2000-2005年浙江省台州市肾综合征出血热监测研究

Surveillance of hemorrhagic fever with renal syndrome(HFRS) in Taizhou City from 2000 to 2005

目的探索浙江省台州市肾综合征出血热（HFRS）流行特征，为制定防治对策提供依据。方法采用描述流行病学、现场调查、实验室病原学、血清学方法。结果2000-2005年浙江省台州市HFRS年均发病率为3．63／10万（4．50／10万-2．64／10万），年均死亡率为0．02／10万，病死率为0．42％；发病主要分布在天台、临海、椒江等三个县市区，占病例总数的73．43％，12．62％个次乡（镇）报告病例数占总发病数的46．33％。各年均出现冬春季和夏秋季两个高峰，属姬鼠型为主的混合疫区；以壮年、老年农民发病居多，占86．54％，健康人群隐性感染率为1．98％。5年监测野外总鼠密度为4．61％；黑线姬鼠捕获率3．59％，居民区总密度为2．67％，褐家鼠捕鼠率为1．99％，黑线姬鼠和褐家鼠分别为野外和居民区的优势鼠种。带毒率17．00％（0．90％-36．40％），带毒鼠指数0．02-0．14，平均为0．08。结论2000—2005年台州市HFRS发病率呈现明显的下降趋势，仍需加强重点疫区重点人群的HFRS防治，姬鼠型为主的混合疫区宜选用双价疫苗进行预防接种。

Objective This study was designed to explore the epidemic characteristics of hemorrhagic fever renal syndrome （HFRS） for providing dada for the formulation of stratigies for its prevention and treatment. Methods Epidemiology, field survey, laboratory etiology and serology were used in the analysis. Results The incidence rate of HFRS were 3.63/lakh （4.50/lakh-2.64/lakh）, average annual mortality 0.02/lakh thousand and case fatality rate 0.42% in Talzhou from 2000 to 2005. Cases of HFRS were mainly distributed in Tiantai, LinHai and Jiaojiang County, accounting for 73.43% of the cases in the whole city, while 12.62% burgh had 46.33% of the cases. Epidemic peaks were observed in periods of winter to spring and summer to autumn in mixed-type infectious area, where Apodenmus agrarius played the dominant role. Peasants at prime of life and at older age made up the major group of the infected, incidence rate 86.54% .The sub-clinical infection rate of healthy people in the epidemic area was 1.98%. In the five years＇ animal surveillance, the total outdoor mouse density was 4.61%, capture rate of Apodenmus agrarius 3.59%, while the indoor density was 2.67% and density of Rattus norvegicus 1.99%, the predominant species of mouse being Rattus norvegicus and Apodenmus agrarius in residential areas. The HV carring rate of the mice was 17.00% （0.90%- 36.40%）, and index of HV carders was 0.02-0.14, averagely 0.08. Conclusion The incidence rate of HFRS presents an obvious declining trend in Taizhou from 2000 to 2005. HFRS prevention and control in main areas should be strengthened. Double-value united vaccine can be used for vaccination in mixed-type epidemic areas dominated by Apodenmus agrarius.