CAJ | 학술논문

目的通过分析2005-2008年全国监测资料,描述近几年中国肾综合征出血热(HFRS)流行特征和变化趋势.方法对2005-2008年全国传染病监测信息报告管理系统网络直报的HFRS病例资料及国家哨点监测资料,用描述性流行病学方法进行统计分析.结果 2005-2008年,全国共报告HFRS病例56 077例,死亡692例,病死率1.23%;发病率和死亡率均呈逐年平稳下降的趋势.病例主要集中在东北和华东地区,发病例数最多的省份依次为黑龙江、辽宁、吉林、山东、陕西、河北和浙江,4年间7省报告发病数占全国报告病例总数的78.61%.全国每年发病明显呈春季和秋冬季两个季节高峰,11月为全年最高发病月份;病例男女性比为3.13:1,青壮年居多;职业分布以农民居多.各监测点发病例数呈逐步下降趋势,各监测点优势鼠种分布、鼠密度及带病毒率相对稳定,黑线姬鼠和褐家鼠仍是数量最多、分布范围最广的宿主动物.病原学监测发现近几年汉坦病毒基因变异不大.结论全国HFRS疫情总体呈现持续平稳下降趋势,这可能与近些年各地采取疫苗接种和防鼠灭鼠为主的综合性防治措施有关.随着国家扩大免疫规划出血热疫苗接种项目的实施,疫情可呈现进一步下降的态势;但受某些因素影响局部地区疫情可能会有一定波动.个别地区鼠密度和/或带病毒率仍然较高,有些疫区也在不断演变,甚至出现新疫区,HFRS暴发流行的隐患依然存在.
목적 통과분석2005-2008년전국감측자료,묘술근궤년중국신종합정출혈열(HFRS)류행특정화변화추세.방법 대2005-2008년전국전염병감측신식보고관리계통망락직보적HFRS병례자료급국가초점감측자료,용묘술성류행병학방법진행통계분석.결과 2005-2008년,전국공보고HFRS병례56 077례,사망692례,병사솔1.23%;발병솔화사망솔균정축년평은하강적추세.병례주요집중재동북화화동지구,발병례수최다적성빈의차위흑룡강、료녕、길림、산동、협서、하북화절강,4년간7성보고발병수점전국보고병례총수적78.61%.전국매년발병명현정춘계화추동계량개계절고봉,11월위전년최고발병월빈;병례남녀성비위3.13:1,청장년거다;직업분포이농민거다.각감측점발병례수정축보하강추세,각감측점우세서충분포、서밀도급대병독솔상대은정,흑선희서화갈가서잉시수량최다、분포범위최엄적숙주동물.병원학감측발현근궤년한탄병독기인변이불대.결론 전국HFRS역정총체정현지속평은하강추세,저가능여근사년각지채취역묘접충화방서멸서위주적종합성방치조시유관.수착국가확대면역규화출혈열역묘접충항목적 실시,역정가정현진일보하강적태세;단수모사인소영향국부지구역정가능회유일정파동.개별지구서밀도화/혹대병독솔잉연교고,유사역구야재불단연변,심지출현신역구,HFRS폭발류행적은환의연존재.
Objective To analyze the epidemiologic and surveillance data of hemorrhagic fever with renal syndrome (HERS) in China, from 2005 to 2008, to describe the epidemiology and trend of HERS. Methods Descriptive epidemiology were studied to analyze the surveillance data from 2005 to 2008, collected from both the internet-based national notifiable disease reporting system and 40 HFRS sentinel sites developed since 2005 in 40 counties around China. Results A total of 56 077 HERS cases and 692 deaths reported in China with case fatality rate as 1.23%. Morbidity and mortality had been annually decreasing since 2004. The top 7 provinces with HFRS cases were Heilongjiang, Lianning, Jilin, Shandong, Shaanxi, Hebei and Zhejiang, which had a total of 44 081 cases reported, accounting for 78.61% of the total number of cases, in the nation. More cases were reported in spring and autumn-winter season, with the peak in November. Cases reported in males were 3.13 times of the females and most cases seen in young and middle-aged farmers. The density and the virus carrying rate of animal hosts and the distribution of dominant species were relatively stable and similar to the previous findings. Apodemus agrarius and Rattus norvegicus were still the most common and predominant animal hosts. No genetic mutation of Hantavirus was detected in the surveillance program. Conclusion The continuous descending trend of the HERS epidemics could be related to the successful strategies on comprehensive prevention and control measures, as controlling the number of rodents and vectors, carrying out HERS vaccination campaign and health education by the local health care takers in the recent years. Implementation of the new national Expanded Program of Immunization on HFRS vaccine in high-risk areas may further reduce the epidemics. However,both the density and the virus carried rate among the host animals remain high in some areas, together with the emergence of new epidemic areas, all call for more attention to be paid on the disease.