周宁县1984~2006年肾综合征出血热监测研究

目的掌握周宁县肾综合征出血热(HFRS)人间疫情及鼠间疫情的变化趋势和流行规律,制定有效的防制策略和措施。方法用流行病学方法综合分析疫情资料,用笼捕法每年春秋季定点+定量捕鼠,疑似病人用间接免疫荧光法(TFAT)和ELISA检测HFRS特异性抗体对鼠肺标本采用冰冻切片直接免疫荧光法(FAT)检测HFRSHV抗原。结果1984~2006年发生HFRS病人340例,年均发病率8.81/10万,死亡15例,病死率为4.41%;发病以20~50岁青壮年农民居多,男多于女,临床表现轻、中型多见,冬春季节为发病高峰。捕获鼠类12种7897只,捕获率为8.70%,野外以黄毛鼠和黑线姬鼠为优势种,居民区以褐家鼠占优势;在黑线姬鼠、褐家鼠、黄毛鼠、社鼠、针毛鼠和黄胸鼠等6种鼠中检出HFRSHV抗原。结论周宁县是属姬鼠型为主的混合型疫区,以灭野鼠为主并灭家鼠是预防和控制HFRS的有效措施,建议重点人群选择HFRS双价疫苗进行预防接种。

Analysis of HFRS Surveillance in Zhouning Country from 1984 to 2006

Objective TO explore the epidemiologic characteristics and trends of hemorrhagic fever with renal syndrome (HFRS) in Zhouning Country and provide effective evidence for making preventive measures. Methods Rats were captured in springs and autumns at specified spots and by cage-capturing method. Frozen sections of rat lungs were detected for HV antigen by direct immunofluorescent assy (FAT).Suspected cases were detected for specified HFRS antibody by indirect immunofluorescent assy (IFAT) and ELISA. Epidemiological analysis were done with all the surveillance data.Results 340 patients were reported from 1984 to 2006 ,with an annual incidence of 8.18/100,000 ,in which 15 patients died, with a mortality of 4.14% .Most of the patients were 20-50 year old young peasants, males were more than females, with slight or medium clinical manifestation. Dominant peak was observed in winter and spring. A total of 7897 rats were captured, the capture rate was 8.70%. The dominant species in fields were R.rattoides exiguous and A.agrarius ningpoensis, while the main species in residential areas were R.norvegicus soccer, Six species of rats including A.agrarius ningpoensis, R.norvebicus soccer, R.rattoides exiguous, R.nivienter confucianus, R.fulvescens huang. R.flavipectus flavipectus were detected with HV antigen.Conclusion sZhouning Country is a mixed type HFRS endemic area with the Apodemus as the dominant rat. Eliminating wild rats and house mousse, vaccinating the high risk population would be the effective Methods for HFRS control.