一起作业场所肾综合征出血热聚集性发病的调查研究

目的探讨此次肾综合征出血热(HFRS)聚集性发病的流行因素。方法采用现场流行病学调查、病例对照、血清学、病原学方法,对病例、感染人群、宿主动物及传染源进行调查研究。结果通过病例搜索发现病例9例,死亡1例。所有病例均集中居住在同一工棚,发生在同一潜伏期内,罹患率达64.28%(9/14),感染率达92.86%(13/14),相距最近的工棚人群隐性感染率仅为5.88%。疫点鼠密度为12.73%。黑线姬鼠携带病毒率达17.65%(3/17);带病毒指数为0.15。结论此次暴发疫情主要是由于患者吸入工棚内含病毒的气溶胶感染引起,不排除个别感染者通过破损的皮肤、鼠体螨叮咬造成感染。其传染源为黑线姬鼠。此次疫情甚为罕见,为聚集性发病,为HFRS的防治提出了新的课题。

Investigation of the aggregate incidence of hemorrhagic fever with renal syndrome in a working place

Objective The study was conducted investigate the epidemiological factors in relation to the aggregate incidence of hemorrhagic fever with renal syndrome(HFRS) in order to provide evidence for responding strategies.Methods Field epidemiological investigation,case-control study,serological and etiological analysis was employed in the study to comprehensively analyze the affected cases,infected population,host animals and source of infection.Results Nine patients were found with one death.All affected cases lived in the identical work shed,with a shared incubation period.The attack rate was 64.28%(9/14),the infection rate 92.86%(13/14).However,the subclinical infection rate among workers who lived in the immediate vicinity was only 5.88%.The mouse density was 12.73% in field.The virus carrier rate of Apodemus agrarius was 17.65%(3/17) and the exponent was 0.15.Conclusion The outbreak was mainly caused by inhaled virus-carrying gasoloid in the work shed.Rare cases could be also found infected through damaged skin or by acarids bites.The source of infection was Apodemus agrarius.The aggregate epidemic was a rare case that had set up a new topic of HFRS prevention and control.