2018年定西市某县流行性出血热发病危险因素调查

目的了解2018年甘肃省定西市某县流行性出血热疫情,查明病原体和发病危险因素,为科学防控疫情提供数据支持。方法对2018年6-11月中国疾病监测信息报告管理系统中,某县上报的所有流行性出血热病例开展个案调查,按照1∶1个体匹配方法,从确诊病例家庭周围选择年龄(±5岁)、性别、职业和住址类似的人员作为对照,资料录入EXCEL建立数据库,以SPSS 19.0软件进行统计学分析。结果 2018年共报告病例43例,是2014-2017年均发病数的34.4倍;临床症状以乏力、发热、"三痛"、"三红"为主;病例全部来自农村,以清水乡、十里镇、禾驮乡和秦许乡发病数较多;鼠密度较往年有大幅上升,发病率与鼠密度有关;单因素Logistic回归分析显示,有无挖药材/捡药籽经历为最终的危险因素。结论 2018年甘肃省定西市某县流行性出血热发病率高于往年,以中老年为主,疫情分布在农村,有一定的时空聚集性;传染源主要为黑线姬鼠,挖药材/捡药籽是病人感染的主要原因。

Investigation on risk factors of epidemic hemorrhagic fever in a county of Dingxi city in 2018

Objective To verify the epidemic situation of epidemic hemorrhagic fever in a county of Dingxi city in 2018, to identify pathogens and risk factors of morbidity, and to provide data support for scientific prevention and control of the epidemic. Methods A case control study was conducted on all cases of epidemic hemorrhagic fever reported in the period of June to November, 2018. According to the method of 1∶1 individual matching, people with similar age(±5 years), gender,occupation and address were selected as the control from the confirmed cases. A database was established and SPSS 19.0 statistical software taken for statistical analysis. Results Totally 43 cases were reported, that was 34.4 times of the annual average number of cases from 2014 to 2017. The clinical symptoms were mainly fatigue, fever, headache,low back pain,eye sockets pain and flushing, vervical red and pleural red. All cases distributed in rural areas, mainly in Qingshui township, Shili town, Hetuo township and Qinxu township. The density of rats increased significantly compared with the previous years, and the incidence rate of epidemic hemorrhagic related to the density of rats. Univariate Logistic regression analysis showed that gathering herbs and seeds was the ultimate risk factor. Conclusions The incidence of epidemic hemorrhagic fever in the county is higher in 2018 than in the previous years. The patients are mainly middle-aged and old people, and distribute in rural areas with certain time and space clustering. The main source of infection is Apodemus agrarius. Gathering herbs and seeds are the main causes of infection in patients.