湖南省2005年肾综合征出血热监测研究

目的 掌握湖南省HFRS疫源地范围、类型、人群分布和流行规律以及宿主动物种类、带病毒率等情况，为防制HFRS提供科学依据。方法 按照2005年《湖南HFRS监测实施方案》，在全省系统开展HFRS的流行病学和病原学监测。采用IFA和ELISA检测健康人群隐性感染状况，采用间接免疫荧光法检查鼠肺HV—Ag，用双抗原夹心ELISA方法检测鼠血HV—Ab，并用单克隆抗体进行病毒分型，调查5个监测点媒介动物自然感染汉坦病毒情况。结果 2005年共报告病例546例，发病率0．84／10万。共捕获478只啮齿动物，总密度为3．4％，室外密度3．31％，室内密度3．59％。黑线姬鼠是野外的优势宿主（占38．29％），褐家鼠是室内的优势宿主（占46．91％），黑线姬鼠和褐家鼠占捕获总数的46．86％。抗原和抗体阳性鼠为39只，总感染率为8，16％。褐家鼠和黑线姬鼠的带毒指数分别为3，17％、2．80％。5个监测点间捕获率和带毒率差异有统计学意义。黑线姬鼠主要携带Ⅰ型HV，褐家鼠主要携带Ⅱ型HV。对17只阳性鼠肺病毒分型，Ⅰ型占41．18％，Ⅱ型占58．82％。结论 湖南省为姬鼠型和家鼠型混合型HFRS疫区，人群隐性感染较高，防制工作应以灭鼠和人群免疫相结合的综合防制措施，加强实验室诊断，提高临床诊断水平。

Study on Hemorrhagic Fever With Renal Syndrome Surveillance in 2005 in Hunan Province

Objective To study the epidemic source region range and type of hemorrhagic fever with renal syndrome(HFRS), the distribution in people and the rule of prevalence, the type of host animals and their virus-carried situation for taking comprehensive scientific measures to prevent and control HFRS in Hunan Province. Methods We carried on HFRS epidemiological and pathogenic surveillance according to the implement scheme of hemorrhagic fever with renal syndrome surveillance in 2005 in Hunan Province. The people's infection rate was detected by indirect immunofluorescence assay (IFA) and enzyme-linked immunosorbent assay (ELISA). Indirect immune fluorescent technology was used to detect the antigen of rats'lungs, ELAISA with double antigen sandwich was applied to detect the rats'serum antibody, and monoclone antibody detected the type of HV. Results Altogether 546 HFRS cases were reported in 2005, and the annual incidence was 0.84/100,000. A total of 478 rodents were captured, and the average rodents density was 3.4%. Indoor rat density was 3.59% with brown rats (Rattus norvegicus Rn.a) predominant accounting for 46.91%, and the outdoor was 3.31% with Apodemus agrarius (Aa) taking up 38.29%. The number of positive animal including antigen and antibody was 39, and the total incidence of virus-carried rodent was 8.16%. There were significant differences between the average rodents density and the virus-carried ratio among the five surveillance sites. The Rn.a with HV type I ranked the virus-carried rate first in indoor rats, while the Aa with HV type II predominated in outdoor rats. Among the 17 positive rats, 7 strains were type I (Apodemusmode) and 10 strains type II (Musmode). The index of HV carrier of Aa and Rn.a was 3.17% and 2.80% respectively. Conclusions Hunan Province belongs to mixed epidemic area of HFRS and the infection rate in healthy people is high. The results suggest that stress should be put on the experimental surveillance, the improvement of diagnostic ability in clinical doctors and the comprehensive measures to prevent and control HFRS through extinguishing rats and vaccine inoculating for risk people.