宝鸡市肾综合征出血热流行状况和趋势研究

目的掌握宝鸡市肾综合征出血热发病趋势和流行规律,评价防制效果,研究制定防制对策,有效遏制其流行势头。方法收集地理地质、水文气象和人口等基础资料,对1955￣2005年宝鸡市肾综合征出血热的疫情资料进行统计分析,研究流行趋势变化及其原因,对高发县16￣60岁人群实施疫苗接种,分析疫苗接种效果。结果宝鸡市肾综合征出血热的流行经历了局部散发期、广泛流行期,现已进入初步控制期;流行特征由单峰型逐渐向双峰型转变;渭河谷地是主要疫源地,渭北台塬发病有增多趋势,男性青壮年农民为主要发病人群;2003￣2005年在高发县高发乡镇实施重点人群疫苗接种试点后,全市出血热逐年大幅下降,2005年比2002年下降76.59%,试点县发病构成显著下降(P<0.005)。结论宝鸡市肾综合征出血热已从姬鼠型逐渐向以姬鼠型为主的混合型疫区转化,疫区范围有从渭河南岸的秦岭山区逐渐向渭北台塬沟壑地带蔓延的趋势。肾综合征出血热的流行受自然、经济、社会因素影响较大,双价疫苗接种是最有效、最快速的防制措施,在高发疫区利用政府财政部分防治经费购买疫苗,对重点人群按成本价实施疫苗普种,是值得借鉴和推广的工作。

A study on the epidemic situation and tendency of hemorrhagic fever with renal syndrome in Baoji City

Objective This study was conducted to gain insight into the epidemic characteristics of hemorrhagic fever with renal syndrome in Baoji City and evaluate the efficacy of prevention and control strategies for the development of better countermeasures and effective control of the epidemic. Methods Statistical analysis was done on the data collected about the epidemic situations of hemorrhagic fever with renal syndrome together with those on geographic and geological conditions, weather and hydrological information, and demography from 1995 to 2005 were collected to understand the epidemic trends of the disease and the causes thereof. Vaccination was implemented among the population aged from 16 to 60 years in the counties with high incidence, and the efficacy of vaccination was analyzed. Results The epidemic of hemorrhagic fever with renal syndrome in Baoji city went through the stages of local sporadic epidemic and wide prevalence. And now it was under preliminary control. The epidemic feature changed from a unimodal peak toward a bimodal peak. Wei River valley was found to be the major epidemic source area with a tendency of increase in the incidence emerging in Taiyuan District of Weibei. Young male peasants were predominantly affected. Immunizations among vulnerable groups in the high-incidence villages and towns of the high-incidence counties were implemented from 2003 to 2005 and the incidence of the epidemic was substantially reduced year by year with a decrease by 76.59% from 2002 to 2005, there being a significant decrease in the disease composition in the experimental county(P<0.005). Conclusion The Baoji city is changing from an Adodemus agrarius Pallas epidemic area of hemorrhagic fever with renal syndrome to a mixed one with Adodemus agrarius Pallas predominance. There is a trend for the epidemic to spread gradually from the Qinling mountain area to the ravine area along the south bank of the Wei River. The epidemic of hemorrhagic fever with renal syndrome has a lot to do with natural, economic and social factors. Immunization with bivalent vaccine is a most effective and rapid preventive method. Using part of the outlay for disease prevention and control from the government finance to buy vaccines and implementing a general vaccination which is charged based on the cost price, among the vulnerable population in the high-incidence area are good measures worthy of being taken and promoted.