1950-2021年中国斑疹伤寒流行特征分析

韩玲; 张云飞; 滕中秋; 阚飙; 秦天

Abstract

韩玲,张云飞,滕中秋,阚飙,秦天.1950-2021年中国斑疹伤寒流行特征分析[J].Chinese journal of Epidemiology,2023,44(3):430-437

1950-2021年中国斑疹伤寒流行特征分析

Epidemiological characteristics of typhus in China, 1950-2021

Received:August 05, 2022

DOI：10.3760/cma.j.cn112338-20220805-00690

KeyWord: 斑疹伤寒立克次体流行病学特征

English Key Word: Typhus Rickettsia Epidemiological characteristics

FundProject:传染病预防控制国家重点实验室科学基金（2019SKLID403，2022SKLID209）；国家卫生健康委员会公共卫生服务能力提升项目（2100409034）

Author Name	Affiliation	E-mail
Han Ling	National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention/State Key Laboratory of Infectious Disease Prevention and Control, Beijing 102206, China
Zhang Yunfei	National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention/State Key Laboratory of Infectious Disease Prevention and Control, Beijing 102206, China
Teng Zhongqiu	National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention/State Key Laboratory of Infectious Disease Prevention and Control, Beijing 102206, China
Kan Biao	National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention/State Key Laboratory of Infectious Disease Prevention and Control, Beijing 102206, China
Qin Tian	National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention/State Key Laboratory of Infectious Disease Prevention and Control, Beijing 102206, China	qintian@icdc.cn

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Abstract:

目的分析斑疹伤寒在我国的流行病学特征，探讨我国斑疹伤寒防控工作面临的问题及挑战和策略。方法资料来源于中国公共卫生科学数据中心传染病历史数据库和中国疾病预防控制信息系统传染病报告信息管理系统1950-2021年斑疹伤寒报告数据，采用描述性统计方法、Mann-Kendall检验和圆形分布法对斑疹伤寒的发病情况、死亡情况、病死率进行分析，研究我国斑疹伤寒流行的时间、空间、人群分布和诊断现状。结果 1950-2021年，我国共报告斑疹伤寒发病数452 965例，死亡数7 339例，分别在20世纪50年代、60年代和80年代的14年中报告发病数均过万。20世纪90年代以来，斑疹伤寒发病数和发病率大幅降低，流行强度以散发为主，但安徽省、湖北省和湖南省报告发病数呈上升趋势。斑疹伤寒在全年均可发病，但可呈现一定的季节聚集性，我国斑疹伤寒的发病率高峰集中在夏、秋季，不同省份斑疹伤寒的月发病高峰从北方至南方逐渐向前推移。斑疹伤寒发病的男女性别比为1.01∶1（18 529∶18 366），近年来女性发病数逐渐超过男性；≤9岁人群发病数占比最大（18.9%），≥50岁人群发病数呈增加趋势；发病人群职业以农民为主，并呈逐年增加趋势，学生和散居儿童发病数占比也较大。斑疹伤寒病例从发病日期至诊断日期间隔时间的中位数为6 d，实验室确诊病例占比较低，检测方法为外斐反应为主。结论尽管我国斑疹伤寒流行态势整体好转，仍需警惕局部暴发的风险，其防控工作仍面临很多挑战，需加强斑疹伤寒病原体检测和监测能力建设。

English Abstract:

Objective To analyze the epidemiological characteristics of typhus in China from 1950 to 2021, and discuss the challenges in typhus prevention and control in China and suggest future prevention and control strategies. Methods Based on the reported data of typhus from 1950 to 2021 in China from the Infectious Disease History Database of China Public Health Science Data Center and the National Notifiable Infectious Disease Reporting Information System of Chinese Center for Disease Control and Prevention, we conducted a descriptive statistical analysis. Mann-Kendall test and circular distribution method were used to analyze the incidence, mortality and case fatality of typhus to reveal the temporal, spatial and population distributions and diagnosis of typhus in China. Results From 1950 to 2021, a total of 452 965 typhus cases and 7 339 typhus deaths were reported in China, with the cases numbers exceeding 10 000 in 14 years of the 1950s, 1960s and 1980s, respectively. Since 1990s, the reported cases and incidence rate of typhus have decreased dramatically and the most cases were sporadic. However, the reported typhus cases in Anhui, Hubei, Hunan Provinces showed significant uptrends. Although typhus could occur all the year round, but the seasonality was observed with the incidence mainly in summer and autumn. For different provinces from the north to the south, the peaks of typhus' monthly incidence tended to shift to earlier dates. The male to female ratio of the cases was 1.01:1 (18 529:18 366). However, more cases occurred in women in recent years. The cases aged ≤ 9 years accounted for the highest proportion (18.9%), but the number of cases aged ≥ 50 years showed an upward trend. Most cases were farmers with the proportion increasing year by year. Moreover, the cases in students and scattered-living children also accounted for relatively higher proportions. The median of the interval between onset and diagnosis of typhus was 6 days. Most cases were clinically diagnosed, while the proportion of laboratory-confirmed cases was low and most laboratory cases were confirmed by Well-Felix reaction. Conclusions Although the incidence and mortality of typhus in China has decreased significantly, the risk for local typhus outbreaks still exists. The prevention and control of typhus still face many challenges. It is indispensable to strengthen the pathogen detection and surveillance for typhus in China.

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