Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation ...Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation of HFRS in China.Data sources Reviews and papers published in Chinese journals, relevant to the objectives, written or collected by the author; and the research work of the author.Study selection An outline was drafted according to the purpose given a bove, and the relevant materials and data were grouped together into different i tems outlined.Data extraction All the materials and data extracted were published or specially assessed.Results HFRS was first recognized in the northeastern China in 1931. It has been found prevalent also in many other parts of China since 1955, and p resently, 28 out of 31 provinces (autonomous regions, or municipalities) have b een proved to be its endemic areas. The total number of cases is 1?256?431 from 1950 to 1997, with 44?304 death (3.53%). 50-100 thousands of cases co uld be registered annually since 1981 when the presence of the Rattus type HFRS wa s first identified serologically in China, with the highest peak in 1986 ( 115 ?985 cases). Three types of endemicity have been differentiated: the Apodemus type, the Rattus type and the mixed type of the two, by their peculiar season al distributions of cases and by methods of serotyping (HI, MAbs serotyping kits ). The epidemiologic features of the Rattus type HFRS are quite different from that of the Apodemus type. 67 species of vertebrates were found to harbor hanta virus antigen or antibodies, but the chief or primary reservoir hosts are A podemus agrarius and Rattus norveg icus only. Besides the commonly recognized enzootic mode of transmission (via co ntact s with the reservoir rodents or their excreta), mite transmission (including cer tain species of gamasid mites, and chigger mites) has been identified as the po tential vectors and reservoir hosts with HFRS. Vertical transmission had been fo un d in pregnant patients with HFRS, and in all three chief host rodents (Apodemus agr arius, Rattus norvegicus, the laboratory rats). The relatively high inapparent i nfection rates in the population of endemic areas of the Rattus type HFRS afte r big outbreaks (8%-20%) are suggested to play a significant role in the gradual decl ine of the incidence of HFRS in that areas. Three kinds of inactivated vaccines ag ainst HFRS (the golden hamster kidney cell vaccine, the Mongolian gerbil kidney cell vaccine and the purified suckling mouse brain vaccine) have been successive ly developed and proved highly effective in the prevention of HFRS. Conclusion Chinese workers on the epidemiology and prevention of HFRS i n China have accomplished great achievements since 1981. As the relatively high annu al incidence of HFRS sustained in recent years, control measures have to be reen forced. Many problems of HFRS and hantavirus infections are still not well under stood or unclear, such as the poly host nature, and the multi modes of transmi ssion, the natural history of hantaviruses and their genetic variation occurred in nature etc. The task for effective control of HFRS and the research on its ep idemiology in China should be held on a high priority.展开更多
文摘Purpose To summarize the major achievements of Chinese work on the epid emiology and prevention of hemorrhagic fever with renal syndrome (HFRS) in recen t years, and to give a general review on the present situation of HFRS in China.Data sources Reviews and papers published in Chinese journals, relevant to the objectives, written or collected by the author; and the research work of the author.Study selection An outline was drafted according to the purpose given a bove, and the relevant materials and data were grouped together into different i tems outlined.Data extraction All the materials and data extracted were published or specially assessed.Results HFRS was first recognized in the northeastern China in 1931. It has been found prevalent also in many other parts of China since 1955, and p resently, 28 out of 31 provinces (autonomous regions, or municipalities) have b een proved to be its endemic areas. The total number of cases is 1?256?431 from 1950 to 1997, with 44?304 death (3.53%). 50-100 thousands of cases co uld be registered annually since 1981 when the presence of the Rattus type HFRS wa s first identified serologically in China, with the highest peak in 1986 ( 115 ?985 cases). Three types of endemicity have been differentiated: the Apodemus type, the Rattus type and the mixed type of the two, by their peculiar season al distributions of cases and by methods of serotyping (HI, MAbs serotyping kits ). The epidemiologic features of the Rattus type HFRS are quite different from that of the Apodemus type. 67 species of vertebrates were found to harbor hanta virus antigen or antibodies, but the chief or primary reservoir hosts are A podemus agrarius and Rattus norveg icus only. Besides the commonly recognized enzootic mode of transmission (via co ntact s with the reservoir rodents or their excreta), mite transmission (including cer tain species of gamasid mites, and chigger mites) has been identified as the po tential vectors and reservoir hosts with HFRS. Vertical transmission had been fo un d in pregnant patients with HFRS, and in all three chief host rodents (Apodemus agr arius, Rattus norvegicus, the laboratory rats). The relatively high inapparent i nfection rates in the population of endemic areas of the Rattus type HFRS afte r big outbreaks (8%-20%) are suggested to play a significant role in the gradual decl ine of the incidence of HFRS in that areas. Three kinds of inactivated vaccines ag ainst HFRS (the golden hamster kidney cell vaccine, the Mongolian gerbil kidney cell vaccine and the purified suckling mouse brain vaccine) have been successive ly developed and proved highly effective in the prevention of HFRS. Conclusion Chinese workers on the epidemiology and prevention of HFRS i n China have accomplished great achievements since 1981. As the relatively high annu al incidence of HFRS sustained in recent years, control measures have to be reen forced. Many problems of HFRS and hantavirus infections are still not well under stood or unclear, such as the poly host nature, and the multi modes of transmi ssion, the natural history of hantaviruses and their genetic variation occurred in nature etc. The task for effective control of HFRS and the research on its ep idemiology in China should be held on a high priority.
