2006—2015年福建省漳州市肾综合征出血热流行病学分析

Epidemiological analysis of hemorrhagic fever with renal syndrome in Zhangzhou,China,2006-2015

目的分析福建省漳州市肾综合征出血热(HFRS)流行特征和发病风险,为疾病防控提供科学依据。方法整理和分析2006—2015年漳州市HFRS病例个案资料及宿主动物监测资料。结果 10年间,漳州市共报告HFRS 171例,死亡1例。年均发病率为0.352/10万,疫情呈上升趋势(χ^(trend^2)=58.60,P<0.01)。累计波及全市11县区70乡镇(56.00%),高发乡镇为华安县仙都镇、华丰镇,南靖县靖城镇,诏安县深桥镇、南诏镇。农村地区报告142例,职业以农民为主(79.58%),其中生猪养殖人员占该职业病例23.01%。病例报告单位集中在市级医院(86.55%),常见临床表现为发热、恶心、呕吐、腰疼、头疼、全身痛、少尿或无尿、眼睑浮肿等,血小板减少占72.67%,蛋白尿阳性83.09%。对比前后5年,病家屋内有鼠比例(80.49%,45.83%)明显下降,工作场所有鼠或鼠排泄物比例(60.98%,73.33%)一直较高。家栖鼠平均鼠密度为6.40%,鼠总带毒率7.42%,主要带病毒鼠种为褐家鼠,携带Ⅱ型汉城病毒。结论漳州市是HFRS家鼠型疫源地,近年整体上处于高度散发,部分县区呈现逐年上升的趋势,建议加大高发地区监测和防治力度,开展全市基层医疗机构HFRS诊疗培训。

In this study, we analyzed the data of hemorrhagic fever with renal syndrome （HFRS） and host animals monito- ring in Zhangzhou City, Fuiian Province, China, 2006-2015, in order to find out the epidemic situation and risk factors, and provide a scientific basis for the prevention and control strategy. A total of 171 HFRS cases, including 1 death, were reported in Zhangzhou in this decade. The incidence rate of 0. 352/105 showed an upward trend （χcrend2 =58. 60, P〈0.01）. And 70 villages and towns in 11 counties have affected, accounting for 56.00% of the counties in Zhangzhou City. The cases were mainly reported in some towns of Huaan, Nanjing and Zhaoan countries. The cases mainly occurred in countryside, which reported 142 cases. The cases in farmers accounted for the highest proportion （79.58 %）, and pig farming staff accounting for 23.01 in farmer cases. Most cases were reported in municipal hospitals （86. 55%）. The common clinical manifestations of those cases were fever, nausea, vomiting, backache, headache, pain, oliguria or anuria, eyelid edema and so on, with 72.67% of thrombocytopenia and of 83.09 % proteinuria positive. Compared with the proportion （80.49 % ） of mice in patients＇ house from 2006 to 2010, that （45.83%） from 2011 to 2015 decreased obviously; however, the proportion of mice or mice droppings in workplaces were rising from 60. 98% to 73.33%. Mean rodent density was 6. 4% and total infection rate in rats was 7.42%. The main kind of rats with virus infection was Rattus norvegicus, carrying Seoul virus II. Results of this study indicate that Zhang zhou is one of the loci of HFRS rodent, and the epidemic is rising in recent years, the overall in the highly distributed, while some counties showed a rising trend year by year. Thus, monitoring and control efforts in prone areas should be increased, and to carry out clinics training of HFRS in primary health care institutions.