宁海县1984～2001年肾综合征出血热监测研究

目的掌握肾综合征出血热流行特征和流行因素,为制订防治对策提供依据.方法采用现场调查、实验室病原学、血清学检测方法,开展人间疫情和宿主动物监测.结果自上世纪90年代以来发病率显著下降,有明显周期性.1980年后从秋冬单峰型转向冬夏两季流行双峰型.80年代以夏季高峰为主,近10年冬季高峰明显增加,夏季峰相应减弱.发病以青壮年农民为主.临床病人检测血清符合率为67.08%,出血热病人抗体持续时间长达14年之久.疫区健康人群隐性感染率为5.20%.宿主动物检测褐家鼠和黑线姬鼠病毒(HV)携带率高于其它动物,分别为11.6%、9.54%和7.50%.重点发病地区开展灭鼠等措施,降低鼠密度,能控制出血热发病.结论宁海地区属姬鼠型和家鼠型的混合型疫区,近年来流行特征出现变化,黑线姬鼠、褐家鼠是主要传染源,人群免疫水平低下,应加强重点地区冬季灭鼠为主综合措施.

The Surveillance of Hemorrhagic Fever with Renal Syndrome in Ninghai County, 1984 ～ 2001

Objective To explore the epidemic characteristics and influencing factors of hemorrhagic fever with renal syndrome (HFRS), and to provide information for establishing preventive countermeasure. Methods Field survey and laboratory detection were used for the surveillance of HFRS epidemic in people and host animals. Results The incidence rate of HFRS had reduced apparently since 1990s and showed apparent periodicity. Since 1980, the epidemic peak had changed from winter's single peak to both winter and summer's peaks. In 1980s, the summer's peak was predominant. The winter's peak value had apparently increased in recent 10 years, while the summer's peak value had reduced. The patients were mainly young and middle aged farmers. The coincidence rate of serum detection in clinical patients was 67.08%. The antibody in HFRS patients could maintain for 14 years. The sub-clinical infection rate of healthy people in the epidemic area was 5.20%. Inspection of host animals showed that the HV carry rates in R. norvegicus and A. aprarius were higher than that in any other animals. Elimination of rats in focal places could reduce the density of rats and control the incidence of HFRS. Conclusions The epidemic characteristics have changed in recent years. R. norvegicus and A. aprarius are the main sources of infection. The immunity level of people is very low, so the comprehensive prevention, especially elimination of rats in winter, in focal regions must be strengthened.