2004-2014年保定市肾综合征出血热疫情分析

Analysis of the prevalence of hemorrhagic fever with renal syndrome in Baoding from 2004 to 2014

目的分析保定市2004-2014年肾综合征出血热（Hemorrhagic Fever with Renal Syndrome,HFRS）的流行特征及变化趋势,为制定防控措施提供科学依据。方法利用＂中国疾病预防控制信息系统＂,检索保定市2004-2014年HFRS临床病例和实验室诊断病例,并采用描述流行病学方法进行统计分析;用夹夜法捕鼠,计算鼠密度及鼠种构成,对鼠肺进行汉坦病毒抗原抗体检测。结果保定市2004-2014年共报告HFRS病例465例,死亡3例,年发病率为0.38/10万。2004-2007年发病率呈下降趋势,2008-2014年波动上升。发病季节性显著,各地区发病差异有统计学意义（χ^2=9.46,P〈0.01）。男性发病337例（0.28/10万）,女性发病128例（0.10/10万）,男女比例为2.63∶1。0-80岁均有发病,但主要分布在20~60岁,共病379例,占81.45%。2004-2014年共布放鼠夹97 602只,捕获鼠2 424只,鼠密度为2.48%。其中,室外的平均鼠密度为4.23%,室内平均鼠密度为1.68%,差异有统计学意义（χ^2=8.86,P〈0.05）。2004-2014年的优势鼠种为黑线姬鼠（1004只,41.43%）、褐家鼠（779只,32.12%）和小家鼠（402只,16.57%）,共占总捕获量的90.12%。2004-2014年间平均带毒率为0.98%,抗体阳性率3.21%。结论保定市属于家鼠型为主的混合型疫区,近年来HFRS疫情呈明显上升趋势,提示HFRS有潜在流行趋势和暴发的可能。

Objective To analyze the epidemiological characteristics of and variations in the prevalence of hemorrhagic fever with renal syndrome（HFRS）in Baoding from 2004 to 2014in order to provide a scientific basis for prevention and control measures. Methods Clinical cases and laboratory diagnosed cases of HFRS in Baoding from 2004 to 2014were identified using the Chinese System for Information on Disease Control and Prevention,and descriptive epidemiology was used to statistically analyze the obtained data.Rodents were caught at night.The rodent density was calculated and species of rodents were determined.Rodent lungs were tested for the hantavirus antigen and antibodies against the hantavirus. Results There were a total of 465 cases of HFRS in Baoding from 2004 to 2014,with 3deaths.HFRS had an annual incidence of 0.38/100 000.There was a decline in morbidity from 2004 to 2007but a rise from 2008 to 2014.The seasonality of outbreaks and outbreaks in different regions differed significantly（χ^2=9.46,P〈0.01）.The sex ratio of patients with HFRS was 2.63：1（M：F）,and 81.45% of patients were age 20-60.The average rate at which rodents carried hantaviruses was 0.98%from 2004 to 2014.Of the captured rodents,3.21% had antibodies against hantaviruses and the average rodent density was 2.48%.Most of the rodents caught were Apodemus agrarius or Rattus norvegicus,and slightly more rodents were caught indoors rather than outdoors（χ^2=8.86,P〈0.05）. Conclusion Baoding is an area with multiple reservoirs of hantaviruses,with R.norvegicus being the primary hantavirus reservoir.Over the past few years,the incidence of HFRS has risen,indicating the potential for an outbreak or epidemic of HFRS.Greater attention should be paid to Baoyang and Boye counties.More comprehensive prevention and control measures should be implemented in key areas such as vaccination,rodent extermination,monitoring of outbreaks,improved laboratory diagnosis,and improved health education.