008.
3.	Morgan O. Infectious disease risks of dead bodies following natural disasters. Rev Panam Salud Publica, 2004, 15(5): 307-312.
4.	Morgan OW, Sribanditmongkol P, Perera C, et al. Mass Fatality Management Following the South Asian Tsunami Disaster: Case Studies in Thailand, Indonesia and Sri Lanka. PLoS Med, 2006, 3(6): e195.
5.	Kirkis EJ. A myth too tough to die: the dead of disasters cause epidemics of disease. Am J Infect Control, 2006, 34(6): 331-334.
6.	Aavitsland P. [Dead bodies are not contagious] Tidsskr Nor Laegeforen. 2005, 125(6):713.
7.	Gionis TA, Wecht CH, Marshall LW Jr, et al. Dead bodies, disasters, and the myths about them: is public health law misinformed? Am J Disaster Med, 2007, 2(4): 173-188.
8.	Nathalie Floret. Negligible Risk for Epidemics after Geophysical Disasters. Emerging Infectious Diseases, 2006, 12(4): 543-548.
9.	Morgan O, de Ville de Goyet C. Dispelling disaster myths about dead bodies and disease: the role of scientific evidence and the media. Rev Panam Salud Publica, 2005, 18(1): 33-36.
10.	WHO/PAHO/ICRC. Management of Dead Bodies after Disasters: A Field Manual for First Responders. WHO/PAHO/ICRC,Washington D.C., 2006: 1-58.
11.	WHO/PAHO. Management of dead bodies in disaster situations (Disaster Manuals and Guidelines on Disasters Series, No. 5).Washington, D.C., 2004.
12.	WHO/ROSEA. Disposal dead bodies in emergency conditions, WHO/SEARO technical notes for emergency, Technical notes No.8: 1-4, 2004.
13.	WHO. Mortuary service and handling of the dead. WHO. Environmental Health In Emergencies And Disasters, 2002, Chapter 14: 198-201.
14.	de Ville de Goyet, Claude. Epidemics caused by dead bodies: a disaster myth that does not want to die. Rev Panam Salud Publica, 2004, 15(5): 297-299.
15.	Claude de Ville de Goyet. Stop propagating disaster myths. Lancet, 2000, 356(9231): 762-764.

1. Watson JT, Gayer M, Connolly MA. Epidemics after natural disasters. Emerg Infect Dis, 2007, 13(1): 1-5.
2. Communicable disease risk assessment and interventions Sichuan earthquake: the People’s Republic of China May 2008. http://www.who.int/diseasecontrol_emergencies/RA_China_Publication.pdf.Accessed June 28, 2008.
3. Morgan O. Infectious disease risks of dead bodies following natural disasters. Rev Panam Salud Publica, 2004, 15(5): 307-312.
4. Morgan OW, Sribanditmongkol P, Perera C, et al. Mass Fatality Management Following the South Asian Tsunami Disaster: Case Studies in Thailand, Indonesia and Sri Lanka. PLoS Med, 2006, 3(6): e195.
5. Kirkis EJ. A myth too tough to die: the dead of disasters cause epidemics of disease. Am J Infect Control, 2006, 34(6): 331-334.
6. Aavitsland P. [Dead bodies are not contagious] Tidsskr Nor Laegeforen. 2005, 125(6):713.
7. Gionis TA, Wecht CH, Marshall LW Jr, et al. Dead bodies, disasters, and the myths about them: is public health law misinformed? Am J Disaster Med, 2007, 2(4): 173-188.
8. Nathalie Floret. Negligible Risk for Epidemics after Geophysical Disasters. Emerging Infectious Diseases, 2006, 12(4): 543-548.
9. Morgan O, de Ville de Goyet C. Dispelling disaster myths about dead bodies and disease: the role of scientific evidence and the media. Rev Panam Salud Publica, 2005, 18(1): 33-36.
10. WHO/PAHO/ICRC. Management of Dead Bodies after Disasters: A Field Manual for First Responders. WHO/PAHO/ICRC,Washington D.C., 2006: 1-58.
11. WHO/PAHO. Management of dead bodies in disaster situations (Disaster Manuals and Guidelines on Disasters Series, No. 5).Washington, D.C., 2004.
12. WHO/ROSEA. Disposal dead bodies in emergency conditions, WHO/SEARO technical notes for emergency, Technical notes No.8: 1-4, 2004.
13. WHO. Mortuary service and handling of the dead. WHO. Environmental Health In Emergencies And Disasters, 2002, Chapter 14: 198-201.
14. de Ville de Goyet, Claude. Epidemics caused by dead bodies: a disaster myth that does not want to die. Rev Panam Salud Publica, 2004, 15(5): 297-299.
15. Claude de Ville de Goyet. Stop propagating disaster myths. Lancet, 2000, 356(9231): 762-764.

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地震后遇難者的尸體處置與傳染病預防的系統評價

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《中國循證醫學雜志》

地震后遇難者的尸體處置與傳染病預防的系統評價

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