中国2005-2008年肾综合征出血热监测及疫情分析

王芹; 周航; 韩仰欢; 王晓芳; 王世文; 殷文武; 李群; 许真

Abstract

王芹,周航,韩仰欢,王晓芳,王世文,殷文武,李群,许真.中国2005-2008年肾综合征出血热监测及疫情分析[J].Chinese journal of Epidemiology,2010,31(6):675-680

中国2005-2008年肾综合征出血热监测及疫情分析

Epidemiology and surveillance programs on hemorrhagic fever with renal syndrome in Mainland China, 2005-2008

Received:January 16, 2010

DOI：10.3760/cma.j.issn.0254-6450.2010.06.017

KeyWord: 肾综合征出血热疫情监测

English Key Word: Hemorrhagic fever with renal syndrome Epidemic Surveillance

FundProject:

Author Name	Affiliation	E-mail
WANG Qin	Intutute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
ZHOU Hang	Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention
HAN Yang-huan	Liaoning Center for Disease Control and Prevention
WANG Xiao-fang	Intutute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
WANG Shi-wen	Intutute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
YIN Wen-wu	Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention
LI Qun	Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention
XU Zhen	Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention	xuzhen@chinacdc.cn

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Abstract:

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.

English Abstract:

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.

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