深圳市流行性出血热流行病学研究

Epidemiological Study on Hemorrhagic Fever with Renal Syndrome in Shenzhen

目的 为监测深圳市流行性出血热疫情及影响发病的因素 ,了解疫源地的分布特征、鼠类及其体表昆虫种群。方法 利用现有监测网络采集全市HFRS疫情 ,采用病例对照研究方法分析影响发病的主要因素。结果 1999～ 2 0 0 0年均发病率 0 10 /10万。分布 :福田区占 81 81% ;1～ 4月占 81 81% ;暂住人口占 63 63 % ,男女比为 10∶1。住临时棚舍 ( χ2 =10 12 ,OR =16)、住处鼠多 ( χ2 =4 5 1,OR =12 )有统计学意义。共获鼠 62 5只 ,捕获率 11 0 7% ,分 2目 2科 4属 11种 ,其中褐家鼠 3 68只 ,占 5 8 88%。鼠汉坦病毒抗原阳性率为0 81% ,抗体阳性率为 7 17% ,GMT为 1∶5 4 4 5。阳性鼠肺和血清全部来自褐家鼠 ,感染率为 10 81% ,带毒率为 1 3 7%。布吉疫点人血清阳性率为 3 2 5 % ,正常人群汉坦病毒抗体阳性率为 0。鼠带蜱、蚤、革螨、恙螨率分别是 7 0 2 % ,10 0 6% ,17 0 8% ,7 4 0 % ,指数分别是 0 16,0 3 3 ,0 86,1 2 8,主要宿主分别是施氏屋顶鼠、黄胸鼠、黄毛鼠、施氏屋顶鼠。蚤分 3属3种 ,印鼠客蚤占 98 5 6%。蜱分 2属 2种 ,粒形硬蜱占87 2 9%。革螨分 2属 3种 ,毒厉螨占 91 94 %。恙螨分 4属 6种 ,西沙无前恙螨占 2 7 12 %。结论 深圳广泛存在家鼠型流行性出血热疫源地 ,属低发病区 。

Objective To investigate the distribution of cases with Hemorrhagic Fever with Renal Syndrome(HFRS),murine-like animals and related insects and to explore the determinants of the disease.Methods The data of HFRS were collected from the cases reporting system in Shenzhen.The risk factors were analysed by case-control study.Results The morbidity rate was 0.10 pre 100 000 from 1999 to 2000.Shenzhen Futian district 81.8%,temporary populatoin occuppied 63.63%?The ratio of male to female is 10∶1.Eighty one point eighty one percent occured in Janary to April.Associations were observed between the outdoor living (χ 2=10.12,OR=16),high density of mice around the living places(χ 2=4.51,OR=12),there exited stastical significance.Six hundred and twenty-five murine-like animals captured were indentified to 11 species,of 58.88% of which were Rattus norvegicus.The positive rate of Hantavirus antigen was 0.81%,the positive rate of antibody was 7.17%,GMT of the antibody was 1∶54.45.The rate of infection is 10.81%,and the positive rate of the antigen to HFRS was 1.37%.All positive samples were from Rattus norvegicus.The rates of mouse carrying tick,flea,gamasid,jigger were 7.02%,10.06%,17.08%,7.40% respectively.The main host was R.sladen,R.flavipectus,R.losea,R.sladen respectively.Flea was Xenopsylla cheopis.Tick was identified to 2 species belonging to 2 genera,87.21% was Ixodes granulatus.Gamasid was identified to 3 species belonging to 2 genera,91.94% was Laelaps echidninus.Jigger was identified to 6 species belonging to 4 genera,27.21% was Walchis Xishacnsis.Conclusion There are rattus-related HFRS epidemic foci in Shenzhen,which belongs to lower morbidity district.