2011-2018年济南市发热伴血小板减少综合征发病热点及流行特征分析

The hot spot and epidemiological characteristics of severe fever with thrombocytopenia syndrome in Jinan in 2011-2018

目的描述2011-2018年济南市发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)发病热点地区,掌握其流行特征。方法利用济南市2011-2018年SFTS情报告资料,采用ArcGis 10.2进行街道/乡镇层级的热点扫描,并进行可视化展现;采用聚类分析、描述性流行病学方法分析流行特征。结果2011-2018年济南市累计报告SFTS 400例,年均发病率为0.69/10万,发病处于低流行状态,发病水平逐年增长;病例高度散在,主要分布在历城区、章丘区和长清区南部的部分乡镇,发病呈双峰分布,发病高峰期出现在5~9月,最高峰多出现在5月和8月,呈现明显的地域性和季节性特点;报告死亡病例54例,病死率13.50%。病例主要分布在50岁以上年龄组,占病例总数的89.75%(359/400);病例职业以农民为主,90.25%(361/400);热点乡镇、街道连接呈带状分布在南部丘陵山区。结论济南市SFTS防控形势严峻,应加强防病意识,早诊断,早治疗;50岁以上农民是发病高危人群,户外活动应做好个人防护;该病季节性明显,呈现典型的自然疫源性疾病的特点;南部的山区丘陵地区为热点的乡镇、街道,高发地区及周边都是防控的重点区域,应按照时空分布特征和高危人群采取相应的防控措施。

Objective To describe the hot spots and epidemiological characteristics of severe fever with thrombocytopenia syndrome(SFTS)in Jinan during 2011 and 2018.Methods Case reports of SFTS in Jinan from 2011 to 2018 were collected and analyzed using ArcGis 10.2 to show the hot spot in different villages and towns.Clustering analysis and descriptive epidemiological method were used for theepidemiological characteristics analysis.Results A total of 400 SFTS cases were reported with the average annual incidence of 0.69/100000 during the 8-year study period,which was at a low epidemic level,however,the incidence went up annually.The cases were highly sporadic and mainly from the southern part of Licheng,Zhangqiu and Changqing county.The disease seasonal peak occurred mostly from May to September,especially in May and August.54 dead cases were reported with the mortality of 13.50%.Of the reported cases,89.75%were over 50 years old and 90.25%were farmers.The hot spots were like a ribbon distributed in the hilly and mountainous areas in the south of the city.Conclusions The incidence of SFTS in Jinan is increasing.Most cases are farmers over 50 years old and occur from May to September and from mountainous and hilly areas in the south part of Jinan,indicating that SFTS is a natural infectious disease.Preventive measures should be adopted in hot spot areas and high risky population to control the disease.