2012—2018年浙江省天台县发热伴血小板减少综合征流行特征分析

Epidemiological characteristics analysis on severe fever with thrombocytopenia syndrome in Tiantai County of Zhejiang Province,2012-2018

【目的】分析浙江省天台县2012—2018年发热伴血小板减少综合征(SFTS)的发病特点及流行特征,为该病的预防控制提供依据。【方法】收集整理天台县2012—2018年SFTS病例个案数据,采用描述性流行病学方法对病例进行流行病学特征分析。【结果】2012—2018年天台县共报告SFTS病例44例,发病率为1.62/10万;死亡病例6例,病死率为13.64%。SFTS病例发病高峰为5—8月;36例(81.82%)病例分布在3个乡镇,流行区域呈山区丘陵向平原地区延伸趋势;发病人群以中老年和农民为主。16例病例有明确蜱叮咬史;发生1起聚集性疫情,2例病例为夫妻关系。病例的临床表现以发热、乏力、头痛、全身酸痛、畏寒、食欲减退、恶心、呕吐、腹泻等症状为主。29例(65.91%)病例在初次就诊时选择乡镇卫生院或村卫生室;18例(40.91%)病例经过至少3次就诊后被诊断报告。死亡病例的发病到就诊时间和就诊到诊断时间均长于存活病例。【结论】天台县SFTS发病及流行范围呈逐年上升和扩大趋势,具有明显的季节性和地域性特征,中老年农民是主要的高危人群,加强个人预防意识和提高医疗机构发现诊断能力对该病的防控有重要意义。

[Objective]To analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome(SFTS)in Tiantai County,Zhejiang Province from 2012 to 2018,and to provide basis for the prevention and control of this disease.[Methods]Data on SFTS cases in Tiantai County from 2012 to 2018 were collected and analyzed for the epidemiological characteristics by descriptive epidemiological methods.[Results]A total of 44 SFTS cases which included 6 deaths were reported in Tiantai County from 2012 to 2018.The peak incidence of SFTS cases was concentrated from May to August.Thirty six cases(81.82%)were distributed in three townships,and the epidemic areas showed the trend of extending from mountainous hills to the plains.Most of the infected cases were middle and old age farmers.Sixteen cases had a clear history of tick bites.A cluster of epidemics occurred,2 of which were husband-and-wife relationships caused by joint exposure.The clinical manifestations were mainly fever,fatigue,headache,body aches,chills,loss of appetite,nausea,vomiting and diarrhea.Twenty-nine cases(65.91%)were at their first visit diagnosed and treated in township hospitals or village clinics and 18 cases(40.91%)diagnosed and reported after at least three visits.And for death cases,their intervals of time were both longer from onset to medical visit or from visit to diagnosis as compared with the survival cases.[Conclusion]Most SFTS cases are the middle and old aged people living in hills and mountain areas of Tiantai County,with a significant regional and seasonal distribution.Strengthening the awareness of prevention and improving the ability of medical institutions to early diagnose is of great significance for the prevention and control of this disease.