2010—2017年黄冈市发热伴血小板减少综合征流行特征分析

Analysis of epidemiological characteristics on cases of severe fever with thrombocytopenia syndrome in Huanggang(2010-2017)

目的分析黄冈市发热伴血小板减少综合征(SFTS)的流行特征及其影响因素,为制定科学的防控措施提供依据。方法采用描述性流行病学方法对2010—2017年黄冈市SFTS疫情数据和流行病学调查数据进行分析。结果 2010—2017年黄冈市累计报告SFTS病例1 210例,死亡85例,报告发病率总体呈上升趋势(趋势χ~2=206.84,P=0.00),病例主要集中在黄冈市北部山区。96.03%的病例发生在4～10月份。发病年龄集中在45～74岁,女性发病率高于男性(χ~2=9.62,P=0.00);男性SFTS病死率高于女性(χ~2=5.18,P=0.02)。80.9%的病例是农民。病例从发病到确诊上报平均时间间隔20.6d。年龄大的病例较年龄小的病例死亡率高(χ~2=3.59,P=0.00)。死亡病例在皮肤出现瘀斑瘀点、呕血、眼结膜充血的发生率明显高于存活病例(χ~2_(瘀点瘀斑)=9.95,P=0.00;χ~2_(呕血)=5.15,P=0.02;χ~2_(眼结膜充血)=12.33,P=0.00)。发生的一起聚集性疫情中患者3最可能是接触患者2的血液和分泌物而感染。结论应重点加强山区SFTS防控工作,提高医务人员早期识别和诊断能力,降低病死率;加强宣教,提高公众特别是农牧民自我防护意识和能力;同时,应加强山区农民生产生活环境蜱等媒介的密度控制工作。

Objective To investigate the epidemiological characteristics and influential factors of severe fever with thrombocytopenia syndrome(SFTS) I Huanggang City, and provide scientific basis for the development of prevention and control measures. Methods Descriptive epidemiological methods were used to analyze the data of SFTS in Huanggang during 2010-2017. Results A total of 1 210 SFTS cases and 85 deaths were reported in Huanggang during 2010-2017. The reported incidence was generally on the rise(trend χ^2=206.84, P=0.00)and the cases were mainly in the northern mountainous area of Huanggang City. 96.03% of the cases mainly occurred between April and October. The age of onset was concentrated in the 45-74 years old group, and the incidence rate of females was higher than that of males (χ^2=9.62, P=0.00). The mortality rate of male SFTS was higher than that of females (χ^2= 5.18, P=0.02). 80.9% of the patients were farmers. The average time interval from onset to final diagnosis was 20.6 days. Older cases had a higher mortality rate than younger cases (χ^2=3.59, P=0.00). The incidence of ecchymosis on the skin, hematemesis and conjunctival congestion of death cases was significantly higher than that of surviving cases(χ ecchymosis on the skin 2=9.95, P=0.00;χ hematemesis 2=5.15, P=0.02;χ conjunctival congestion 2=12.33, P=0.00). In the case of a clustering epidemic, the patient 3 was most likely to be exposed to the blood and secretions of the patient 2 and become infected. Conclusion It is critical to strengthen the prevention and control of SFTS in mountainous areas, and improve the ability of medical personnel to identify and diagnose SFTS at the earliest stage to reduce the mortality rate. It is necessary to strengthen publicity and education to promote the self-protection awareness and ability of the public, especially farmers and herdsmen. At the same time, the density control of medium of tick in the living environment of mountain farmers should be strengthened.