浙西地区肾综合征出血热40年防制

Study on the Epidemiological Charactristics of Hemorrhagic Fever of Renal Syndrome in Western Area of Zhejiang Province for 40 Years

目的 分析监测数据，提出防制策略。方法 描述性流行病学方法分析疫情，调查宿主动物，用直接免疫荧光法检测肾综合征出血热（HFRS）抗原，用间接免疫荧光法检测特异性IgG抗体。结果 40年来浙西衢州市共发生HFRS18070例，死亡271例，年均发病率为20．71／10万，病死率为1．50％。20世纪60～70年代呈低发病率、高病死率，80～90年代则为发病率很高，病死率下降。进入21世纪后则呈低发病率、低死亡率。以开化县发病数最多。全年均有发病，其中4～6月和11月至翌年1月病例较多。发病以15～54岁人群为主，占发病总数的93．47％；职业以农民为主，占74．28％；男女比例2．3：1。病例的临床诊断符合率为62．66％；健康人群隐性感染率为5．20％。鼠类带病毒率为6．33％，血清阳性率5．32％；鸭血清阳性率23．26％。野外以黑线姬鼠为优势鼠种，其次为褐家鼠；室内以褐家鼠为优势鼠种。现场研究疫苗人群保护率达100％。结论 需对HFRS疫区加强监测与预防。

Objective To study the epidemiological charactristics of hemorrhagic fever of renal syndrome （HFRS） in western area of Zhejiang province, and make the measures targeting HFRS prevence. Methods Animal hosts in surveillant area were investigated. The serum of the patients and rodents were collected to test by immunofluorescence assay（IFA）. Analysing virus carried rate of rodents by fluorescent antibody（FA）. Results 18 070 cases were reported from 1965 to 2004 in western area of Zhejiang province, and the annual incident rate is 20.71/100,000. 271 patients died and the fatality rate is 1.50 %. HFRS was primarily a disease of the male peasants of the youth adults occurring predominantly. Most infections happened in November to January next year and April to June. The serum positive rate of patients is 62.66 %. Apodemus agrarius and Rattus norvegicus are the main type of species rodents, The virus carried rate of rodents is 6.33 %. Conclusion We still need enhance surveillance and prevention to control the HFRS.