2014年浙江省发热伴血小板减少综合征流行特征分析

目的分析浙江省2014年发热伴血小板减少综合征(SFTS)流行病学特征。方法收集2014年浙江省SFTS病例资料,建立数据库并分析。结果2014年浙江省SFTS确诊病例57例,死亡10例,病死率为17.54%。病例呈现出5月和8月两个高峰期;平均年龄为(58.75±16.30)岁,不同年龄组人群病死率不同(χ²=10.148,P=0.008,P=0.05);农民占89.29%。病例发病前2周内53.85%的病例有户外活动史,多从事种地、割草、采茶等活动,29.09%有明确蜱暴露史,54.90%家里饲养动物,51.06%有老鼠暴露史。大部分病例有发热、疲劳、畏寒、肌痛等非特异性症状,且均伴有血小板和白细胞进行性下降;存活和死亡病例间牙龈出血症状不同(χ²=4.114,P=0.043,P=0.05)。存活组从发病到确诊时间间隔平均5.5 d,死亡组7.5 d,病例从确诊到死亡平均3.5 d,其中有2人是死亡后才被确诊。结论浙江省发热伴血小板减少综合征发病具有一定的地域性和季节性,中老年农民高发,户外活动做好个人防护及早诊断、早治疗对该病的预防控制有重要意义。

Epidemiologic analysis on severe fever with thrombocytopenia syndrome in Zhejiang Province,2014

We analyzed the epidemic characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province in the year of 2014 to provide the scientific evidence for prevention and control of the disease. In 2014, 57 SFTS cases were reported in Zhejiang Province, with fatality rate as 17.54% (10/57). Epidemic peak was from May to August (73.68%). The age of the cases ranged from 0.5 to 84 years old with the median age of (58.75±16.30). Additionally, the median age of the death cases was 71 with the highest fatality rate in the 65-75 age group (χ²=10.437, P=0.015<0.05). The most cases were farmers (89.29%). The 53.85% of patients had the history of outdoor activities, such as farming, mowing the lawn and tea plucking, two weeks before the onset of SFTS; 87.03% of the cases engaged in different kinds of work which was associated with agriculture; 29.09% of the patients had been exposed to ticks; 54.90% of the cases engaged in raising animals at home; 51.06% of the patients had been exposed to mouse. The overwhelming majority of cases experienced fever with the body temperature form 37.7 ℃ to 41 ℃, which was the major onset symptom of 82.14% cases. Meanwhile, most patients also experienced fatigue, chill, myodynia and other non-specific symptoms but all appeared progressive thrombocytopenia and leucopenia. Bleeding gums symptoms showed significant statistical differences between survival and death cases (χ²=4.114, P=0.043<0.05). The median time of the survival cases from illness onset to confirmation was 5.5 days, and for the death cases was 7.5 days. The median time from confirmation to death was 3.5 days. What’s more, 2 cases were confirmed after death. In conclusion, SFTS in Zhejiang Province has certain regional and seasonal characteristics. Most cases were older farmers. Early diagnosis and treatment may have important implications to reducing SFTS mortality.