湖北省2016-2021年蜱传传染病流行病学特征分析

Epidemiological characteristics of tick-borne infectious diseases in Hubei Province,2016-2021

目的了解2016-2021年湖北省蜱传传染病流行病学特征并进行重症和死亡危险因素分析。方法基于2016-2021年报告的发热伴血小板减少综合征、恙虫病、斑疹伤寒等蜱传传染病个案数据,分析流行病学特征。现场调查2021年高发地区报告蜱传传染病病例,开展人群特征、流行病学史等因素logistic回归分析,探索重症和死亡危险因素。结合现场媒介调查,开展病例家庭及周边草地游离蜱和宿主动物体表蜱监测和检测。结果2016-2021年湖北省共报告蜱传传染病病例3826例,其中发热伴血小板减少综合征病例占71.30%(2728/3826),恙虫病病例占13.04%(499/3826),斑疹伤寒病例占15.66%(599/3826)。6年累计死亡44例,病死率为1.15%(44/3826)。发病高峰为5-7月,农民占84.61%(3237/3826)。女性发病率高于男性,≥50岁病例占81.02%(3100/3826),且发病率随年龄增加呈上升趋势(P<0.001)。报告蜱传传染病病例地区分布涉及16个城市,86个县(区),不同地区发病率差异有统计学意义(P<0.05),高发地区病例存在一定的时空聚集性和范围不断扩大趋势。现场捕获微小牛蜱和长角血蜱,宿主动物和草地蜱阳性检出率分别为10.94%(7/64)和40.00%(2/5)。单因素logistic分析结果显示,年龄≥50岁和白细胞计数<2.0×109/L是蜱传疾病病例发生重症和死亡的危险因素。结论湖北省报告的蜱传传染病主要为发热伴血小板减少综合征、恙虫病和斑疹伤寒。蜱传传染病重点防治对象为年龄≥50岁的女性,高发流行期要减少野外暴露和蜱叮咬。

Objective To understand the epidemiological characteristics of tick-borne infectious diseases(TBID)and the risk factors of severe illness and death in Hubei Province from 2016 to 2021.Methods Based on the incidence data of fever with thrombocytopenia syndrome(SFTS),tsutsugamushi disease,typhus and other TBID reported during 2016-2021,the epidemiological analysis was conducted.Field investigation results of TBID in areas with high incidence in 2021,logistic regression analysis of population characteristics,epidemiological history and other factors were used to explore the risk factors of severe and fatal cases.In the field vector investigation,free ticks and surface ticks of the host animals in the cases'home and surrounding grassland were monitored and detected.Results A total of 3826 TBID cases were reported in Hubei from 2016 to 2021,of which 71.30%(2728/3826)were SFTS,13.04%(499/3826)were tsutsugamushi disease and 15.66%(599/3826)were typhus.A total of 44 cases died in 6 years;the fatality rate was 1.15%(44/3826).In the peak seasons of incidence from May to July,the cases in people engaged in agriculture related work accounted for 84.61%(3237/3826).The incidence rate in women was higher than that in men,and the cases aged≥50 years accounted for 81.02%of the total(3100/3826),and the incidence rate increased with age(P<0.001).The TBID cases were distributed in 86 counties and districts in 16 prefectures(municipality).The incidence rates of different areas had significant differences(P<0.05),and there was a certain spatial-temporal clustering and expasion.Bovis microplus and Haemaphysalis longicornis were captured in the field,and the positive rates in host animals and grassland ticks were 10.94%(7/64)and 40.00%(2/5),respectively.Univariate logistic regression analysis results showed that age≥50 years and leukocyte<2.0×109/L were risk factors for severe illness and death.Conclusions The TBID reported in Hubei were mainly SFTS,tsutsugamushi disease and typhus.In order to reduce the incidence of TBID,it is necessary to strengthen the prevention and control in women aged≥50 years and reduce field exposure and tick bites during the epidemic period.