2012-2013年河南省发热伴血小板减少综合征流行特征及病原学监测分析

Analysis of the epidemiological and pathogenic characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Henan Province of China,2012-2013

目的分析2012-2013年河南省发热伴血小板减少综合征（SFTS）流行特征及病原学特点。方法应用描述流行病学方法分析河南省201242013年SFTS病例特征，利用PHGIS1．7．0软件绘制SFTS地区分布图，采用时间分布曲线结合圆形分布法分析SFTS季节性分布特征。收集病例急性期血清标本，应用实时荧光定量RT—PCR检测发热伴血小板减少综合征布尼亚病毒（SFTSV）核酸。结果2012～2013年河南省共报告SFTS病例1225例，确诊病例年均发病率为0．2948／10万。死亡18例，病死率为1．47％。信阳市报告病例1210例，占98．78％。病例主要集中在4～10月，5月份出现第1个发病高峰，9月份出现第2个发病高峰；2年间SFTS总的流行高峰期为4月23日～8月18日，SFTS发病在时间上存在集中趋势（Z=nr2=441．00，P〈0．01）。男性发病率0．4869／10万，女性发病率为0．8292／10万，差异有统计学意义（χ2=84．35，P〈0．01）。病例年龄1～93岁，平均59岁，其中40～79岁年龄组占病例总数的90．29％。农民1172例，占病例总数的95．67％。本省医疗机构共报告SFTS1207例，占病例总数的98．53％；三级医院、二级医院和一级医院分别占报告机构总数的60．87％、30．43％和8．70％。2012和2013年SFTSV检测阳性率为57．14％和50．87％，差异无统计学意义（χ2=3．21，P〉0．05）。结论河南省SFTS发病具有明显的地域性和季节性，发病范围有扩大趋势。高龄女性农民为高危人群，SFTSV仍为主要致病病原。

Objective To analyze the epidemiologieal and pathogenic characteristics of severe fever with thrombocytopenia syndrome （SFTS） in Henan Province from 2012--2013. Methods Descriptive epidemiology was used to analyze the characteristics of SFTS in Henan Province from 2012--2013. PHGIS1.7.0 software was used to map the regional distri bution of SFTS. Seasonal distribution was analyzed with a time distribution curve and circular distribution. Patient sera were collected in the acute phase and were tested using real-time fluorescence RT-PCR. Results There were 1 225 cases of SFTS reported in Henan Province from 2012--2013. The average yearly incidence of lab-confirmed cases was 0. 2948 per 100 000. Eighteen patients died, indicating a fatality rate of 1.47%. There were 1 210 cases reported in Xinyang, accounting for 98.78% of the reported cases. Cases mainly occurred between April and October. Incidence peaked first in May and then in SeptemBer. From 2012--2013, the incidence of SFTS peaked from April 23rd to August 18th , and cases tended to be concentrated throughout the period SFTS was prevalent （Z= nr2 = 441.00, P〈0.01）. SFTS was less prevalent in men （0. 4869 per 100 000） than in women （0. 8292 per 100 000）, and the difference in prevalence was statistically significant （χ2= 84.35, P〈0.01）. The ages of patients ranged from 1 to 93 years. The average patient age was 59 years, and 90.29% of patients were between ages 40 and 79. The vast majority of patients with SFTS were farmers （1 172 patients, 95.67%）. The vast majority of cases of SFTS in Henan Province were reported by medical facilities （1 207 cases, 98.53 %）. Among the reporting bodies, tertiary hospitals reported 60.87 % of cases, secondary hospitals reported 30.43%, and primary hospitals reported 8. 700/00. Individuals tested positive for SFTSV at a rate of 57.14% in 2012 and at a rate of 50.87%/oo in 2013, and the difference in that rate was not statistically significant （χ2 =3.21, P〈0.07）. Conclusion SFTS in Henan Province has obvious regional and seasonal characteristics. The range of SFTS is expanding. Elderly female farmers are at risk of developing SFTS. SFTSV is still the main pathogen responsible for SFTS.