2009-2014年承德市肾综合征出血热流行特征分析

Epidemiology of hemorrhagic fever with renal syndrome in Chengde city from 2009 to 2014

目的分析2009-2014年承德市肾综合征出血热（hemorrhagic fever with renal syndrome,HFRS）监测资料,描述承德市HFRS流行特征和变化趋势,为疾病的防控提供依据。方法对承德市2009-2014年HFRS病例资料及宿主动物监测资料,采用描述性流行病学方法进行分析。结果 2009-2014年承德市共报告HFRS病例137例,死亡4例,平均发病率为0.64/10万,病死率为2.92%。2009年以后发病率呈逐年上升趋势,至2012年达到高峰,随后逐渐下降,但始终保持在低发水平。病例主要集中在双桥区、丰宁县、宽城县和承德县,占报告病例总数的71.53%。各月均有病例报告,以3~6月最多,占报告病例总数的55.47%。发病年龄主要集中在25~59岁之间,占病例总数的75.91%。男女性别比为2.81∶1,男女发病差异有统计学意义（Z=5.56,P〈0.01）。发病人群以农民为主,占病例总数的62.04%。2009-2013年间未检出鼠肺带毒,2014年鼠带毒率为6.93%,均为宅区褐家鼠带毒。结论承德市HFRS疫区以家鼠型为主。对高发地区加强监测,强化疫苗接种和防鼠灭鼠工作,是控制疫情的有效措施。

Objective To analyze the epidemiologic and surveillance data of hemorrhagic fever with renal syndrome（ HFRS） for the past few years in Chengde city,to describe the epidemiology and trend of HFRS,and provide evidence for HFRS prevention and control. Method Descriptive epidemiology methods were used to analyze the surveillance data of HFRS from 2009 to2014. Results A total of 137 cases and 4 death cases were reported in Chengde city during that period. Mobidity and case fatality rate were 0. 64 /100 000 and 2. 92% respectively from 2009 to 2014. After 2009,it showed an upward trend year by year,reaching the peak in 2012,then gradually decreased,but remained at low levels. Of all cases,71. 53% were distributed in Shuangqiao District and Fengning county and Kuancheng county and Chengde county. Each month had a case report,with the largest number of 36 months,accounting for 55. 47% of the total number of cases. The patients＇ ages range from 25 to 59 years old,occupying 75. 91%. The proportion of men to women was 2. 81∶ 1. The difference between male and female was statistically significant（ Z = 5. 56,P 0. 01）. The majority of patients were farmers,accounting for 62. 04% of the total number of cases. No virus lungs of rats were observed from 2009 to 2013. The virus carrying rate was 6. 93%,for the residential area of Rattus norvegicus infected. Conclusion The HFRS epidemic presents that Chengde city was the Rattus dominant epidemic area. In the high incidence area the need to strengthen the monitoring,strengthening vaccination and deratization work,are effective measures to control the epidemic.