浙江省2013—2019年发热疫情的病原学和流行病学特征分析

目的了解浙江省引起发热疫情的病原学种类及其流行病学特征,为疫情的调查处置提供参考。方法收集整理2013—2019年浙江省报告的有发热病例的暴发疫情,分析其病原学特征,并按照不同的疾病种类分组,分析罹患率、持续时间和三间分布特征,描述发热伴皮疹、咽痛、咳嗽等症状暴发疫情的病因和流行病学特征。结果共发现614起发热疫情,有疾病23种,涉及的病原体包括诺如病毒(167起)、流感病毒(147起)、水痘-带状疱疹病毒(129起)、手足口病病原体(59起)、登革病毒(43起)、流行性腮腺炎病毒(10起)、腺病毒(8起)、基孔肯雅热病毒(8起)、人感染H7N9禽流感病毒(8起)、沙门菌(7起)、新型布尼亚病毒(5起)、致泻性大肠埃希菌(3起)、布鲁氏菌(3起)、寨卡病毒(3起)、狂犬病毒(2起)、空肠弯曲菌(2起)、乙型脑炎病毒(2起)、鼻病毒(1起)、鹦鹉热衣原体(1起)、札如病毒(1起)、副溶血性弧菌(1起)、脑膜炎奈瑟菌(1起)。诺如病毒引起的暴发罹患率中位数为3.52%,持续时间2.90 d,流行性感冒罹患率为6.82%,持续时间19.17 d,水痘罹患率为2.16%,持续时间为36.00 d。发热暴发疫情在3—5月和9—12月各有一个高峰,在浙江全省11个市都有分布。持续时间超过1个月的有水痘、流行性腮腺炎、布病;罹患率大于30%的有乙脑、寨卡病毒病、狂犬病、基孔肯雅热、布病。伴有皮疹195起(占31.76%),涉及病种8种,咽痛200起(占32.57%),涉及病种11种,咳嗽211起(占34.36%),涉及病种13种。结论2013—2019年浙江省发热疫情病原体种类多,流行特征复杂,了解引起发热疫情的病因,对疫情判断和及时处置具有重要的参考价值。

Etiological and epidemiological characteristics of fever outbreaks in Zhejiang Province, 2013-2019

Objective To understand the etiological and epidemiological features of fever outbreaks in Zhejiang Province, and to provide reference for epidemic control. Methods We collected the information about outbreaks with fever cases reported in Zhejiang Province from 2013 to 2019, analyzed their etiological characteristics, and subgrouped the cases according to types of diseases. Characters of the attack rate, duration, and time, space and population distribution were analyzed according to different diseases. Etiological distribution and epidemiological characteristics of fever outbreaks with rash, throat pain, and cough were described. Results A total of 614 outbreaks with fever cases and 23 types of diseases were detected, and pathogens involved were as follows: norovirus (167 outbreaks), influenza virus(147 outbreaks), varicella-zoster virus(129 outbreaks), pathogens causing hand-foot-mouth disease(59 outbreaks), dengue virus(43 outbreaks), mumps virus(10 outbreaks), adenovirus(8 outbreaks), Chikungunya virus(8 outbreaks), human H7N9 avian influenza virus(8 outbreaks), Salmonella(7 outbreaks), new Bunia virus(5 outbreaks), diarrheagenic Escherichia coli(3 outbreaks), Brucella(3 outbreaks), Zika virus(3 outbreaks), rabies virus(2 outbreaks), Campylobacter jejuni(2 outbreaks), Japanese encephalitis virus(2 outbreaks), rhinovirus(1 outbreak), Chlamydia psittaci(1 outbreak), Zharu virus(1 outbreak), Vibrio parahaemolyticus(1 outbreak), and Neisseria meningitidis(1 outbreak). The median attack rates of norovirus, influenza, and chicken pox outbreaks were 3.52%, 6.82% and 2.16%, respectively, with the outbreak durations being 2.90 days, 19.17 days, and 36.00 days, respectively. There were two peaks, namely March-May and September-December, in the outbreaks, distributing all of the 11 cities in Zhejiang Province. The outbreak durations of varicella, mumps and brucellosis were more than one month. Outbreaks with the attack rate more than 30% were Japanese encephalitis, Zika virus disease, rabies, Chikungunya fever and brucellosis. There were 195 (31.76%) fever outbreaks with rash (involving 8 types of diseases), 200 (32.57%) fever outbreaks with throat pain (involving 11 types of diseases) and 211 (34.36%) fever outbreaks with cough (involving 13 types of diseases). Conclusion The fever outbreaks in Zhejiang Province during 2013-2019 were caused by various pathogens, and the epidemiological characters were complex. It is of great reference value for judging and timely handling the epidemic to understand etiology of the fever outbreaks.