2004 - 2015年连云港市肾综合征出血热流行病学分析

目的 掌握连云港市肾综合征出血热（Hemorrhagic Fever with Renal Syndrome，HFRS）的流行态势,为进一步开展防控工作提供参考依据。 方法 数据来源于连云港市疫情信息、赣榆县监测资料，利用Excel建立数据库，用IBM SPSS 22.0版进行统计分析。 结果 连云港市2004 - 2015年共报告HFRS发病1 225例,年平均发病率2.20/10万，发病呈总体下降趋势；各县区均有HFRS病例报告，年平均发病率排前三位的分别是灌云县、市区、赣榆县；呈现明显的秋冬季发病高峰，秋冬峰占全年发病的79.18%；发病相对集中在30～69岁年龄段，占发病总数的83.27%；男女性别比为2.68∶1；发病职业构成中以农民为主，占82.86%；2004年以来赣榆县监测点每年春秋两季进行鼠密度和带毒率调查,共捕获鼠种2 目3 科5 属6 种，室内优势鼠种为褐家鼠, 野外优势鼠种为黑线姬鼠，总捕获率3.41%,总带毒率1.00%，春秋两季捕获率和带毒率差异均无统计学意义 (χ2 = 2.00, P = 0.157)；鼠总带毒指数与赣榆总发病率（Z = 2.449，P＜0.001）、春季带毒指数与春峰发病数（Z = 1.429，P = 0.034）、秋季带毒指数与秋峰发病数（Z = 2.449，P＜0.001），差异均有统计学意义且均呈正相关。 结论 连云港市HFRS发病高危人群为广大农村地区长期在野外从事农业工作的农民，发病高峰为野鼠型的秋冬峰。建议开展以疫苗接种保护高危人群为主，以防鼠、灭鼠、健康行为养成为辅的综合性防控措施。

Epidemiological analysis of hemorrhagic fever with renal syndrome in Lianyungang between 2004 and 2015

Objective The aim of this study was to understand the HFRS（hemorrhagic fever with renal syndrome）epidemiological characteristics, in order to provide the evidence for making the control measures. Methods The data from China information system for disease control and prevention, document on the communicable diseases in Lianyungang from 1953 to 2008, HFRS surveillance data in Ganyun were collected. The database was set up with EXCEL, and analyzed with IBM SPSS 22.0. Results The reported HFRS cases were 1225 during 2004 and 2015. The average annual incidence was 2.20/100000, which showed a decreasing tread. The reported HFRS cases were distributed in all counties and districts in Lianyungang. The top three of the average incidence were Guanyun county, downtown and Ganyu county. The epidemic of HFRS showed a higher peak with 79.18% of all cases occurred during autumn and winter obviously. 83.27% of all cases occurred among the group aged between 30 and 69. The ratio of male to female was 2.63:1. 82.86% of all cases were farmers. The HFRS surveillance in Ganyu county involved rats density. And virus carried rate in spring and autumn showed that brown rat was superior indoors and agrarius was superior in fields in this county. The total rats were identified in six species, five genus, three families, and two orders. The total capture rate was 3.41% and the total virus carried rate was 1.00%, with no statistical significance between the capture rate and the virus carried rate both in spring and autumn (χ=2.00, P＝0.157). There were statistical significance and positive correlation between the total capture rate and total incidence in Ganyu county （Z＝2.449，P=0.000）, the virus carried rate and incidence in spring（Z＝1.429，P=0.034）, the virus carried rate and incidence in autumn （Z＝2.449，P=0.000）.Conclusion The majority of HFRS cases were mainly focused on the farmers engaged in fieldworks long times in rural areas, and showed higher incidence peak correlation with wide rat both in autumn and winter. It is suggested that the effective comprehensive measures to control HFRS should be performed based on the vaccination priority to prevent the high risk groups with deratization and education of health behavior.