一起聚集性肾综合征出血热疫情的流行病学调查及处置

Analysis of epidemiological investigation and disposal of a case in clusters of hemorrhagic fever with renal syndrome

目的对广州市发生的一起聚集性肾综合征出血热疫情的流行病学调查及处置进行分析,为完善防控方案提供依据。方法收集病例临床资料,开展现场流行病学调查;采用笼夜法和鼠迹法进行鼠密度调查;同时进行防鼠设施检查。结果 4例病例均为临床诊断病例,均有可疑鼠类间接接触史;聚集地无有效的防鼠设施。发生疫情后紧急灭鼠,灭鼠前鼠密度2.6,外环境路径指数为20,革螨感染率为28.6%;灭鼠后5~8月连续监测,鼠密度分别为1.0、2.0、2.0、2.2,路径指数分别为5、8、7、8,革螨感染率分别为0.0%、12.5%、10.0%、7.7%,恙螨感染率前后均为0.0%。结论处置后未再出现病例,说明防控措施得当;笼夜法测得鼠密度适中,鼠迹法测得鼠密度极高,提示需加强鼠的防控,探讨更有效的监测方法。

Objective To analyze the epidemiological investigation and treatment of an episode of epidemic hemorrhagic fever with renal syndrome in Guangzhou,and provide evidence for the improvement of prevention and control programs. Methods Collect clinical data of cases,conduct field epidemiological investigations; use rat cage method and rat trace method to conduct rat density surveys; and conduct rodent-proof facility inspections at the same time. Results All the 4 cases were clinically diagnosed cases,all of them had a history of indirect contact with suspicious rodents; there was no effective rodent protection facility in the gathering place. After the epidemic occurred,the rodent was extinguished. The mice had a density of 2. 6 before the rodent extermination,an outer environmental path index of 20,and a gegal infection rate of 28. 6%. The rodents were continuously monitored from the 5 th to the 8 th month after rodent control. The rat densities were 1. 0,2. 0,2. 0 and 2. 2 respectively. The path index was 5,8,7,8 respectively,and the infection rate of geese was 0. 0%,12. 5%,10. 0%,and 7. 7%,respectively. Before and after the infection rate was 0. 0%. Conclusion There were no recurrences of the cases after treatment,indicating that the control measures were appropriate; cage density was moderate when measured by the caged night method,and mouse density was extremely high when measured by the rat trace method,suggesting that the prevention and control of rats must be strengthened to explore more effective monitoring methods.