2018-2021年河南省信阳市1 461例发热伴血小板减少综合征流行特征及病原学监测

AnaIysis of the epidemioIogicaI and pathogenic characteristics of 1 461 cases of severe fever with thrombocytopenia syndrome in Xinyang of Henan,2018-2021

目的 分析2018-2021年河南省信阳市发热伴血小板减少综合征(severe fever with thrombocytopenia syndrome,SFTS)流行特征及病原学特点,为科学制定防控策略提供依据。方法 应用描述流行病学方法对信阳市2018-2021年SFTS监测资料进行分析。利用Excel 2010软件绘制SFTS病例县区分布图,收集病例急性期血清标本,应用实时荧光定量RT-PCR方法检测新布尼亚病毒(severe fever with thrombocytopenia syndrome bunyavirus,SFTSV)核酸,并对信阳市疾病预防控制中心(疾控中心)检测的样本进行分析。结果 2018-2021年信阳市共报告SFTS病例1 461例,确诊病例747例,死亡12例,病死率为1.61%。男性发病率(2.85/10万)低于女性(4.01/10万)(P<0.001);70~79岁人群高发,占32.49%;农民占95.48%。4-10月发病较多,5-7月出现第一个发病高峰,10月出现次高峰,发病在时间上存在集中趋势(P<0.001);病例主要集中在商城县、光山县、浉河区和平桥区,占78.64%。信阳市疾控中心检测的741例样本中,新布尼亚病毒阳性检出率为37.25%。结论 信阳市SFTS发病具有明显地域性和季节性,高龄女性农民为高危人群,SFTSV仍为主要致病病原。

Objective To analyze the epidemiological and pathogenic characteristics of severe fever with thrombocytopenia syndrome(SFTS) in Xinyang in 2018-2021,and provide reference for scientifically formulating prevention and control strategies.Methods Descriptive epidemiology was used to analyze the characteristics of SFTS in Xinyang in 2018-2021.Excel 2010 software was used to map the regional distribution of SFTS.The chi-square test was used to analyze the difference of rates.Patient sera were collected in the acute phase and were tested using real-time fluorescence RT-PCR,the samples tested by Xinyang Center for Disease Control and Prevention were analyzed.Results 1 461 cases were reported in Xinyang during 2018-2021.A total of 747 cases were confirmed,there were 12 lab-confirmed patients died,and the mortality rate was 1.61%.The incidence rate of males(2.85/105) was significantly slower than that of female(4.01/105)(P<0.001),70-79 year old was the high risk group,accounted for 32.49% of all cases,farmers accounted for 95.48% of all cases.Cases mainly occurred between April and October.Incidence peaked first from May to July and then in October.SFTS had central tendency in time distribution(P<0.001).Cases concentrated in Shangcheng county,Guangshan county,Shihe county and Pingqiao county,accounting for 78.64%.Among the 741 samples tested by Xinyang Center for Disease Control and Prevention,the positive rate for nucleic acid of severe fever with thrombocytopenia syndrome bunyavirus(SFTSV) was 37.25% in Xinyang during 2018-2021.Conclusion SFTS in Xinyang has obvious regional and seasonal characteristics.Elderly female farmers are at high risk of developing SFTS.SFTSV is still the main pathogen responsible for SFTS.