2009-2019年湖南省肾综合征出血热病例及宿主动物监测分析

Surveillance results of cases of hemorrhagic fever with renal syndrome and host animals in Hunan Province,2009-2019

目的掌握湖南省肾综合征出血热病例的流行特征和临床特点,为防治工作提供参考依据。方法采用描述性流行病学方法分析2009-2019年湖南省肾综合征出血热病例临床和流行病学特征以及宿主动物监测情况。结果2009-2019年湖南省共报告肾综合征出血热病例7001例,年均报告发病率为0.95/10万。患者以男性青壮年农民为主,各市州病例发病日期距离就诊日期中位数集中在3~5 d,就诊日期距离诊断日期中位数集中在0~2 d。病例症状以轻型、中型为主(82.45%)。临床症状和体征以发热(93.49%)、乏力(91.57%)、起病急(85.39%)等多见。相关暴露因素中,主要有鼠或鼠排泄物接触史。2009-2019年各监测点平均鼠密度为3.22%,室内鼠密度3.47%高于野外(1.77%,χ^(2)=648.794,P=0.000)。鼠肺标本HFRS总抗原阳性率1.75%,4个监测点HFRS的抗原阳性率差异有统计学意义(χ^(2)=29.445,P=0.000),双峰县鼠病毒携带率最高,邵东县鼠病毒携带率最低。结论近年来湖南省出血热疫情出现上升趋势,汉城型和汉滩型混合分布,患者临床表现不典型,就诊不够及时,需要加强健康教育工作,提高民众自我保护和及时就诊意识。

This study aimed to determine the epidemiological and clinical characteristics of hemorrhagic fever with renal syndrome in Hunan Province,and to provide a basis for disease prevention and control efforts.Descriptive epidemiological methods were used to analyze the surveillance results of cases of hemorrhagic fever with renal syndrome and host animals in Hunan Province in 2009-2019.A total of 7001 HFRS cases were reported during the period,with an average annual incidence of 0.95/100000.Most cases involved young male farmers.The median time between the date of onset and the date of visit was 3-5 days,and that between the date of visit and the date of diagnosis was 2 days.Most cases had mild or moderate clinical classification(82.45%).The major clinical symptoms and signs were fever(93.49%),fatigue(91.57%)and acute onset(85.39%).Most patients had a history of exposure to rats or rat excreta.From 2009 to 2019,the average rodent density was 3.22%.The density of rodents indoors was 3.47%higher than that in the wild(1.77%)(χ^(2)=648.794,P=0.000).The positive rate of antigen of rodent lung samples was 1.75%.A significant difference was observed in the positivity rate of antigen of rodent lung samples in the four monitoring points(χ^(2)=29.445,P=0.000).The highest virus-carrying rate was found in Shuangfeng county,and the lowest was found in Shaodong County.In recent years,the epidemic situation of hemorrhagic fever has increased in Hunan Province.Both Seoul virus and Hantaan virus are distributed in the region.The clinical characteristics of the patients are not typical of medical consultations and are not identified in a timely manner.Health education efforts should be reinforced to improve self-protection awareness among the public.