1976-2013年四川省高县钩端螺旋体病流行特征分析

Epidemiological Characteristics of Leptospirosis in Gaoxian County of Sichuan Province,1976-2013

目的了解四川省高县钩端螺旋体病（钩体病）流行特征,为制定控制策略提供科学依据。方法采用描述性流行病学方法对1976-2013年高县钩体病疫情报告及其相关资料进行分析。结果 1976-2013年累计发病3 814例,死亡16例,年均死亡率和发病率为0.09/10万和21.42/10万,年均发病率经趋势卡方检验,χ2=604.74,P〈0.01。1976-1983年发病率波动在5.39/10万~38.10/10万之间,年均发病率为27.63/10万;1984-1993年发病呈现3次暴发流行,发病率波动在7.55/10万~169.95/10万之间,年均发病率为58.43/10万;1994-2013年发病率波动在0.21/10万~7.84/10万之间,年均发病率为1.34/10万。发病主要集中在8~10月,占病例总数的94.87%,流行形式以稻田型为主,流行菌群以黄疸出血群为主。病例集中在10~34岁,年均发病率为66.05/10万,男女病例性别比2.63∶1,职业主要集中在农民,其次是学生分别占总病例数的77.66%和14.55%。结论四川省高县钩体病年均发病率呈现逐年下降趋势,提示钩体病综合防治措施成效显著。8~10月为高发季节,男性发病高于女性,10~35岁的农民和学生是高危人群。

Objective To understand the epidemiological characteristics of leptospirosis in Gaoxian county,Sichuan Province and to provide scientific basis for formulating control strategies. Methods With descriptive epidemiology,cases of leptospirosis reported in Gaoxian during 1976-2013 and relevant data were analyzed.Methods During the period in Gaoxian,3814 cases were reported in total,with 16 deaths. The average mortality rate and incidence were respectively 0. 09 /105 and 21. 42 /105. The annual average incidence showed statistical differences（ χ2= 604. 74,P 0. 01）. During 1976-1983,the incidence fluctuated between 5. 39-38. 10 /105,with an annual average incidence of 27. 63 /105. Three outbreaks occurred during 1984-1993 and the incidence fluctuated between 7. 55-169. 95 /105,with the annual average incidence of 58. 43 /105.During 1994-2013,the incidence rate fluctuated between 0. 21-7. 84 /105 and the average annual incidence was 1. 34 /105. The peak-incidence season was in Aug. to Oct. of the year,in which the reported cases accounted for 94. 87% of the total. The gender ratio of male： female was 2. 63： 1. Occupational distribution was mainly peasants（ 77. 66%）,followed by students（ 14. 55%）. Conclusion The annual incidence of leptospirosis is on an decreasing trend as a whole,indicating that the comprehensive control measures is outstanding effective. The peak-season is Aug. to Oct and the vulnerable populations are males,10-35 peasants and students.