浙江省2013年肾综合征出血热流行特征及监测分析

Analysis of epidemiological characteristics and surveillance of hemorrhagic fever with renal syndrome in Zhejiang province, China, 2013

目的分析浙江省2013年肾综合征出血热（HFRS）疫情及宿主种群分布和带病毒情况,为制定下一步防控措施提供科学依据。方法采用描述性流行病学方法分析HFRS疫情三间分布特征,在全省5个HFRS监测点采用夹夜法捕获鼠形动物,分别取其肺和血清,用免疫荧光法检测汉坦病毒抗原和抗体,分析浙江省鼠形动物种群分布及其带病毒情况。结果 2013年浙江省共报告HFRS病例527例,发病率为0.9622/10万,比2012年升高了3.89%,无死亡病例。病例主要集中在宁波、台州、绍兴、衢州、丽水等地区,全省除舟山市外各地级市均有病例报告;发病高峰时间主要集中在5-6月和12月前后;浙江省HFRS的高发人群为20~65岁年龄组,占发病总数的93.17%（491/527）;全省5个监测点鼠密度监测中共布放有效鼠夹13 785夹次,捕鼠546只,平均鼠密度为3.96%;共检测鼠血清678份,阳性80份,阳性率为11.80%;共检测鼠肺669份,阳性44份,带病毒率为6.58%,5个监测点HFRS抗体阳性率差异有统计学意义（χ2=30.962,P〈0.05）;HFRS病原携带率差异亦有统计学意义（χ2=9.83,P〈0.05）。结论 2013年浙江省HFRS疫情较2012年有上升趋势,宿主动物密度和带病毒率较高,需采取措施进行预防控制。

Objective To analyze the epidemic situation of hemorrhagic fever with renal syndrome（HFRS） and the population distribution and virus-carrying status of the hosts in Zhejiang province, China, in 2013, and to provide scientific evidences for establishing further prevention and control measures.MethodsThe descriptive epidemiological method was used to analyze the three-dimensional（time, region, and population） distribution of HFRS. Rodents were captured by nigh ttrapping in five HFRS monitoring points in Zhejiang province. Lung and serum samples were collected followed by detection of hantavirus antigen and antibody using an immunofluorescence assay, and the rodent population distribution and virus-carrying status in Zhejiang province were analyzed.ResultsA total of 527 HFRS cases were reported in 2013 in Zhejiang province. The incidence rate was 0.9622/100 000, resulting in a 3.89% increase compared with 2012, and no death was reported. The cases were mostly seen in five cities（Ningbo, Taizhou, Shaoxing, Quzhou and Lishui）, and all the prefectural level cities had cases reported except Zhoushan. There were two peaks of incidence, one in spring（May-June）and the other in winter（around December）. The high-risk age group of HFRS was between 20 and 65 years, accounting for 93.17% of the overall incidence rate（491/527）. A total of 13 785 effective traps were set in the five monitoring points, and 546 rodents were captured, so the average density of rodents was 3.96%. A total of 678 rodent serum samples were collected and 80 were positive（positive rate： 11.80%）. A total of 669 lung samples were collected and 44 were positive（positive rate：6.58%）. There were significant differences in the positive rate of HFRS antibody and the virus-carrying rate between the five HFRS monitoring points（χ2=30.962, P〈0.05 and χ2=9.83, P〈0.05, respectively）.Conclusion The incidence of HFRS in Zhejiang province in 2013 is on a rising trend compared with that in 2012, and the density of host animals and virus-carrying rate are both higher. Preventive measures should be taken into consideration to control the epidemic situation.