云南省1976--2012年肾综合征出血热流行特征分析

目的分析云南省肾综合征出血热（HFRS）流行特征，为防治提供参考。方法收集云南省HFRS病例资料并用Excel2003软件建立数据库，用SPSS13．0软件对HFRS的发病率、死亡率及疾病的地理、季节、人群分布进行统计学处理，其中方差分析应用于比较不同地区间的发病率差异，线性相关分析用于比较不同人群与发病的相关性。结果1976—2012年，云南省共报告HFRS患者876例，死亡50例，年平均发病率为0．058／10万，年平均死亡率为0．0042／10万，病死率为5．71％。1984—1987年和1998—2006年出现两次流行高峰。全省14个州（市）的75个县（市、区）有病例报告，各州（市）之间发病率差异有统计学意义。主要流行地区为昆明市及红河、楚雄和大理州，占全省病例数的80．48％，其中昆明市占全省发病数的35．50％。从地理特点分析，疫区分布在中部和西北部海拔1500~2500m的地区。西南部低海拔（〈1500m）地区和海拔〉2500m的山区几乎无病例报告。全年均有发病，春夏季为流行高峰；主要发病人群为男性青壮年农民。结论HFRS在云南省分布较广，主要流行区为中部和西北部海拔在1600~2000m的盆地地区，应加强主要疫区的监测和防控工作。

Epidemiological analysis of hemorrhagic fever with renal syndrome during 1976 to 2012 in Yunnan province,China

Objective To analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome （HFRS） in Yunnan province, China and to provide reference for the prevention and control of HFRS. Methods The data on HFRS cases in Yunnan were collected to establish a database using Excel 2003. Statistical analysis was performed using SPSS 13.0 to evaluate the incidence and mortality of HFRS, as well as the geographical, seasonal, and population distributions of the cases; analysis of variance was used to determine the regional differences in incidence, and linear correlation analysis was used to determine the population distribution of HFRS. Results From 1976 to 2012, a total of 876 cases of HFRS were reported in Yunnan province, and 50 cases were fatal; the average annual incidence was 0.058/100 000, the average annual mortality rate was 0.0042/100 000, and the fatality was 5.71%. Two epidemic peaks occurred in 1984-1987 and 1998-2006. The cases of HFRS were reported in 75 county-level regions （counties, cities, or districts） of 14 prefecture-level regions （prefectures or cities） in Yunnan. There were significant differences in the incidence of HFRS among the prefecture-level regions. The main epidemic areas （prefecture-level regions） were Kunming, Honghe, Chuxiong, and Dali, where 80.48% of all cases occurred, and particularly 35.50% of all cases were reported in Kunming. The epidemic areas were distributed in the central and northwestern regions at 1500-2500 m elevation; few cases were reported in the mountainous areas （〉2500 m elevation） and low-elevation areas （〈 1500 m elevation） in the southwestern region. The incidence of this disease was found through the whole year, and the epidemic peak was in spring and summer. Young and middle- aged male farmers were the main affected population. Conclusion HFRS cases are widely distributed in Yunnan province, and the central and northwestern basin areas at 1600-2000 m elevation are the main epidemic areas. The surveillance and control of HFRS should be strengthened in the main epidemic areas.