2008-2020年河北省秦皇岛市昌黎县肾综合征出血热流行病学特征分析

Epidemiological characteristics of hemorrhagic fever with renal syndromes in Changli county of Qinhuangdao, Hebei,2008–2020

目的 掌握昌黎县肾综合征出血热(HFRS)疫情流行特征和变化趋势,为制定针对性的预防控制措施提供依据。方法 收集中国传染病监测信息系统报告的2008—2020年昌黎县HFRS病例信息,用描述流行病学方法对HFRS疫情资料进行统计分析。结果 2008—2020年河北省秦皇岛市昌黎县共报告HFRS病例577例,年均发病率为7.93/10万,死亡2例,病死率为0.35%。发病率位前5个乡镇分别是靖安镇(14.03/10万)、刘台庄镇(13.11/10万)、茹荷镇(12.82/10万)、团林乡(12.15/10万)和泥井镇(11.18/10万)。按地理位置划分的4个区域累计病例数从高到低依次为西北部(244例)、东北部(193例)、东南部(84例)和西南部(56例)。病例居住地聚集性分析显示,有40个村/社区累计病例数在3例及以上,其中27个、9个和4个村/社区的累计病例数分别在3例、4例和5例及以上。2011年发病率最高(21.64/10万)。年发病中位数为28例,高峰月的发病中位数为5例。3—4月为发病高峰月。男女性别比为2.41∶1。发病年龄为2~92岁;以35~65岁年龄组发病最多,占发病总数的73.14%(422/577)。病例职业分类以农民为主,占发病总数的86.14%(497/577),其次是学生(4.51%)和工人(2.25%)。结论 秦皇岛市昌黎县HFRS发病水平较高;青壮年农民和中学生为高发人群;高发地区为西北部和东北部乡镇。有40个村/社区为病例聚集居住地。建议对病例聚集地开展鼠类监测研究;每年在春节前开展统一大规模灭鼠行动,并对高发人群进行健康教育和疫苗接种,以降低本地区HFRS发病风险。

Objective To understand the epidemiological characteristics and trends of hemorrhagic fever with renal syndrome(HFRS) in Changli county, Qinhuangdao of Hebei province, and provide evidence basis for the development of targeted prevention and control measures. Methods The incidence data of HFRS in Changli from 2008 to 2020 were collected for a descriptive epidemiological analysis. Results A total of 577 cases of HFRS were reported from 2008 to 2020in Changli, with an annual incidence of 7.93/100 000. There were two deaths with a case fatality rate of 0.35%. The top 5townships with high incidences were Jing’an(14.03/100 000), Liutaizhuang(13.11/100 000), Ruhe(12.82/100 000), Tuanlin(12.15/100 000) and Nijing(11.18/100 000). The cumulative case number was highest in northwestern area(244 cases),followed by northeastern area(193 cases), southeastern area(84 cases) and southwestern area(56 cases). Cluster analysis on cases showed that 40 villages/communities had more than 3 cases accumulatively, in which 27, 9 and 4 villages/communities had accumulative case numbers of 3, 4 and 5, respectively. The incidence was highest in 2011(21.64/100 000). The median of annual case number was 28 and the median of case number in peak month was 5. The incidence peaked in March and April.The male to female ratio of the cases was 2.41∶1. The age of the cases ranged from 2 years to 92 years. Most cases occurred in the age group 35–65 years, accounting for 73.14%(422/577) of the total cases. In the HFRS cases, farmers accounted for86.14%(497/577), followed by students(4.51%) and workers(2.25%). Conclusion The incidence of HFRS was high in Changli. Young and middle-aged farmers and middle school students were at high risk. The highest incidence was in the northwestern and northeastern townships. There were 40 villages/communities where HFRS cases occurred. It is suggested to carry out surveillance on rodents in the cluster areas of HFRS cases. To reduce the risk of HFRS, a unified large-scale antirodent campaign should be carried out before the Spring Festival every year, and health education and vaccination should be conducted for high-risk population.