1995-2005年江苏省赣榆县肾综合征出血热监测

目的 分析1995-2005年江苏省赣榆县肾综合征出血热(HFRS)人间与兽间疫情及控制效果监测的结果,探索控制HFRS的有效途径.方法 利用赣榆县疾病预防控制中心疫情监测资料、人口资料及调查资料进行回顾性调查分析.结果 江苏省赣榆县11年来共发生HFRS 923例,年平均发病率8.06/10万,死亡9例,病死率0.98%;全年各月均有发病,呈现春峰和秋冬峰,春峰有下降趋势,而秋冬峰则呈上升趋势;该县18个镇均有发病,呈现丘陵＞平原＞沿海的地区发病特点,丘陵与平原发病呈下降趋势;发病年龄集中在30～50岁年龄组,占67.28%;男女性别比2.25:1,有下降趋势;病例职业分布以农民为主占87.97%,其次学生占6.18%;11年健康人群免疫水平调查显示,抗-HV IgG抗体平均阳性率11.37%,隐性感染率与人间疫情间呈负相关;从临床诊断患者的血清学核实情况看,符合率为64.39%,存有大量误诊.1995年以来,每年对春季室内、秋季野外进行宿主动物密度及带毒情况调查,捕获的宿主动物种类有2目3科6种,其中褐家鼠、黑线姬鼠分别为室内及野外的优势鼠种,带病毒率分别为2.76%、3.06%;春、秋季鼠带毒指数分别为0.028、0.025.对该县1995年以来监测资料与人间疫情进行相关性分析,春季鼠带毒指数与年发病率及春峰、秋峰发病率均呈正相关,秋季鼠带毒指数(1995-2004年)与次年(1996-2005年)春峰发病率均呈正相关.结论 疫苗接种是控制HFRS的有效途径.

Surveillance of hemorrhagic fever with renal syndrome in Ganyu County from 1995 to 2005

Objective The study was conducted to analyze the surveillance results of the epidemic of hemorrhagic fever with renal syndrome (HFRS) among rats and crowds and the control effect of HFRS,and to explore the effective way of HFRS controlling. Methods The disease surveillance data,information and population data from the Center for Disease Control and Prevention of Ganyu County were retrospectively analyzed. Results The number of HFRS cases was 923 with 9 deaths in the last 11 years,the annual incidence being 8.06/lakh; the fatality rate was 0.98%. Cases occurred in each month all the year round,presenting with the spring peak with a declining trend and the autumn and winter peak with an ascending trend. Cases of HFRS were distributed in all 18 towns,more cases in the hilly lands than in the plain area and thus than in the coastal area. The incidence in hilly and plain area was declining. The cases distributed mainly in the 30-50 age group,accounting for 67.28%. The sex ratio was 2.25∶1,showing a declined trend. 87.97% of the cases occurred among farmers,and 6.18% among the students. The immunological study in the last 11 years indicated that the average anti-HV lgG positive rate among health people was 11.37%,the sub-clinical infection rate being negative correlated with the epidemic among people. The coincidence of the serum test among clinical diagnosed patients was 64.39%,indicating considerable misdiagnoses. The density and carrier rate of host rats indoor in spring and outdoor in autumn and winter were investigated each year since 1995. The captured rats were divided into 6 species in 3 families of 2 orders. Among them,the predominant species of the rats were R.rattus indoor and A.arariue outdoor,the virus carrier rate being 2.76% and 3.06%,respectively; the virus carrier index was 0.028 in spring and 0.025 in autumn and winter. The carrier index in spring was positively correlated with the annual incidence and incidences of the spring peak and the autumn and winter peak; the index in autumn of outdoor rats (1995-2004) was positively correlated with the spring peak of HFRS incidence next year (1996-2005),according to the correlation analysis between the surveillance data and epidemic since 1995 in the county. Conclusion Vaccine inoculation is an effective way to control HFRS.