湖南省肾综合征出血热监测研究

Monitoring study on hemorrhagic fever with renal syndrome(HFRS) in Hunan Province

目的了解2002-2005年湖南省肾综合征出血热流行特征和流行趋势,以制定针对性防制措施。方法采用描述流行病学研究方法进行疫情分析;在5个监测点,采集健康人群血清进行隐性感染率调查,以夹夜法在室内外捕获小兽,以免疫荧光法(DFA、IFA)和酶联免疫吸附实验(ELISA)检测汉坦病毒(HV)抗原、抗体,并用单克隆抗体分型;对实验大鼠进行质量监测,对疑似病例进行动态IgM、IgG抗体检测。结果全省2002-2005年发病呈下降趋势,主要发病在11月至次年1月,低峰处于8～9月,高发区为湘潭市、长沙市、邵阳市、怀化市和益阳市;青壮年男性农民为主要发病者,男女发病率之比为2.05∶1,临床疑似病例实验室确诊率为26.84%;兽间疫情调查表明,总鼠密度为3.4%,室外为3.31%,室内为3.59%,黑线姬鼠是野外的优势宿主,褐家鼠是室内的优势宿主,监测点间捕获率、带毒率差异有统计学意义,其中黑线姬鼠主要携带Ⅰ型汉坦病毒,褐家鼠主要携带Ⅱ型汉坦病毒;健康人群的隐性感染率为5.88%;实验大鼠HV抗体阳性率为1.72%。结论湖南省为混合型的肾综合征出血热疫区,为有效控制肾综合征出血热应加强监测和预防措施,加强灭鼠和预防接种。

Objective The present study was conducted to find out the epidemiological characteristics and tendency of hemorrhagic fever with renal syndrome （HFRS） during the years from 2002 to 2005 in Hunan Province, so as to formulate specific pertinent prevention and control measures. Methods Descriptive epidemiologic methods were used to analyze the epidemic situation： at the 5 monitoring sites, the blood serum samples of healthy people were collected to investigate the covert infections; the night trapping method was used to capture the indoor and outdoor small animals; the HV antigens and antibodies were examined by immunofluorescence assay （DFA, IFA） and enzyme-linked immunosorbent assay （ELISA）, and they were classified by monoclonal antibody; the quality monitoring was conducted to the laboratory rats; and the suspected cases received examinations of dynamic HV-IgG/IgM antibodies. Results During the years from 2002 to 2005, the incidence of HFRS declined significantly in Hunan Province. And HFRS concentrated from November to the following January, and the lower peak was at August and September. There were high incidences in Xiangtan, Changsha City, Shaoyang City, Yiyang and Huaihua City; the cases were mainly young male farmers, and the sex ratio of the incidence was 2.05：1. The laboratory positive rate of suspected cases was 26.84%. The interanimaI investigation showed that the total density of rats was 3.4%, with indoor density 3.31% and outdoor 3.59%; Apodemus agrarius was advantageous host in the field while rattus norvegicus was advantageous host indoor. The differences of the capture rates and viruliferous rate at the monitoring sites were of statistical significance. Apodemus agrarius mainly carries Hantavirus Ⅰ and Rattus norvegicus mainly carries Hantavirus Ⅱ. The covert rate of healthy populations was 5.88%. And the positive rate of HV antibodies of laboratory rats was 1.72%. Conclusion Hunan Province is a mixed type of hemorrhagic fever with renal syndrome （HFRS） epidemic area. To effectively prevent and control the disease of hemorrhagic fever with renal syndrome （HFRS）, the monitoring and prevention measures should be reinforced and the deratization and preventive inoculation work should be strengthened.