北京市恙虫病发病时空扫描分析及感染危险因素研究

Study on space-time cluster detection and infection risk factors of scrub typhus in Beijing

目的分析北京市恙虫病感染高危人群——农民在秋季农业劳作中的感染危险因素,根据分析结果有针对性地开展健康教育和调整防控措施。方法对病例开展面对面问卷调查,采用EpiData 3.0软件建立数据库,采用SPSS 16.0软件分析北京农民恙虫病病例流行病学特征,并通过时空扫描分析了解病例的时空分布特征和发病聚集性热点区域,采用描述流行病学的方法初步探讨患者的感染来源。结果 2008—2014年北京市累计报告330名农民恙虫病病例,病例潜伏期内主要接触了玉米(46.97%,155/330)、桃(35.45%,117/330)、豆角(10.00%,33/330)等农作物。时空扫描结果显示,病例发病时间集中在每年10月份,病例最可能聚集区域为平谷区平谷镇、东高村镇、大兴庄镇和兴谷街道、滨河街道。结论北京市恙虫病病例多为农民,农民在发病前21天内接触的农作物种类居前3位的分别为玉米、桃和豆角。在做好病例监测的基础上,可考虑流行期内在疾病高发区域,在农民活动较多的作物地及周边布点,采集恙虫,做媒介监测和病原携带状况检测,明确疫情形势和变化趋势。

[Objective]To analyze the risk factors of scrub typhus infection among high risk population（farmers） during autumn agricultural labor in Beijing,carry out the health education,and adjust prevention and control measures according to the analysis results.[Methods]Face-to-face questionnaire survey was performed.Epidata 3.0 software was used to establish database,and SPSS16.0 software was used to describe the epidemiological features of the scrub typhus cases among farmers in Beijing.The temporal and spatial distribution characteristics,and clustered area of the scrub typhus cases were analyzed by space-time cluster detection.The sources of infection were explored by descriptive epidemiological method.[Results]A total of 330 farmer cases infected with scrub typhus were reported in Beijing from 2008-2014.During the latent period,the patients have been exposed to the crops of corn（46.97%,155/330）,peach（35.45%,117/330） and snap bean（10.00%,33/330）.The space-time cluster detection showed that the peak season appeared in October,and the possible clustered areas of the scrub typhus cases were Pinggu Town,Donggaocun Town,Daxingzhuang Town,Xinggu sub-district,and Binhe sub-district in Pinggu District.[Conclusion]Most of the scrub typhus cases are farmer in Beijing,and the top three crops which the patients have been exposed to within 21 days before onset are corn,peach,and snap bean.On the basis of case surveillance,it is necessary to capture the vectors in the high-risk areas during the peak period,to carry out the surveillance of intermediary agent and detection of pathogen carrying status,to get the message of the epidemic situation and the changing trend.